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HomeMy WebLinkAbout04-1074Register of Wills of Cumberland co gnsylvania PETITION FOR GRANT OF LETTERS 3t Estate of BLAKE EARL WINTERS No. ~"~'- U'~ also known as -/07V Petitioner(s) who is/are 18 years of age or older apply(les) for: (COMPLETE "A" OR "B" BELOW:) ' , Deceased Social Security ~ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execute_ × nan~ed in the last Will of the decedent, dated 0 3 - 3 1 - 1 q q 5 and codicil(s) dated ( State relevant circumstances, e.g. renunciation, death of executor, etc.) Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: [~ B. Grant of Letters of Administration (d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLy- i i= IN ALL ~ASES:) Attach additional sheets if necessary Decedent was domiciled at death in C u m b e r i a n d or principal residence at 227 W. Springville Rd. , (list street, number, and municipality) County, Pennsylvaniai~Nith his/her last family Boiling Springs 'c Decedent, then 49 years of age, diedMOvember 12 ,2004 [)ecedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of Real Estate in Pennsylvania $ situated as follows: ,at Residence (Location) 0. oo 0. oo ~,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 I snace/WillsPetGrantLt/2001 Oath of Personal Representative Commonwealth of Pennsylvania County of York The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief or Petitioner(s) and that, as personal representative(s) of the Decedent, Petition(s) will well and truly administer the estate according to law. Sworn to or affirmed and sj~bscribed ~,__~,..~"INL~, before me this o~0~¢ut day of For the ;r Estate of Social Security No.: AND NOW, Date of Death: of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters are hereby granted to Deceased ,20 , in consideration I~ Testamentary [~ Of Administration Amy E. Winters d.b.n.c.t.a.; pendente lite; durante absentia; durante rninodtate in the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ............ $ Shod Certificate(s)...$ Renunciation ....... $ Affidavits ( ) ....... $ Extra Pages ( ) ..... $ Codicil ............ $ JCP Fee ........... $ Inventory ........... $ Automation Fee ..... $. Other .............. $. TOTAL ........ $. Register of Wills Attorney: Andrew H. Shaw I.D. No: g 7 R 7 1 Address: 61 West Louther St. Carlisle, PA 17013 Telephone: 2 4 9 - '1 '1 7 7 snace/WillsPetG rantLt/2001 - ~: () ccrlil'v d~al lhe information here given is correctly copied from aH ()riginal certificate of death duly filed with mc as ,~ ti I,.:gislrar. Thc original certificate will be l:ol-wardcd lo thc State Vital Records Office for permaneHt filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fcc For riffs certificate, $2.00 No. YPE/PRINT ERMANENT #29-386 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH (Coroner) STATE FILE NUMBER Blake E Winters Male 387-62-9325 4. November 12, 2004 49 Feb.10,1955 Harrisburg, PA ..... [] ~o~,.,,m ~o~E3 ,o~__[] Iv'NO[~ ........ Yss E] Ify~,spectfyCuban,R ...... ~0~ Cumberland South Middleton 227 W. Springvtlle Road I~ ~) White __ ~ .... ~ - ~ ~___ Financial Planner Financial ,a. ~'. / ~ ~4. Married Amy Freeman 227 W. ~,. s~,, Pennsylvania Boiling Springs, Pa 17007 Cumberland ~. Isazah Winters [~. Elizabeth Kline ~Amy W~nters [~ 277 W. Springville Rd., Boiling Springs, Pa ]7007 M~HOD OF Oii~i,, i~ -- ~ I~E OF ~S~SITION P~OE OF DISP~ION ~t~ ~ ~ Nov 16, 2004 ~ll~r ~ & ~to~ ~. ~lly S~s, Pa 17~5 , ~. ~ F~ral ~ 255 York ~. ~lisle~ Pa 17013 ,~)~ ,. Hanging ,~a~,, ~ .o~ U Nov. 12,2004 [ m D .~ [ Intentional hanging ~,~(o~ } .... ~ ~ ~me_ __~11e Rd,Bo~ T~t~eln~kn~,de~occun~da{~iflme, dite, an~pMce, andduetotheeauee(a)and~n~..~ .......................... [] ~le. 31d. November ~, 2004 ~n~ex~n~t~na~nv~g~t~n~nmy~n~n~d~th~u~a~t~t~me~da~e~andp~andduet~t~nd 6375 Basehore Road, Suite (~1 "~'"'-"~ ............................................................................................ :.' .... ~ ~. ~echa~lcsbu~g, Yd. 17050 LAST WILL AND TESTAMENT OF BLAKE EARL WINTERS I, BLAKE EARL WINTERS, of South Middleton Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking and making void all previous Wills and Codicils heretofore made by me. FIRST I order and direct my Executor hereinafter named to pay my funeral expenses and expenses involved or connected with the administration of my estate as soon after my death as is reasonably possible. However, my Executor need not accelerate and pay those unmatured obligations which, in his, her or its opinion, it might be proper and more advantageous to retain or renew and pay as they become due and payable. If I do not own a buc~ial plot or a grave marker at the time of my death, I authorize my Executor, in his, her, or its sole discretion, to purchase a burial plot and to erect a suitable marke{~--at my grave, and to expend sums from my estate for this purpose. SECOND I give, devise, and bequeath my entire estate together with all insurance proceeds thereon of whatever nature and wheresoever situate to my beloved spouse, AMY ELIZABETH WINTERS, provided that she survives me by sixty (60) days. THIRD Should my spouse, AMY ELIZABETH WINTERS, predecease me or die on or before the sixtieth (60th) day following my death, then I give, devise, and bequeath my entire estate together with all insurance proceeds thereon of whatever nature and wheresoever situate to the following beneficiaries in the following manner provided that they survive me by sixty (60) days: (a) One-quarter (1/4) to my son, BLAKE ARTHUR WINTERS, and my daughter ELIZABETH K. WINTERS, share and share alike, or to the survivor of them, both of W2826 Shorewood Court, West Salem, WI 54669; (b) Three-quarters (3/4) to my son, WILLIAM ISAIAH WINTERS, of South Middleton Township, Cumberland County, Pennsylvania. (c) In the event, BLAKE ARTHUR WINTERS and ELIZABETH K. WINTERS, do not survive me, then I give, devise, and bequeath my entire estate to WILLIAM ISAIAH WINTERS. (d) In the event, BLAKE ARTHUR WINTERS or ELIZABETH K. WINTERS survive me, but WILLIAM ISAIAH WINTERS does not survive me, then Three-quarters of my estate shall pass as designated in the FOURTH Paragraph. FOURTH If neither my spouse nor my children survive me, then I give, devise and bequeath all of the residue of my estate, both real and personal, of every kind and description and wherever located, in equal shares, to those or that one of the following persons who survive me: (a) One share to my sister-in-law, SUSAN C. BLANKENBILLER; (b) One share to my sister-in-law, MARTHA G. GLASS; (c) One share to my sister, PATRICIA M. EVANS; and (d) One share to the descendants of RICHARD A. WINTERS. If any of the beneficiaries listed above fail to survive me by sixty (60) days or are unwilling or unable to accept their gift, then the share of said beneficiary shall be added to the residue to be taken by the remaining surviving beneficiaries. FIFTH If, at the time of my death, any beneficiary of this my Last Will and Testament is under the age of thirty (30) years or is, in the written opinion(s) of two physicians licensed to practice in the state in which my beneficiary then resides, that the beneficiary is mentally disabled, I give, devise and bequeath said beneficiary's share to my Trustee, in Trust for said beneficiary, in accordance with paragraph 7 below. SIXTH If my spouse, AMY I~.LIZABETH WINTERS, fails to survive me for a period of sixty (60) days, then I nominate, constitute and appoint my sister-in-law, SUSAN BLANKENBILLER, of 326 Freeman Drive, Fleetwood, Pennsylvania 19522, the guardian of the person and of the estate of WILLIAM ISAIAH WINTERS. If SUSAN BLANKENBILLER is unwilling or unable to serve for any reason, I appoint my sister-in-law, MARTHA G. GLASS, of P.O. Box 247, Adamstown, Pennsylvania 19501, to serve as successor guardian of the person and of the estate. I direct that no Guardian shall be required to give or post bond for the faithful performance of the Guardian's duties in this or any other jurisdiction. SEVENTH All bonds, bank accounts, savings accounts, savings and loan accounts and other similar property that I may own at the time of my death in my name and/or any other person or persons which are in terms payable on or after my death to such person or persons shall be the sole property of such person or persons, as the case may be, and my executor shall make no claim against the recipient thereof. EIGHTH During the term of any trust created pursuant to this Will the Trustee shall be the same person as the Executor of this Will. Said Trustee is authorized to expend and apply so much of the net income and principal of each such trust as the Trustee shall consider advisable for the health, maintenance, support, and education (including college education, undergraduate and graduate) of each such beneficiary until he or she attains thirty (30) years of age, or until all such amounts are paid out of the Trust. When the beneficiary graduates from college or attains the age of twenty-three (23) years of age, one-third (1/3) of the remainder of the Trust shall be paid to said beneficiary. When the beneficiary attains the age of twenty-five (25) years, one-half (1/2) of the remainder shall be paid to said beneficiary. When the beneficiary attains the age of thirty (30) years the Trust shall terminate and the remainder thereof shall be paid to said beneficiary. However, any gifts made under this Will which were placed in trust due to a determination that the beneficiary was mentally disabled at the time of the gift shall continue to be held in trust and shall not be paid to the beneficiary unless my Executor, relying upon the written opinion(s) of two physicians licensed to practice in the state where beneficiary then resides, determines that beneficiary is no longer afflicted with a mental disability. If any beneficiary dies before the termination of said Trust, the Trust shall terminate and the remainder thereof shall be paid in accordance with paragraphs 3 and 4 above. I direct that no Trustee shall be required to give or post bond for the faithful performance of the Trustee's duties in this or any other jurisdiction. NINTH My executor and trustee are authorized and empowered to exercise his, her or its sole discretion and without prior authority from any Court, in respect of any property forming part of any trust hereby created or otherwise in its possession hereunder all powers conferred by law upon trustees or executors and the Testator intends that such powers be construed in the broadest possible ma n n er. TENTH I nominate, constitute and appoint my spouse, AMY ELIZABETH WINTERS, Executrix. In the event AMY ELIZABETH WINTERS is deceased, unable or unwilling to serve or shall cease to serve for any reason whatsoever, then I nominate, constitute and appoint my sister-in-law, SUSAN BLANKENBILLER, as successor Executrix. In the event SUSAN BLANKENBILLER is deceased, unable or unwilling to serve or shall cease to serve for any reason whatsoever, then I nominate, constitute and appoint my sister-in-law, MARTHA G. GLASS, as alternate successor Executrix of this Will. I direct that my personal representative shall not be required to give or post bond for the faithful performance of his, her or its duties in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and Testament this ..-p?,~- day of .;~..t;~,;~. ,~ ., 1995. WITNESS Blake Earl Winters ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA : : SS COUNTY OF CUMBERLAND · I, BLAKE EARL WINTERS, the Testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to the 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 voluntary act for the purposes therein expressed. Blake Earl Winters Sworn or affirmed and acknowledged before me by Blake Earl Winters, the Testator, this ~2 I'3~ day of ~t~htO~/~ , 1995. Public Notal~ C~m E. ~1, ~ p~ anis~e ~o, Cure.and Cou~ My ~mmimion ~ June 3, 1~ AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA : : SS COUNTY OF CUMBERLAND : ~" /,,~,,-,~- ~'-e ~i ~_. and ~)_ C~-Y~ L~ f-)-.~~0 . the witnesses whose names are attached" o the foregoing document, being duly qualified according to the law, do depose and say that we were present and saw Testator sign and execute the instrument as his Last Will and Testament; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the Testator signed the Last Will and Testament as witnesses and that to the best of our knowledge the Testator was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed and subscribed before me by day of &~ctt3 , 1995. Not~ry Public Notadal ,Seal Barbara E. Steel Notary Public Carlisle Boro, Cumberland County My Cornmissior: F_xp res June 3 1996 IN THE COURT OF COMMON PLEAS,CUMBERLAND PENNSYLVANIA ORPHANS' COURT DIVISION COUNTY ESTATE OF BLAKE WINTERS ) ) Deceased) CLAIM To the Clerk of the Orphans' Court Division : Index and make proper entry in your official records of the claim of CITIBANK(SOUTH DAKOTA)NA in the amount of $20,050.93 against the estate of the above-named decedent. This claim is filed under Section 3532 (b) (2) PEF Code, 20 Pa. C.S. ss. 3532 (b) (2) The said decedent, whose last known residence was at PO BOX 41 CARLISLE PA 17013 Written notice of this claim was given to AMY E WINTERS 227 W SPRINGVILLE RD BOILING SPRINGS PA 17007 on December 13, 2004 DAVE HIPPENSTEE~',manager of Citicorp Credit Services, Inc. USA under limited power of attorney for CITIBANK(SOUTH DAKOTA)NA 7930 NW 110TM ST KANSAS CITY, MO 64153 (Claimant's Address) Account %(s) 4147110844924376 linda 1 SUMM <== TRNCD ACCNT# > 4147110844924376 CUSTOMER STATEMENT DISPLAY - ACCOUNT SUM~ARY AVAIL CRED: ********** CRED LINE: DESCRIPTION PREY BAL PURCH/ADV PYMT/CR PURCHASES 20,249.43 222.50 421.00 ADVANCES .00 .00 .00 LOAN .00 .00 .00 TOTAL 20,249.43 222.50 421.00 NOVEMBER 22, 2004 22800 DUE DATE: 12/16/04 FIN CHG NEW-BAL 249.46 20,300.39 .00 .00 .00 .00 249.46 20,300.39 PURCHASES BAL SUB FIN CHG PER. RATE NOM. APR Standard ?urch 20,398.28 0.03945 14.400% Standard Adv .00 0.05477 19.990% Purch/Adv 00/00/00 .00 0.03945 14.400% .00 0.00000 0.000% .00 0.00000 0.000% PFll = ALL BALANCE SEGMENTS APR 14.400% 19.990% 14.400% 0.000% 0.000% DAYS THIS BILL 31 AMOUNT OVER CL > PURCH/ADV MIN DUE > 0.00 PAST DUE > 0.00 422.00 MIN AMT DUE > 422.00 MONTHS: _ 10/22/04 _ 09/22/04 _ 08/23/04 07/22/04 06/22/04 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Blake E. Winters Date of Death: November ]2, 2004 Will No.: 2004-01074 To the Register: ] certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on February 11,2005: Amy Winters Blake A. Winters Beth Winters William Winters Timothy Winters 227 W. Springville Rd., Boiling Springs, P A 17007 ]29 Susan Court, West Salem, WI 54669 880] LaCresada Drive, #1526, Austin, TX 78749 227 W. Springville Rd., Boiling Springs, PA 17007 227 W. Springville Rd., Boiling Springs, P A 17007 Notice has now been given to all persons entitled thereto under Ru]e 5.6(a) except: None. ;,J') c.; I~~ftr' Andrew H. Shaw, Esquire 61 W. Louther Street Carlisle,PA 17013 (717) 249-1177 Date: February 11, 2005 Attorney for Personal Representative ~ COMMONWEALTH OF PENNSYLVANIA COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ORPHANS' COURT DIVISION NOTICE OF CLAIM In Re: The Estate of: BLAKE E WINTERS Deceased Court File No: 21-04-1074 TO: THE CLERK OF THE ORPHANS' COURT DIVISION: Notice of claim by creditor, Pursuant to Section 3532(b)(2) of the Probate, Estates, and Fiduciaries Code, 20 PA.C.S.A. ~3532(b)(2). MBNA AMERICA 1) Claimant's name: P.O. BOX 15137 2) Claimant's address: WILMINGTON, DE 19850--5137 877-767-9383 3) Creditor listed below is the owner and holder of a claim in the amount of $ 23459.40 4) The facts upon which this claim is based: This claim is based on an account for credit evidenced by the attached Affidavit of Account Stated. 5) Decedent's address: PO BOX 41 CARLISLE, PA 17013 6) Date of Death: 11/12/04 7) That the claim arose prior to the death of the decedent on or about " ...1 8) That the claim is secured by On behalf of the claimant, I do solemnly declare and affirm under the penalties-of perjury that they Information and representations made herein are true and correct to the best of my knowledge, information and belief. ....'r..., Dated :2 L /:::-.4PtA<1I 7w;;- - Leah SchenkenberglJesslca Lerbs - Authonz epres tatlve-In-Fact ForMaNA Amenca Written notice of claim was given to Personal Representative and/or his/her. counsel N as stated below: AMY WINTERS Name 227 w SPRINGVILLE RD Address BOILING SPRINGS, PA 17007 City /State/~} . :J _J-J /os- Date notice mailed' ; I erR IN RE ESTATE OF: BLAKE E WINTERS AFFIDAVIT OF ACCOUNT The undersigned, being first duly sworn deposes and states the follows: 1. Your Affiant is authorized by the Claimant as its Authorized Representative- In-Fact to make this Affidavit. 2. Your Affiant has reviewed the account records of the Claimant with respect to the decedent. Your Affiant is familiar with these records and accounts and reviews them as a regular part of his/her duties. 3. The Decedent purchased merchandise in the amount of$ 23459.40 evidenced by account number 5490994584051023 4. The unpaid balance does not include any post-death late payment charges, accrued interest, collection costs or attorney's fees. Further your affiant sayeth not MBNA America. By: One of it Leah Schenkenberg _ Jessica Lerbs /" MBNA America P. O. Box 15137 Wilmington, DE 19850-5137 Subscribed and sworn before me This d;< dayof ~J ,2005. 1---:-1 I~ MBNA America P.O. Box 15137 Wilmington, DE 19850-5137 877-767-9383 02/18/05 REGISTER OF WILLS CUMBERLAND COUNTY COURTHOUSE 1 COURTHOUSE SQUARE, #102 CARLISLE, PA 17013 Re: In the Estate of BLAKE E WINTERS Probate Case No. Social Security No: Last known residence: Claimant: Account Number: Amount of Debt: 21-04-1074 387629325 PO BOX 41 CARLISLE, PA 17013 MBNA AMERICA 5490994584051023 $ 23459.40 Dear Sir or Madam Enclosed please find a Creditor's claim to be filed in the record with the above-referenced Estate. Please return a file stamped copy of the claim in the enclosed self-addressed, stamped envelope. Thank you for your assistance. If you have any questions or if this is a duplicate claim, please call our firm toll free at 1-877-767-9383. Cordially, MBNA America Enclosures A check for $10.00 for the filing fee. cc: Attorney for Estate Personal Representative This letter is an attempt to collect a debt and any information obtained will be used for that purpose. This letter is from a debt collector. 5616 2/1412005 1270672 WELTMAN, WEINBERG & REIS CO., L.P.A. ATTORNEYS AT LAW 175 South Third Street, Suite 900 Columbus, Ohio 43215 800.325.9965 614.801.2710 www.weltman.com BURLINGTON, NJ 609.914.0437 CHICAGO,IL 847.940.9812 C1NClNNA n, OH 513.723.2200 CLEVELAND,OH 216.685.1000 DETROIT, MI 248.362.6100 PHILADELPHIA, PA 215.599.1500 PITTSBURGH, PA 412.434.7955 March 1, 2005 Cumberland, Register Of Wills One Courthouse Square Carlisle, PA 017013 ) Re: Estate of Blake E Winters Case No. 2004-01074 Our Client: Jp Morgan Chase Bank,N.A.As Successor By Merger With Bank One,N.A. Account No. 94005804513 Balance Due: $4, I 52.03 Our File No. 4171466 (' Dear Clerk of Courts: This law firm represents Jp Morgan Chase Bank,N.A.As Successor By Merger With Bank One,N.A. in connection with its claim which we wish to file on our client's behalf into the estate of Blake E Winters. deceased. Enclosed is our check in the amount of$10.00 which we understand is the filing fee for this claim. Our client's claim is based upon its account number 94005804513 in the amount of$4,152.03. As of the date of this letter, this is the amount due. Included with this letter is the claim form which we wish to present to this court and which we are forwarding to the attorney and/or fiduciary of this estate. It would be appreciated if all correspondence and disbursements with respect to this matter be forwarded to our office and to the attention of the undersigned. Additionally, it would be appreciated if any notices ofany hearings also be forwarded to the undersigned. Thank you for your cooperation in this matter. A LA TINKER Authorized agent for the claimant PJT:sek Enclosures cc: Amy Winters, Fid Andrew H Shaw, Esq WWR#4171466 FORM 93-0.C. DIVISION IN THE COURT OF COMMON PLEAS of CUMBERLAND, REGISTER OF WILLS, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ESTATE OF No. 2004-01074 Blake E Winters Deceased For an installment loan with Jp Morgan Chase Bank,N.A.As Successor By Merger With Bank One,N.A., Account No. 940058045 I 3 CLAIM To the Clerk of Orphans' Court Division: Index and make proper entry in your official records of the claim of Jp Morgan Chase Bank.N.A.As Successor Bv Merger With Bank One.N.A. c/o Weltman. Weinberg & Reis Co.. L.PA. ]75 South Third Street. Suite 900 Columbus OH 432]5 (Claimant) in the amount of $4.152.03 against the estate of the above named decedent. This claim is filed under Section 3532 (b) (2) of the Probate, Estates and Fiduciaries Code. The said decedent, who resided at 227 West Springville Rd Boiling Springs PA 17007 , died on 11112/04 (Address) . Written notice of this claim was given to Amv Winters. Fid Andrew H Shaw. Esq at (Personal representative. if any, or counsel) 227 West S rin ville Rd Boilin S rin s PA 17007 61 W Louther St Car 'sle PA 17013 Address or Personal Representative, if any, or counsel ~ aula Tinker Authorized Agent for Claimant Weltman, Weinberg, & Reis Co., L.P.A. 175 South Third Street, Suite 900 Columbus,OH 43215 WWR # 4171466 STATEMENT OF ACCOUNTS FOR: Tp Morgan Chase Bank,N.A.As Successor Bv Merser With Bank One,N.A. DECEDENT'S NAME: Blake E Winters ADDRESS: 227 West Springville Rd CSZ: Boiling Springs, P A 17007 SSN: 387-62-9325 ODD: 11/12/04 ACCOUNT #: 94005804513 BALANCE DUE: _$4,152.03 J EXHIBIT A REV-1500"EXI&Wi . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 lllK LIe. cu (\ p i'\ dd {)lJ l::t\ I 'if. Clb 1-1.. U REV-150~~~ INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 04 01074 COUNTY CODE YEAR NUMBER I- Z W C W U W C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Winters, Blake E. SDCIAL SECURITY NUMBER 387-62-9325 DATE OF BIRTH (MM-DD. YEAR) : 02/10/1955 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER DATE OF DEATH (MM-DD-YEAR) 11/12/2004 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST. AND MIDDLE INITIAL) Winters, Amy E. w "' ::w::Scn ,,"''' w"" ",00 "",~ .... .. '" ~ 1. Original Return o 4. Limited Estate o 6, Decedent Died Testate (Attach copy of Will) o 9, Litigation Proceeds Received o 2. Supplemental Return D 4a. Future Interest Compromise (dale of death after 12-12"82) D 7. Decedent Maintained a Living Trust (Attach copy of Trust) o 10, Spousal Poverty Credit Idateoldeall1 belween 12-31-91 and 1-1. 951 D 3. Remainder Retum (date ofdealh prior to 12.1J.82) o 5, Federal Estate Tax Retum Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) "' z W Q Z o .. '" w '" '" o " THIS SECTION MOST aECOMl'LETEO.Au.cORRESPONDENCE ANO>CONFIDENTIAL TAX I/IIFOIlMI\TION $flOOLD SEtlIRECTEDTO: NAME COMPLETE MAILING ADDRESS Andrew H. Shaw, Esquire Andrew H. Shaw, Esquire FIRM NAMEllfAppllcable) 61 W. Louther Street Carlisle, PA 17013 . TELEPHONE NUMBER (717) 249-1177 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule 8) (1) (2) (3) (4) (5) 0.00 4,920.00 0.00 0.00 3,543.74 4. Mortgages & Notes Receivable (Schedule D) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G orL) (6) 94,612.73 z o ~ ...I :J !:: D.. <C u w 0:: (7) 0.00 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 Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) (8) 10,258.29 81,924.34 (11) (12) (13) '->f'o3,076.47 (9) (10) 92,182.63 10,893.84 0.00 13 Charitable and Govemmental 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) 10,893.84 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ I-' :J D.. ::!E o u ~ 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 0.00 x .0 0 (15) 0.00 x.045 (16) 0.00 x .12 (17) 0.00 x.15 (18) (19) 0.00 0.00 0.00 0.00 0.00 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER: I\LL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < '>- 'J Decedent's Complete Address: STREET ADDRESS 22LWSpringyille Roild CITY Boiling Springs STATE PA ZIP 17007 Tax Payments and Credits: 1. Tax Due (Page 1 Line1g) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 0.00 0.00 0.00 Total Credits (A + B + C ) (2) 0.00 3. InteresUPenalty if applicable D. Interest E. Penalty 0.00 0.00 TotallnteresUPenalty ( 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) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SA) (5B) 0.00 0.00 0.00 0.00 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. 0.00 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; "..."" ..........".... ............................ ............ .. D [i] b. retain the right to designate who shall use the property transferred or its income; ................. .... 0 [iJ c. retain a reversionary interest; or.. .. .................. .................... ................................................................. ... 0 [iJ d. receive the promise for life of either payments, benefits or care? .................................... ......................... ...... 0 [iJ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....'............. ...... ....................,............................. .................. .. 0 [K] 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 ~ 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 penaRies of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declarabon of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE O~SON RESPONSIBLE FOR FILING RETURN -- CLU-w-- UA.o ADDRESS 227 "t:,;//,rin. gville Road, BOilin.g Springs, PA 17007 SIGNV~,o/~ENTATlVE ADORESS 71, filM. 61 W. Louther St., Carlisle, PA 17013 DATE 3- ..<Q-05 DATE ..--- -, -,r>. A' ~.-,^l'- .> 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)J. 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)(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. 99116(1.2) [72 P.S. 99116(a)(1)J. The tax rate imposed on the net value of transfers to orfor 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. REV-1503 EX+ 16-98* CQMMQNV"oJEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Blake E. Winters FILE NUMBER 21-04-1074 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT OATE OF DEATH E-Trade Securities Account, #60471260 4,920.00 TOTAL (Also enter on line 2, Recapitulation) $ 4,920.00 (If more space is needed, insert additional sheets of the same size) E~TRADE' FINANCIAL. March 2, 2005 Dear Sir or Madam: ESTATE OF BLAKE WINTERS, an employee of Prudential Financial, account #60471260, has a balance of stock options. Below is the summary of the current account value: Total Shares Current "Net Market Value Exercisable Price/Share 240 240 $48.00 Total *AII figures based on closing market value of PRU on 11/12/04. Employee Stock Options Plan Detail G t Oat Grant Price Total Shares ran e Granted 12/31/2001 $27.50 $4,920.00 $4,920.00 Ryan Murp OptionsLink A Division of E*TRADE Financial Phone:(916)-858-5000 x5548 E*TRADE Securities lLC P.O. Box 989030 West Sacramento, CA 95798 tel 1.800.786.2575 etrade.com Member NASa/SIPe CJ?7~ REV-1508 EX+ (6-98) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Blake E. Winters FILE NUMBER 21-04-1074 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. 2001 Chrysler Town and Country 2,043.74 2. 1996 Chrysler Cirrus 1,500.00 TOTAL (Also enler on line 5, Recapilulallon) $ (If more space is needed, insert additional sheets of the same size) 3,543.74 WARNER CHRYSLER JEEP HUMMELSTOWN, PA REMITTANCE ADVICE CHECK NUMBER CONTROL NUMBEH KEY 38803 I OFFICE USE ONLY CASH DISBURSEMENiS JOURNAL -SOURCE 11 ACCOUNT AGeT.NO AMOUNT KEY 01 Chrysler T&C 2 1 5 A + 609C + 201 A + 99091 128 2043 74 + + + + + - 60 1 - GASH 103 ono " - DETACHED CHECK IS PAYMENT IN FULL OF ACCOUNT SHOWN ABOVE. IF INCORRECT RETURN WITHOUT ALTERATIONS. III ~~ ~"'.,?:.- WARNER CHRYSLER JEEP 131 E. Main Street HUMMELSTOWN, PA 17036 .- .'>i- ~ -- "".'~ \ . ~.-<...'~ ~.. "',,-' . ,. Sebring PI Cruiser Town & Country Bus. Phone (717) 566-2519 FAX 566-9787 www.WarnerChryslerJeep.com WarnerChryJeep@AOL.Com MARCIA E, MORAN Sales Manager . / ~\~S i .qb \ ])5 f:) ;t.[;/J/2- ,/'LtS/l ,;L .60 M jJC /L ILLjZ1 (/v-Ie---fJ 1I1L2'S ,....:. ILl c:r'iY:; II /:>00 '" " ) ml!/~tJ PAGE3B 1992 CHRYSLER LEBARON DESCRIPTlON WHOlfSAtE LOAN lIVe MODEL ON. AVG. RGH. 845 OlB XA'6' IlDSl:DAN lll50 "" 3" 7115017 XUA1' 2DCQlIf'f 135() 75. 32S 895016 XU4S' 20 CONVERTIBLE '000 "" 375 870027 ,^,<>3 .4D SEDAN LX 1600 1f75 35() 770026 XU']3 2DCOUPE lJ( 1525 775 32' 995025 XU'53 2DCON\IERTIlllfLX lB5() '''''' 475 970023 XA'6' ADSEOANlANOAlJ 175" 975 ,5() BAS 022 '"'" 2DCOUPEGTC "'" '50 37' 11.40021 '"'" 20 CONVERTIBlE GlC """ "00 000 1991 CHRYSLER LEBARON 6.4501B ""'" 4Dst:OAN 1175 65() 300 57DOI7 ""', lDCOOO 1075 '75 '" 7A5016 XJIlS' 2D CONVERTIBlE \32, '''' 350 670 033 XJ513 2DCOUPEPRfMK.JM "5() 675 ,,>0 820'32 ~'53 2DCNVlPREMlUM 1525 '" 300 720 022 ""', 2OCOUPEGTC "00 ", 250 995021 "",. 2DCONVEillBlEGl( 1725 1000 32' 1990 CHRYSLER LEBARON 4200\8 XA56' 4D5l13AN "" 425 22' 370017 )(J'I' 2DCQUPE .25 375 22' 520016 ""- ID CONVERTIllI.E 01'''' 32' 32' 495033 XJ')' 2D COUPE PREMIUM V7S 5110 '" 770 032 "',- 2DGMPREMlUM 1300 77S 32S sro ON "'" 2DCOJPEGT 01>00 51' 200 no 019 Xl'S' 2DCQNVER.TlBlEGT 131>0 715 32' sro '22 )(.1'1' 2D COUPE GTC 1100 575 200 710021 XI'S' '2OCONV8I1lBlEG/C ''''' 77S 32S 1997 CHRYSLER CIRRUS -_- ISO f'O'oN8l SUNROO' 225V6 2075001 EJ56' 40SUlANlX 21151156EJ56I-l.ID~OO ~--- . DEDUCT' 3150 2100 10:50 3250 2200 1150 = 1996 CHRYSLER CIRRUS 'ADO' 'OmlJCT' 150 f'QW'l:RSlJ'lROOf 200V6 DES<:RII'1lON .Ji{~':;) ! ",LQt.N-UVCMt)DE1 '1835 iXlr'EJS6' ~~sroANI.X" 1935 fl56 EJS6' ADSEDANlXi 1995 CHRYSLER CIRRUS 1625 001 fJ56H 4l1SEDANlX 1997 CHRYSLER CONCORDE 'AOO' 'bEDUO' 15() POWER MOQNROOF 2200 003 '056f AD SEDAN LX 2645 1M2 'OW .4DSEDANLXi 1996 CHRYSLER CONCORDE 'AbD' 'DEDUCT' 150 POWER MOQNll.OOf 1860003 'OU' 4DSEDANLX 2180 062 'OS6f ADSEDANlXi 1995 CHRYSLER CONCORDE '~D' '~Dua' 150 POWElIMCIONROOf 1600 002 "56' ADSEDAN 1994 CHRYSLER CONCORDE '''DO' 'OiEDlJCT' 150 POWER MQONROOf \340002 'l.S6' JDSEDAN 1993 CHRYSLER CONCORDE 104500'2 El56' ADSEDAN 1800 1100 500 1993 CHRYSLER FWD 1140043 XC66R ADNyoij(ERSAlON 1850 1200 650 PAGE 39 24751675800 317522251275 36252675 Ins 1150 1900 1100 30752225 1400 2450 1650 900 2\50 14()(J 725 'i.' 0: '.""::.:~.,' -.=.,'.: .-.=.' ',V,"'1'..!' REv-,sa9 EX+ (6-9'. COMMONI,AJEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTlY-OWNED PROPERTY ESTATE OF Blake E. Winters FILE NUMBER 21-04-1074 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINTTENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A Amy E. Winters 227 W. Springville Road Boiling Springs, PA 17007 Spouse B. David Kutz 289 Bonnybrook Road Carlisle, PA 17013 Collateral 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 DATE OF DEATH DECO'S VAlUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE VALUE OF ASSET INTEREST DECEDENT'S INTEREST ,. A Real Estate located at 227 W. Springville Road, Boiling Springs, PA 184.490.00 50 92,245.00 2. A. M&T Bank Account, # 3741347433 245.39 50 122.69 3. A. M&T Bank Account, # 10440879 3,731.07 50 1,B65.53 4. A. M& T Bank Account, # 15004208612033 34.03 50 17.01 5. B. 10/05/2001 Utility Trailer. Serial Number 108609 PA 725.00 50 362.50 TOTAL (Also enter on line 6, Recapitulation) $ 94,612.73 (If more space is needed, insert additional sheets of the same size) '~i JYtl. lit; _1'~Ff""T:: .r"'~ ~~ <J :: ,-,,:r;.T.~, '~~....i!" \l 'F> ,.. .ri ~..,j;JrL;1. ~~=,-'"",":w!.~-_-'>.- 3741347433 ACCl)U~T.TY~~ Wl)RRY FR~~ CH~CKIHG STAT~~~T ~~RIl)D ~AG~ ACCl)U~T~l). QCT.27-~l)V.26,2004 1 l)F 1 00 o 04303H HH 017 52024 BLAKE E WINTERS AMY E WINTERS 150 CORPORATE CENTER DR STE 105 CAMP HILL PA 17011-1759 Bl)ILI~G S~RIHGS ACCOUNT SUMMARY rl)5tS& ... ... bTHER. AIll)ITIOHS. NCI. AHlIUNT 1 0.42 CHECK PUO. NQ. AtlllUNT 3 20.00 l)HER sllliTR"'CnO~S Nl) . AHlIUNT 2 5.81 245.39 0.00 0.00 ACCOUNT DAILY BAL CE l)STI~G DATE 10-27-04 BEGINNI~G BALANC~ 10-29-04 CHECK ~BER 6487 11-08-04 DEPOSIT 11-09-04 CHECK MUNBER 6489 11-09-04 CHECK NUHBER 6488 11-18-04 ~HON~ TRANSF~R WITHDRAWAL 11-18-04 CLl)S~l)UT 25.00 $245.39 220.39 350.81 130.42 80.00 15.00 255.81 0.00 255.81 0.00 ~NDING BALANCE $0.00 .CH~CKS.~AIDSUNNARY 6487 10-29-04 25.00 6488 11-09-04 15.00 6489 11-09-04 80.00 IHPR~SSED BY THE SERVICE YlIU RECEIVED AT NIT? IF YDU'D LIKE TD Nl)NINATE A~ NIT BANK ~NPLl)YEE FDR ~XCEPTIl)NAL CUSTDNER S~RVICE, PLEAS~ CQHPLETE lIUR NIT SERVICE EXCELLENCE FDRM AT WWW."ANDTBANK.Cl)N/EXC~LLENCE. WE APPRECIAT~ YDUR FEEDBACK! NIT'S WEBSITE IS A POWERFUL RESl)URCE THAT CAN HELP YDU NAKE INFl)RNED FINANCIAL DECISIONS. YDU CA~ ACCESS Yl)UR ACClIUNTS, USE PLANNING TDl)LS, l)~~N AN ACC~T, l)R FI~D YlIUR ~EAREST NIT BRANCH l)R ATN. VISIT WWW.NA~DTBANK.Cl)N Tl)DAY! L.D08A,il.'03, M.."p::T'~"",.....'l~ .L ~w~ L~UJ.ll~ STATEMENT PERIOD PAGE DCT.23-NOV.24,2004 1 OF 3 00 0 04319M NM 017 280 BLAKE E WINTERS OR AMY E WINTERS 150 CORPORATE CENTER DR STE 105 CAMP HILL PA 17011-1759 SELECTEPACCOUNT SUMMARY ACCOUNT TYPE ACCOUNT NUMBER INTEREST EARNED YEAR-TO-DATE MATURITY DATE ENDING BALANCE RELATIONSHIP CHECKING PERSONAL STATEMENT SAVINGS 000000010440879 015004208612033 0.00 0.00 3,731.07 34.03 TOTAL DEPOSITS 3,765.10 RELATIONSHIP CHECKING BLAKE E WINTERS OR AMY E WINTERS ACCOUNT NO. 10440879 HIGH STREET-CARLISLE BEGINNING DEPOSITS & ... . OTHER CURRENT . . ENDING aALANCE OTHER ADDITIONS ... CHECKS PAID SUBTRACTIONS INTERESTPD BALANCE NO.1 ANOUNT NO. I AHOUNT NO. ANOUNT 1,662.51 121 11,689.27 61 1,686.24 22 7,934.47 0.00 3,731.07 ACCOUNT SUMMARY POSTING .. DEPOSITS, INTEREST CHECKS & OTHER . DAILY DATE TRANSACTION DESCRIPTION ... .. & OTHER ADDITIONS SUBTRACTIONS BALANCE 10-23-04 BEGINNING BALANCE $1,662.51 10-25-04 S HIODLETON TWP DIRECT DB 115.00 1,547.51 10-26-04 DEPOSIT 3,000.00 10-26-04 H&T ATH CASH WITHDRAWAL ON 10/25 100.00 BOILING SPRIN,l FORGE RD,BOILING SPRINGS,PA 4A47.51 10-27-04 PRUDENTIAL PIC POLICY 179.70 4,267.81 10-28-04 DEPOSIT 1..100.00 5,367.81 10-29-04 PRUDENTIAL PIW DIR DEP 337.40 5,705.21 11-01-04 BOILING SPRINGS SERVICE CHECHANICSB 493.43 5,211.78 11-02-04 CHECK NUNBER 6237 321. 66 11-02-04 UGI UTILITIES UGI BILL 160.00 4,730.12 ~--'-~'------- 11-03-04 CHECK NUMBER 6174 258.00 11-03-04 FIRSTENERGY OPCO ACH 154.00 4..318.12 11-04-04 CHASE EFT - OTHE PAYABLES 200.00 11-04-04 CHECK NUNBER 6238 331. 75 4,,186.37 ACCOUNT ACTIVITY l'j03A (1/0~, ~lfJ- 9 (g (1-0 furz.y ~ 7 3 3 6 71~ NAME CUSTOMER'S ORDER NO. ADDRESS CllY, STAT!::, ZIP QUAM. SOLD 8Y CASH C.O.D. CHARGE ON ACCT. . 2 3 4 5 6 9 7 B 10 11 12 RECEIVED BY r:Adams 4705 KEEP TjiIS,llLIP FOR REFERENCE '1 4-iL~# (0 fl 1009 A' tiTLE. 5'-1/cfr; 0 9 REV-1511 EX+ (12-99) '*' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Blake E. Winters FILE NUMBER 21-04-1074 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. AMOUNT DESCRIPTION 1. FUNERAL EXPENSES: Ronan Funeral Home Shalters Cemetary Otterbein United Methodist Church 2,870.00 350.00 50.00 2. 3. 1. B. ADMINISTRATIVE COSTS: 1,000.00 2. 3. 4. Personal Representative's Commissions Name of Personal Representative(s) Amy E. Winters Social Security Number(s)/EIN Number of Personal Representative(s) SlreetAddress 227 W. Springville Road City Boiling Springs State PA Zip 17007 Year(s) Commission Paid: 2005 Attorney Fees 2,200.00 Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Amy E. Winters Street Address 227 W. Springville Road City Boiling Springs 3,500.00 State PAZip 17007 Relationship of Claimant to Decedent Spouse Probate Fees 69.00 5. Accountant's Fees 7. 6. Tax Return Preparer's Fees Advertising rees 219.29 10,25829 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-D3) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Blake E. Winters FILE NUMBER 21-04-1074 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unrelmbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Citibank (South Dakota) NA, Account # 4147110844924376 20,050.93 13,117.00 22,982.82 21,641.56 4,132.03 2. Discover Financial Services, Inc., Account # 6011004449501143 3. MBNA America, Account # 5490994584051023 4. American Express, Account # 372268080572004 5. Bank One, Account # 94005804513 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 81,924.34 I I IN THE COURT OF COMMON PLEAS, CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF BLAKE WINTERS ) ) Register's # 2004-01074 Deceased) CLAIM To the Clerk of the Orphans' Court Division : Index and make proper entry in your official records of the claim of CITIBANK(SOUTH DAKOTA)NA in the amount of $20,050.93 against the estate of the above-named decedent. This claim is filed under Section 3532 (b) (2) PEF Code, 20 Pa. C.S. ss. 3532 (b) (2) The said decedent, whose last known residence was at PO BOX 41 CARLISLE PA 17013 Written notice of this claim was given to AMY E WINTERS 227 W SPRINGVILLE RD BOILING SPRINGS PA 17007 on December 13, 2004 aimant) DAVE HIPPENSTEE ,manager of Citicorp Credit Services, Inc. USA under limited power of attorney for CITIBANK(SOUTH DAKOTA)NA 7930 NW 110TH ST KANSAS CITY, MO 64153 (Claimant's Address) Account #(s) 4147110844924376 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF BLAKE E WINTERS , Deceased No. 21-2004-1074 of 2001 To the Clerk of the Orphans' Court: Enter the claim of DISCOVER FINANCIAL SERVICES, INC Accl. 6011004449501143 In the amount of $13,117.00 , against the above entitled estate. The decedent, who resided at PO BOX 41 CARLISLE PA 17013 died on 11/12/2004 . Written notice of said claim was given to AMY WINTERS ,if known to ciaimant, at (Personal Representative or counsel) 227 W SPRINGVILLE RD, BOILING SPRINGS, PA 17007 on December 7, 2004 (Date) llch()1C1LC73'(1j04'\ Address: 5330 East Main Street, Suite 200 Columbus, Ohio 43213 Claimant's Counsel Address COMMONWEALTH OF PENNSYLVANIA COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ORPHANS' COURT DIVISION NOTiCE OF CLAIM In Re: The Estate of: BLAKE E WINTERS Deceased Court File No: 21-04-1074 TO: THE CLERK OF THE ORPHANS' COURT DIVISION: Notice of claim by creditor, Pursuant to Section 3532(b)(2) of the Probate, Estates, and Fiduciaries Code, 20 PA.C.S.A. 93532(b)(2). MBNA AMERICA 1) Claimant's name: P.O. BOX 15137 2) Claimant's address: WILMINGTON. DE 19B50--5137 877-767-9383 3) Creditor listed below is the owner and holder of a claim in the amount of $ 23459.40 4) The facts upon which this claim is based: This claim is based on an account for credit evidenced by the attached Affidavit of Account Stated. 5) Decedent's address: PO BOX 41 CARLISLE, PA 17013 6) Date of Death: 11/12/04 7) That the claim arose prior to the death of the decedent on or about 8) That the claim is secured by On behalf of the claimant, ] do solemnly declare and affirm under the penalties of perjury that they Information and representations made herein are true and correct to the best of my knowledge, information and belief. Dated :2 L F../~rr H#:5' -----:::, Leah Schenkenberg/Jesslca Lerbs ~ Authonz epre tative-in-Fact For MBNA America Written notice of claim was given to Personal Representative and/or his/her counsel as stated below: AMY WINTERS Name 227 w SPRINGVILLE RD Address BOILING SPRINGS. PA 17007 CitY/State/L;,UJj J :.J _~.:J jO, Date notice m'ailecf [6 >M':~~s Business Cash Rebate Card SMALL BUSINESS NETWORKs" Page 1 of 5 Payment Due Date 12/13/04 Please refer to page 2 for important information regarding your account ---~--~_._----~-------- ----------------------- ----.-----.....-----..--- Finance Charges Average Dail$' Daily Actual ANNUAL Nominal ANNUAL Billing days this penod: 30 Balance Periodic Rate PERCENTAGE PERCENTAGE RATE RATE Purchases 0.00 0.0267% 0.00% 9.74% Cash Advances 3,754.23 0.0541% 19.74% 19.74% Special Balance Transfer 14,092.84 0.0137% 5.00% 4.99% Interest Rate 0178 1,927.95 0.0219% 39.54% 7.99% Certain of the periodic rates and APRs above may be variable. Those rates may vary based upon the prime rate identified in the Wall Street Journal, as described in your Cardmember Agreement as currently in effect. t Please fold on the perlorelion below, detach and relurn w~h your payment + Payment Coupon Account Number 3722-680805-72004 Payment Due Date: 12/13104 Prepared For BLAKE E WINTERS BLAKE WINTERS/ASSOC Account Nunblll 3722-680805-72004 Closing Dale 11/18/04 To manage your Account, visit us online at open.americanexpress.com or call Customer Service at 1-800-521-6121. ~ " N Amount $ N o g BLAKE E WINTERS BLAKE WINTERS/ASSOC BLAKE WINTERS/ASSOC PO BOX 41 CARLISLE PA 17013-0041 1",111",111,,,,,,11,,11,11,,,11,,,,1,,1,,,11,1,,1,,,111,,1,1 Minimum Amount Due $433.00 PrlWIQUII Balance $ 17,969.0511 New Activily $ inc. Adjustments and Finance Charges if any +4,031.5111 433.00 3,850.00 50.00 131.51 4,031.51 Minimum Amount Due $ Payment ActIVity $ -359.0011 New BaJa.t1Cl; $ =21,641.561 Credit Line Summary on 11/18/04 Total Credit Une$ 21,900.00 Available Credit Line $ 258.44 Cash Advance Limit $ 4,380.00 Available Cash Umit$ 258.44 ActivitY 'I,,,",.~ _cO""", New Activltv for E WINTERS Card XXXX-XXXXXS:720J4 11/04/04' CK 5281 . MBNA AMERICA Balance Transfer 11/04104 ChecklBT Transaction Fee FINANCE CHARGE 1 1/18/04 Periodic FINANCE CHARGE Total of New Activity Periodic FINANCE CHARGE $ 0.00 60.93 57.92 12.66 ~---- 131.51 Continued on Page 3 Please enter account number on all checks and correspondence. Total New Balance Make check payable to $ 21 ,641.56 American Express. ~ " N o o o . . ~ - o . $ I . I Amount enclosed ~ o - o Mail Payment to' 11,1,111,1,11"1,,111,,1111,11,111,,1,11,111,,,11,1,,11111,1,1 AMERICAN EXPRESS PO BOX 360002 FT LAUDERDALE FL 33336-0002 1"11",11",11",11"11"11",11,,,11,,,,,1,11,1,,1,1""I,ll 000037226BOB0572004 002164156000043300 16 rl To avoid additional Finance Charges on Purchases, pay the New Balance before the Payment Due Date. Check here if address or telephone number has changed. Note changes on reverse side. [] WWR#4171466 FORM 93-0.C. DIVISION IN THE COURT OF COMMON PLEAS of CUMBERLAND, REGISTER OF WILLS, PENNSYL VANIA ORPHANS ' COURT DIVISION IN RE: ESTATE OF No. 2004-01074 Blake E Winters Deceased For an installment loan with Jp Morgan Chase Bank,N.A.As Successor By Merger With Bank One,N.A., Account No. 94005804513 CLAIM To the Clerk of Orphans' Court Division: Index and make proper entry in your official records of the claim of Jp Morean Chase Bank.N.A.As Successor Bv Mereer With Bank One.N.A. cia Weltman. Weinbere & Reis Co.. L.PA. ] 75 South Third Street. Suite 900 Columbus Oll 432]5 (Claimant) in the amount of $4.152.03 against the estate of the above named decedent. This claim is filed under Section 3532 (b) (2) of the Probate, Estates and Fiduciaries Code. The said decedent, who resided at 227 West Sprineville Rd Boiline Sarines P A 17007 , died on 11/]2/04 (Address) . Written notice of this claim was given to Amv Winters. Fid Andrew H Shaw. Esg at (Personal representative, if any, or counsel) 227 West S rin ville Rd Boilin S rin s PA 17007 61 W Louther St Car 'sle PA ] 7013 Address or Personal Representative, if any, or counsel = aula Tinker Authorized Agent for Claimant Weltman, Weinberg, & Reis Co., L.P.A. 175 South Third Street, Suite 900 Columbus, OH 432]5 REV-1513EX'(~OO) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Blake E_ Winters FILE NUMBER 21-04-1074 RELATIONSHIP TO OECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1- Amy Winters Spouse 0.00 ENTER DOLLAR AMOUNTS FOR OISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 (If more space is needed, insert additional sheets of 1I1e same size) LAST WILL AND TESTAMENT OF BLAKE EARL WINTERS I, BLAKE EARL WINTERS, of South Middleton Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking and making void all previous Wills and Codicils heretofore made by me. FIRST I order and direct my Executor hereinafter named to pay my funeral expenses and expenses involved or connected with the administration of my estate as soon after my death as is reasonably possible. However, my Executor need not accelerate and pay those unmatured obligations which, in his, her or its opinion, it might be proper and more advantageous to retain or renew and pay as they become due and payable. If I do not own a burial plot or a grave marker at the time of my death, I authorize my Executor, in his, her, or its sole discretion, to purchase a burial plot and to erect a suitable marker at my grave, and to expend sums from my estate for this purpose. SECOND I give, devise, and bequeath my entire estate together with all insurance proceeds thereon of whatever nature and wheresoever situate to my beloved spouse, AMY ELIZABETH WINTERS, provided that she survives me by sixty (60) days. THIRD Should my spouse, AMY ELIZABETH WINTERS, predecease me or die on or before the sixtieth (60th) day following my death, then I give, devise, and bequeath my entire estate together with all insurance proceeds thereon of {;"M~ , whatever nature and wheresoever situate to the following beneficiaries in the following manner provided that they survive me by sixty (60) days: (a) One-quarter (1/4) to my son, BLAKE ARTHUR WINTERS, and my daughter ELIZABETH K. WINTERS, share and share alike, or to the survivor of them, both of W2826 Shorewood Court, West Salem, WI 54669; (b) Three-quarters (3/4) to my son, WILLIAM ISAIAH WINTERS, of South Middleton Township, Cumberland County, Pennsylvania. (c) In the event, BLAKE ARTHUR WINTERS and ELIZABETH K. WINTERS, do not survive me, then I give, devise, and bequeath my entire estate to WILLIAM ISAIAH WINTERS. (d) In the event, BLAKE ARTHUR WINTERS or ELIZABETH K. WINTERS survive me, but WILLIAM ISAIAH WINTERS does not survive me, then Three-quarters of my estate shall pass as designated in the FOURTH Paragraph. FOURTH If neither my spouse nor my children survive me, then I give, devise and bequeath all of the residue of my estate, both real and personal, of every kind and description and wherever located, in equal shares, to those or that one of the following persons who survive me: (a) One share to my sister-in-law, SUSAN C. BLANKENBILLER; (b) One share to my sister-in-law, MARTHA G. GLASS; (c) One share to my sister, PATRICIA M, EVANS; and (d) One share to the descendants of RICHARD A. WINTERS. If any of the beneficiaries listed above fail to survive me by sixty (60) days or are unwilling or unable to accept their gift, then the share of said beneficiary shall be added to the residue to be taken by the remaining surviving beneficiaries. \\r..r.,~ \1 !~' " FIFTH If, at the time of my death, any beneficiary of this my Last Will and Testament is under the age of thirty (30) years or is, in the written opinion(s) of two physicians licensed to practice in the state in which my beneficiary then resides, that the beneficiary is mentally disabled, I give, devise and bequeath said beneficiary's share to my Trustee, in Trust for said beneficiary, in accordance with paragraph 7 below. SIXTH If my spouse, AMY ELIZABETH WINTERS, fails to survive me for a period of sixty (60) days, then I nominate, constitute and appoint my sister-in-law, SUSAN BLANKENBILLER, of 326 Freeman Drive, Fleetwood, Pennsylvania 19522, the guardian of the person and of the estate of WILLIAM ISAIAH WINTERS. If SUSAN BLANKENBILLER is unwilling or unable to serve for any reason, I appoint my sister-in-law, MARTHA G. GLASS, of P.O. Box 247, Adamstown, Pennsylvania 19501, to serve as successor guardian of the person and of the estate. I direct that no Guardian shall be required to give or post bond for the faithful performance of the Guardian's duties in this or any other jurisdiction. SEVENTH All bonds, bank accounts, savings accounts, savings and loan accounts and other similar property that I may own at the time of my death in my name and/or any other person or persons which are in terms payable on or after my death to such person or persons shall be the sole property of such person or persons, as the case may be, and my executor shall make no claim against the recipient thereof. EIGHTH During the term of any trust created pursuant to this Will the Trustee shall be the same person as the Executor of this Will. Said Trustee is authorized f~ to expend and apply so much of the net income and principal of each such trust as the Trustee shall consider advisable for the health, maintenance, support, and education (including college education, undergraduate and graduate) of each such beneficiary until he or she attains thirty (30) years of age, or until all such amounts are paid out of the Trust. When the beneficiary graduates from college or attains the age of twenty-three (23) years of age, one-third 0/3) of the remainder of the Trust shall be paid to said beneficiary. When the beneficiary attains the age of twenty-five (25) years, one-half (1/2) of the remainder shall be paid to said beneficiary. When the beneficiary attains the age of thirty (30) years the Trust shall terminate and the remainder thereof shall be paid to said beneficiary. However, any gifts made under this Will which were placed in trust due to a determination that the beneficiary was mentally disabled at the time of the gift shall continue to be held in trust and shall not be paid to the beneficiary unless my Executor, relying upon the written opinion(s) of two physicians licensed to practice in the state where beneficiary then resides, determines that beneficiary is no longer afflicted with a mental disability. If any beneficiary dies before the termination of said Trust, the Trust shall terminate and the remainder thereof shall be paid in accordance with paragraphs 3 and 4 above. I direct that no Trustee shall be required to give or post bond for the faithful performance of the Trustee's duties in this or any other jurisdiction. NINTH My executor and trustee are authorized and empowered to exercise his, her or its sole discretion and without prior authority from any Court, in respect of any property forming part of any trust hereby created or otherwise in its possession hereunder all powers conferred by law upon trustees or executors and the Testator intends that such powers be construed in the broadest possible manner. ,~",O-r.'l.{--~ x], TENTH I nominate, constitute and appoint my spouse, AMY ELIZABETH WINTERS, Executrix. In the event AMY ELIZABETH WINTERS is deceased, unable or unwilling to serve or shall cease to serve for any reason whatsoever, then I nominate, constitute and appoint my sister-in-law, SUSAN BLANKENBILLER, as successor Executrix. In the event SUSAN BLANKENBILLER is deceased, unable or unwilling to serve or shall cease to serve for any reason whatsoever, then I nominate, constitute and appoint my sister-in-law, MARTHA G. GLASS, as alternate successor Executrix of this Will. I direct that my personal representative shall not be required to give or post bond for the faithful performance of his, her or its duties in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and Testament this ,::; I ,~k day of il, .. 'I t Llc/l./e...__L..... , 1995. 1 .. I 1/ .kL--c:--...;,..-;1........f:.-L"'l..--l?_ ~7f~cES S ;'l ,.A. /. f /f .~/ --' ---- L..t..v......~.(. - c..t.-- o~-_ r / j!7 !/~/"~-e~1 o (:3QJ;L~~ Gtlxz~ Blake Earl Winters /(} _ J f.<..--',,'.r'!-~' WITNESS ACKNOWLEDGEMENT COMMONWEAL TH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND I, BLAKE EARL WINTERS, the Testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to the 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 voluntary act for the purposes therein expressed. ~2~v.JJ) l~\Jr:~ Blake Earl Winters Sworn or affirmed and acknowledged before me by Blake Earl Winters, the Testator, this ;; (5& day of '--rrtUtC)1 I ~!Cb(Lk 0 C:t,,5&JL '--.'".-) Notary Public , 1995. Notarial Seal _ra E. Steel, Notary Pubic C,,1isle Bore, Cumoon.nd County My COmmission Expires June 3, 1996 AFFIDA VIT COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND --) .." , ,/ f1/f (I --,... ----;; We.,' t._A__J-~-;--J!,t...--f //'. I ,L-\.........-~~~l.. and j )('J_y/ci,," H, /:(1)j[] , the .! I; ,//7 il (,,-' witnesses 'whose names are attached" to the foregoing document, being duly qualified according to the law, do depose and say that we were present and saw Testator sign and execute the instrument as his Last Will and Testament; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the Testator signed the Last Will and Testament as witnesses and that to the best of our knowledge the Testator was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. , , U ;/ .__<..,."'_7..-:>.<_(___......,__,..........". ,'j /) /l 1../ /"1 -;?7' ///7 /. t- /~,-,'-C'" J~ o l1 /i. ./l;!..y~:j!.,., ~ '-.--- /GoJ../...uC v'- I~,-- ~-- Sworn or affirmed and subscribed before me by ..JO..cOCLe.IJiE' tn, ~ -.J (l~ /- <"/ -,)t, \....,;.......'/1 f .l.JO...I!' CL Ii, h (J" ')t, this .,J /- day of f) It]c.K(t.. ") , 1995. , / ~er lie v f and ...,) '. -" /. !' ~. 1. . . , -', /-;" '"I' -' F ': I" . ..~,. i ' " i, -. ! lJr,)(. JI L" C .' ,..-' ~..tJ.C . Notary Public Notan.i Seal Barbara E. Steel, Notary Public Carlisle Bara, Cumbenand County My C-ornmis.sion E-\pires ~!L::le 3, '1996 Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Kirk S. Sohonage, Esq Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 INVOICE ANDREWH SHAW, ESQ 61 W. LOUTI-IERST InvoiceNo: Invoice Date: Estate of: Estate No: 282 3/31/2005 BLAKE E. WINTERS 21-04-1074 Bill To: JA CARLISLE, PA 17013 Qty 1 Fee Description Additional Probate Fee Total 22.00 $22.00 Total: $22.00 Olecks should be made payable to the Register of Wills. Tenns: Net 30. Please return one copy of this invoice with your payment. Thank you. Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Kirk S. Sohonage, Esq Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 INVOICE Bill To: InvoiceNo: Invoice Date: Estate of: Estate No: 282 3/31/2005 BLAKE E. WINTERS 21-04-1074 ANDREW H SHAW, ESQ 61 W. LOUTHERST JA CARLISLE, PA 17013 Qty 1 Fee Description Additional Probate Fee 22.00 Total $22.00 Total: $22.00 ? d '-f !<{! Oi' C;-1 ( c:) Otecks should be made payable to the Register of Wills. Terms: Net 30. Please return one copy of this invoice with your payment. Thank you. RECEIVED APR 25 7JJi/; IN RE: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, COMMONWEAL TH OF PENNSYL VANIA ESTATE OF BLAKE E. WINTERS, DECEASED NO. 2004-01074 ORPHAN'S COURT DIVISION ORDER AND now this 'Zr "day of Apt,; I ,2005, upon consideration of the attached Petition, it is hereby ORDERED AND DECREED that the sum of $3,500 shall be set apart to be distributed to Amy E. Winters as set forth in the within Petition. By: dd .- ,0",/ _..J r;"? 0'\ 4! 7- 'T I 05 ~I LIt> To AN b Krw 3\mv D&. ;11 rY\ \V If,] fERS , m" N . M, W INTl2RS, BLAtL WII\lTI2RS J 13E:-TH- V\}/(\frER,s ])/WE- ~PPE:NSTEC2t.- t:::>TA Tt:.. I}J 5 I / FO. V~') MBNA A-rvtERlCAJ AYV1~CA--N U.P~SSI ~D NEUt'V\Jl'N, WUI\JBt:'REj <L~S LPA- . """~~~ }1?L. '~ \1:; ESTATE OF BLAKE E. WINTERS, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, COMMONWEALTH OF PENNSYLVANIA INRE: NO. 2004-01074 ORPHAN'S COURT DIVISION PETITION FOR FAMILY EXEMPTION To the Honorable Judge of said Court: The petition of Amy E. Winters, respectfully requests: 1. Blake E. Winters died on November 12, 2004, and at the time of death the Decedent's last principal residence was 227 West Springville Road, Boiling Springs, Cumberland County, Pennsylvania. 2. Petitioner, who resides at 227 West Springville Road, Boiling Springs, Cumberland County, Pennsylvania, is the spouse of Decedent, and formed a part of the Decedent's household at the date of his death. 3. Petitioner and Decedent were married on May 25, 1984 at Salem Shalters Church in Fleetwood, Pennsylvania, with Reverend Paul L. Rahn presiding. 4. The above-named Decedent died testate, leaving a will dated March 31,1995, which was admitted to probate on November 23, 2004, by the Register of Wills of Cumberland County. estate ofthe Decedent as beneficiaries are as follows: r..... (.,,:1 5. The names, addresses and relationships of all persons having an interesHn the ..,_....... , a. Amy E. Winters 227 W. Springville Road Boiling Springs, P A 17065 Spous,e I ,,'j , "":1 r.....) (.)'"1 -::--..L Q-~ b. Blake A. Winters 129 Susan Court West Salem, WI 54669 c. Beth Winters 8801 LaCresada Drive, # 1526 Austin, TX 78749 d. William Winters 227 W. Springville Road Boiling Springs, P A 17065 e. Timothy Winters 227 W. Springville Road Boiling Springs, P A 17065 Son Daughter Son Son 6. Petitioner claims $3,500.00 in money, now in the hands of the personal representative, as the family exemption under Section 3121 of the Probate, Estates and Fiduciaries Code. WHEREFORE, Petitioner requests that the said sum of $3,500.00 be set apart unto her immediately. Date: L-j ~ ;Z2-0 S By: ndrew . ha , squire Sup. Ct. ID No. 87371 61 W. Louther St. Carlisle, P A 17013 (717) 249-1177 Attorney for Petitioner 2 VERIFICA nON I verify that the statements made in this Petition are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904, relating to unsworn falsification to authorities. Date: , /' Y - L'7--() ~ ~[WM7T;/! Amy . Wmters -o"{:, RECEIVED APR 252005.jJ/ ~/ ESTATE OF BLAKE E. WINTERS, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, COMMONWEALTH OF PENNSYL VANIA IN RE: NO. 2004-01074 ORPHAN'S COURT DIVISION ORDER AND now this z.1-' day of t.1.....~1 , , 2005, upon consideration ofthe attached Petition, it is hereby ORDERED AND DECREED that the personal property of Blake E. Winters, deceased, shall be distributed to the persons entitled thereto as set forth in the within Petition, and upon completion of such distribution, Amy E. Winters is discharged as Executrix of the estate of the aforesaid Decedent. By: 4/21(05: f'Vl&LEl> To Af-lDR-t:W~ lSQ _ j I \ \ VV\ WI r\1 rERS j W M. W Il\X 11:jQ I ~lA KE:- W] NfE:R5 , lJETti Wt N fE:RS J -nAVE ~.bpPeN$rI2E-L, ~TATS [NF().~\Jl:S'J t'v\St\SA- ~~~lcAJ ~eRJCA1J ~~S AN D W eL TmftN) \\J t:tf\l Be:iZ6 ~ KElS L{)A- ~ en EST ATE OF BLAKE E. WINTERS, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, COMMONWEAL TH OF PENNSYL VANIA IN RE: NO. 2004-01074 ORPHAN'S COURT DIVISION PETITION FOR SETTLEMENT OF SMALL ESTATE To the Honorable Judge of said Court: The petition of Amy E. Winters, Executrix of the Estate of Blake E. Winters, respectfully requests: 1. Blake E. Winters died on November 12, 2004, and at the time of death the Decedent's last principal residence was 227 West Springville Road, Boiling Springs, Cumberland County, Pennsylvania. 2. The above-named Decedent died testate, leaving a will dated March 31, 1995, which was admitted to probate on November 23, 2004, by the Register of Wills of Cumberland County. 3. The names, addresses and relationships of all persons having an interest in the estate ofthe Decedent as beneficiaries are as follows: a. Amy E. Winters 227 W. Springville Road Boiling Springs, P A 17065 Spouse r~ ., .._1 :'\ b. Blake A. Winters 129 Susan Court West Salem, WI 54669 Soh c. Beth Winters 8801 LaCresada Drive, # 1526 Austin, TX 78749 Daughter, t.'; ---I r" ) ,. ., ,-".,... d. William Winters 227 W. Springville Road Boiling Springs, P A 17065 Son ! ....,,,'- Q:::> e. Timothy Winters 227 W. Springville Road Boiling Springs, P A 17065 Son 4. The Decedent was survived by Amy E. Winters, who is the Decedent's spouse, and is entitled to the family exemption under 20 Pa.C.S.A. S 3121. 5. The total value ofthe Decedent's personal estate is less than $10,000 and consists of the following assets which have the following values: a. E- Trade Securities $4,920.00 b. 2001 Chrysler Town and Country $2,043.74 c. 1996 Chrysler Cirrus $1,500.00 6. In addition to the above assets, Decedent's estate continues to receive periodic payments on insurance commissions for insurance policies sold by Decedent during his lifetime. Said payments have totaled $4,037.96 since Decedent's death. 7. The commissions payments represented above may continue to be paid for up to 10 years, but at a dwindling rate. Said payments cannot be estimated. 8. The following is a list of paid expenses and the amount oftheir claims: a. Ronan Funeral Home $ 2,870.00 b. Shalters Cemetery $ 350.00 c. Otterbein United Methodist Church $ 50.00 d. Amy E. Winters (Personal Rep fees) $ 1,000.00 e. Andrew H. Shaw (Atty fees) $ 3,000.00 (actual and estimated) f. Filing fees $ 121. 00 g. Advertising fees $ 219.29 2 9. The following is a list of unpaid creditors and the amount of their claims, which claims are proposed to be paid from the assets of the Decedent: a. Amy E. Winters (family exemption) $ 3,500.00 b. Citibank $20,050.93 b. Discover Financial Services $13,117.00 c. MBNA America $22,982.82 d. American Express $21,641.56 e. Bank One $ 4,132.03 10. It is proposed that the following distribution of the decedent's estate be made to the following creditors, heirs, or next of kin: a. Amy E. Winters $ 3,500.00 b. Citibank $ 340.50 c. Discover $ 222.79 d. MBNA $ 390.32 e. American Express $ 367.64 f. Bank One $ 70.16 11. It is proposed that with all future commissions paid to Decedent's Estate, that said commissions be placed in an interest bearing account, and distributed once per year after the income taxes and administrative costs are paid, pursuant to the percentage interest of each outstanding creditor, until each creditor is paid in full, and thereafter distributed to the beneficiaries as designated in Decedent's will. 3 WHEREFORE, Petitioner requests your Honorable Court to decree the distribution of the Decedent's personal estate to the persons entitled thereto as set forth on Paragraphs 10 and 11 above. Date: 1-;Z;2-0~ By: ndrew H. Shaw, Esquire Sup. Ct. ID No. 87371 61 W. Louther St. Carlisle, P A 17013 (717) 249-1177 Attorney for Petitioner 4 VERIFICATION I verify that the statements made in this Petition are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904, relating to unsworn falsification to authorities. Y-;)2-oS Am~~e~ WMW Date: CERTIFICATE OF SERVICE I, Andrew H. Shaw, Esquire, do hereby certify that a true and correct copy of the following document, Petition For Settlement of Small Estate, was served this date on the below named, by placing same in the United States mail, first-class, postage prepaid thereon, addressed as follows: Blake A. Winters 129 Susan Court West Salem, WI 54669 Beth Winters 8801 LaCresada Drive, #1526 Austin, TX 78749 William Winters 227 W. Springville Rd. Boiling Springs, P A 17007 Timothy Winters 227 W. Springville Rd. Boiling Springs, P A 17007 Dave Hippensteel Citicorp Credit Services 7930 NW 11 oth Street Kansas City, MO 64153 Estate Information Services 5330 East Main Street, Suite 200 Davis Professional Buildings Columbus, OH 43213 Representative for Discover MBNA America Estate Recovery Unit P.O. Box 15137 Wilmington, DE 19850-5137 American Express Estate Recovery Unit P.O. Box 297879 Ft. Lauderdale, FL 33329-7879 Date: 1... ;2;2-0~ Paula Tinker Weltman, Weinberg & Reis, LP A 175 South Third Street, Suite 900 Columbus, OH 43215 Attorneys for Bank One Andrew H. h w, uire Sup. Ct. I.D. No. 87371 61 West Louther Street Carlisle, P A 17013 (717) 249-1177 (phone) (717) 249-4514 (facsimile) Attorney for Petitioner ':i~ ;~ STATE OF PENNSYL VANIA IN THE MATTER OF ESTATE OF: BLAKE WINTERS IN THE ORPHANS' COURT OF CUMBERLAND COUNTY --) ESTATE#: 2120041074 DATE OF DEATH: 11/12/d4 STATEMENT OF CLAIM I. The creditor, American Express, certifies that there is due and owing by BLAKE WINTERS, deceased, the sum of TWENTY ONE THOUSAND SIX HUNDRED FORTY ONE DOLLARS AND FIFTY SIX CENTS ($ 21,641.56). 2. The nature of the claim is a Business Cash Rebate, account number 372268080572004, . 3. The name and address of the claimant is: American Express, 200 Vesey Street, New York, NY 10285-3830. 4. The name and address of the claimant's agent is: Kate Schalizki, Estate Recoveries, Inc., P. O. Box 24566, Baltimore, Maryland 21214. 5. This claim is not contingent and is not secured by any liens or judgments. 6. This claim is not based on anyone instrument. Said balance has accrued since the account was established. On behalf of American Express, creditor, I do solemnly declare and affirm under the penalties of peljury that the information in the foregoing claim is true and correct to the best of my knowledge, information and belief. I have made diligent inquiry and examination, and I believe the claim is just and all legal offsets, payments, and credits made known to the affiant have been allowed. -/J; c-;J. Q; Zt- TE SCHALIZKI Estate Recoveries, Inc. P.O. Box 24566 Baltimore, Maryland 21214 (410) 444-8022 County of Baltimore, Maryland: IN WITNESS WHEREOF, I hereunto set my hand and Notarial Seal ~:t;PriI26, 2005. ()'~ ~ LISA M. GE My Comnlission ,2008. 7"" /~!i~"/ ~f' !: ~ cO, ''l \.:};/ l:l fi- 5 N ... .<7' ~~~ ~~F: po- -$<( 'C';.>':.p.... ~aJ _"" 0'-;;; ~~;;: ~O'> ~ ~~<..> III V) :::s ::2: + '> ~ 23 ~ 3\'<:) ~ r - 3 g <::....J cc ~~~ \.. 5i. .J '\J >-- + ~,Vl '. J:) It:> .~. ~ a <;I) S c.J 0::0 If) - -- ~ L,., G - ::::: - - - - ...:: ,- - == - - ,;'() J . ,1 ~ - ~ ~ - ".\ i1't (.) t') >"-, ft) .,.. () r.. 'j'''' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z8060l HARRISBURG~ PA 171Za-0601 *' INFORMATION NOTICE :~AND TAXPAyeR RESPONSE FILE NO. 21 04-1074 ACN 05002006 DATE 05-03-2005 REV.1543 EX AFP (09~DDl TYPE OF ACCOUNT o SAVINGS o CHECKING o TRUST o CERTIF. ~ J r EST. OF BLAKE E WINTERS 5.5. NO. 387-62-9325 DATE OF DEATH 11-12-2004 COUNTY CUMBERLAND CLG"1!( DAVID KUTZ 289 BONNYBROOK RD CARLISLE PA 17013 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 UTILITY TRAILER has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent~ you were a joint owner/beneficiary of this account. If you feel this infor.ation is incorrect~ please obtain written correction from the financial institution~ attach a COPy to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Questions may be answered by calling {717l 787-a3Z7. COMPLETE PART 1 BELOW * * . SEE REVERSE SIDE FOR FILING AND PAYKENT INSTRUCTIONS Account No. 108609 Oat. 10-05-2001 Established x 725.00 50.000 362.50 .15 54.38 To insure proper credit to your account~ two {Zl copies of this notice must acco.pany your pay.ent to the Register of Wills. Make check payable to: "Register of Wills, Agent". Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x NOTE: If tax payments are .ade within three {3l Months of the decedent"s date of death, you may deduct a Sr. discount of the tax due. Any inheritance tax due will become delinquent nine {9l .onths after the date of death. Tax PART TAXPAYER RESPONSE [!]l~~!~~.ii!i.!iii"iiiil~~~ii!ii.~~~!iiii~liiii.!!iiJTI~~~i~~~iiiii~U!iiii~~...!i!il!.!i!i~liii!~~~iiii.~~.i!iiiI [CHECK ] ONE BLOCK ONLY A. Q The above information and tax due is correct. ~ 1. You .ay choose to re.it pay.ent to the Register of wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of Wills and an official assess.ent will be issued by the pA Depart.ent of Revenue. B. 0 The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent"s representative. C. c=J The above information is incorrect and/or debts and deductions were paid by you. You must complete PART 0 and/or PART 0 below. x PART @] TAX RETURN - COMPUTATION OF If you indicate a different tax rate} please state your rel.tionship to decedent: TAX ON JOINT/TRUST ACCOUNTS LINE 1. Data Established 1 2. Account Balance 2 3. Percent Taxable 3 4. Amount Subject to Tax 4 S. Debts and Deductions S 6. Amount Taxable 6 7. Tax Rate 7 8. Tax Due 8 PART [!] DATE PAID PAYEE x DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax Computation) I $ Under penalties of cO~~,~st of TAXPAYER SIGNATU~ p.rjury} I d.clare that the facts I my knowledge and belief. have reported above are true} correct HOME (1/7) /14;' 85/t., WORK ('JI:lJ) 20 ^ ~>, l./ TELEPHO E NUMB R and -r (1 5- ~&-D DAT GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on infoillation submitted by the financial institution. Z. Inheritance tax becomes delinquant nine lIonths after the dBcedant's date of daath. 3. A joint account is taxable even though the decedent's na.e was added as a Mattei of convenience. 4. Accounts (including those held between husband and wife) which the decedent put in joint names within ona year prioi to death are fully taxable as transfers. 5. Accounts astablished jointly bBtwaan husband and wife more than ona year prior to death are not taxable. 6. Accounts hald by a decedent "in trust for" another or others are taxable fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice ara correct and deductions are not being clai.ed~ place an "X" in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and sub.it them with your check for the amount of tax to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt of the return fro. the Ragister of Wills. z. BLOCK B - If tha asset specified on this notice has been or will be reported and tax paid with the PennSylvania Inheritance Tax Return filed by the decedent's representative~ place an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign one COpy and return to the PA Department of Revenue~ Bureau of Individual Taxas~ Dept Z80601~ Harrisburg~ PA 17128-0601 in the envelope provided. 3. BLOCK C - If the notice information is incorrect andlor deductions are being clailllllld~ check block "C" and cOllplete Parts 2 and 3 according to the instructions below. Sign two copies and sub. it them with your check for the alllount of tax payable to the Register of Wills of the county indicated. The PA Dapart.ent of Revenue will issue an official assass.ant (For. REV-1548 EX) upon receipt of the return fro. the Register of Wills. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Entar NOTE: the date the account originally was established or titled in the manner existing at date of death. For a decedent dying after 12/12/82: Accounts which the decedent put in joint na.es within one (1) year of death are taxable fully as transfers. However~ there is an exclusion not to exceed $3~000 per transferee regardless of the value of the account or the nu.ber of accounts held. If a double asterisk (..) appears before your first name in the address portion of this notice~ tha $3~000 exclusion already has been deducted from the account balance as reported by the financial institution. Z. Enter the total balance of the account including interest accruad to the date of death. 3. The pBrcant of the account that is taxable for each survivor is detarmined as follows: A. The percent taxable for joint assets established .ore than one year prior to the decedent"s death: DIVIDED BY TOTAL NUMBER OF JOINT OWNERS Exa.ple: A joint asset registered DIVIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE SURVIVING JOINT OWNERS in the na.e of the decedent and two other persons. I DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) = .167 X 100 l6.7X (TAXABLE FOR EACH SURVIVOR) B. The percent taxable for assets created within one year of the decedent's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): 1 DIVIDED BY TOTAL NUMBER OF SURvIVING JOINT OWNERS OR TRUST BENEFICIARIES X 100 PERCENT TAXABLE Example: Joint account registered the decedent. 1 DIVIDED BY 2 (SURVIVORS) = .50 in the nallle of the decadent and two other persons and established within one year of death by X 100 sox (TAXABLE FOR EACH SURVIVOR) 4. The a.ount subject to tax (line 4) is determined by multiplying the account balance (line 2) by the percent taxabla (line 3). 5. Enter the total of the debts and daductions listad in Part 3. 6. Tha a.ount taxable (line 6) is dater.inad by subtracting the debts and deductions (line 5) from the alllount subject to tax (line 4). 7. Enter the appropriate tax rate Clina 7) as determined below. p ounger at death to or for the use of a natural parent~ an adoptive parent~ or a stepparent of the child is OX. The lineal class of heirs includes grandparents~ parents~ children~ and lineal descendents. "ChIldren" includes natural children whether or not thay have been adopted by others~ adopted children and step childran. "Lineal descendents" includes all children of the natural parents and their descendents~ whether or not they have been adopted by others~ adopted descendents and their descendants and step-descendants. "Siblings" are defined as individuals who have at least one parent in co.mon with the decedent~ whether by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. D.t. of D..th Spouse Lineal Sibling Coll.teral 07/01/94 to 12/31/94 3% 6% 15% 15% 01/01/95 to 06/30/00 0% 6% 15% 15% 07/01/00 to present 0% 4.5%"_ 12% 15% .The tax rate 1111 csed on the not value o' transfers frolll a deceased child twenty-one years of age or y CLAIMED DEDUCTIONS PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. You legally are rasponslble for payment~ or the estata subject to ad.inistration by a personal representative is insufficient to pay the deductible ite.s. B. You actually paid the debts after death of the decedent and can f~rnish proof of pay.ent. C. Debts being claimed must be ite~ized fully in Part 3. If additional space is needed~ use plain paper 8 1/2" x 11". Proof of payment may be requested by the PA Department of Revenue. COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT,280601 HARRISBURG, PA 17128-060'1 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT KUTZ DAVID 289 BONNYBROOK RD CARLISLE, PA 17013 ______n fold EST A TE INFORMATION: SSN: 387-62-9325 FILE NUMBER: 2104-1074 DECEDENT NAME: WINTERS BLAKE EARL DATE OF PAYMENT: 05/18/2005 POSTMARK DATE: 05/17/2005 COUNTY: CUMBERLAND DATE OF DEATH: 11/12/2004 NO. CD 005339 ACN ASSESSMENT CONTROL NUMBER AMOUNT 05002006 I $54.38 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 1377 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WillS $54.38 GLENDA FARNER STRASBAUGH REGISTER OF WILLS I,..... ; () INRE: ESTATE OF: BLA KE WINTERS ESTATE NO. 2120041074 DECEASED. SATISFACTION AND RELEASE OF CLAIM The undersigned, Kathy M Peyton, Agent for AMERICAN EXPRESS, has received a pro-rata distribution of$367.64 equal to 2%, satisfying the claim filed in this proceeding on behalf of the Creditor to the extent of insolvency of the estate. This satisfaction and Release of Claim is executed to acknowledge discharge of the claim and to release the estate and personal representative from all further liability in respect to the date of death liability on account number 372268080572004. Executed this June 20,2005. AMERICAN EXPRESS Claimant By: Kathy M Pe on, Agent Estate Recoveries, Inc. P.O. Box 24566 Baltimore, MD 21214 \J'. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-15~8 EX AFP (03-05) ,,'j DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 07-04-2005 WINTERS 11-12-2004 21 04-1074 CUMBERLAND 387-62-9325 05002006 AoIo....t R..itt.d BLAKE E DAVID KUTZ 289 BONNYBRDDK RD CARLISLE PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO CDURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ A~-;r:I~1ri!!:~J.~5J:-1J.I'.................................................................................... NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE DR DISALLONANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD DR TRUST ASSETS DATE 07-04-2005 ESTATE OF WINTERS BLAKE E DATE OF DEATH 11-12-2004 COUNTY CUMBERLAND FILE NO. 21 04-1074 TAX RETURN WAS: S.S/D.C. NO. 387-62-9325 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 05002006 FINANCIAL INSTITUTION: UTILITY TRAILER ACCOUNT NO. 108609 TYPE OF ACCOUNT: () SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 10-05-2001 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 725.00 0.500 362.50 .00 362.50 .15 54.38 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTIDN OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 05-17-2005 CD005339 .00 54.38 TOTAL TAX CREDIT 54.38 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER TMIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL OUE IS REFLECTED AS A "CREDIT" ( CRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J Q... '::> '<- Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 10/30/2006 SHAW ANDREW H ESQUIRE 1202 PHEASANT DR S CARLISLE, PA 17013 RE: Estate of WINTERS BLAKE EARL File Number: 2004-01074 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COUF(T RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 11/12/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report" please disregard this notice. Sincerely, ~r. , .~~. i^4::: ' j} , ~~ d.$',-, ~~~'j J,,/f,t~~ , I Glenda Farner Strasbau~h Clerk of the Orphans' Court cc: File Personal Representative(s) \ r("\: Cumberland County - Register Of WiLls One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 10/30/2006 WINTERS AMY 227 WEST SPRINGVILLE ROAD BOILING SPRINGS, PA 17007 RE: Estate of WINTERS BLAKE EARL File Number: 2004-01074 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 11/12/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, / (/ ,b-/~ ~U.WhfWJ~ Glenda Farner Strasbaugh Clerk of the Orphans' Court :c: File Counsel ci . Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 N f D d t Blake E. Winters ame 0 ece en : Date of Death: November 12, 2004 Estate No.: 2004-01074 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration ofthe above-captioned estate: I. State whether administration of the estate is complete: Yes 0 No I8l 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: One year 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 0 No 0 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 0 No 0 c. Copies of receipts, releases, joinders and approval 05.-,pfu~1 or informal accounts may be filed with the ClerkAfthe OrphaJ]S' out and may be attached to this report. /~ jl /)/ ! : / (/ (/ /1')/ Date: 1/~'.20 "OC? .It/v ~?lA~' SIgnature Andrew H. Shaw, Esquire Name 200 S. Spring Garden Street, Suite 11 Carlisle, PA 17013 Address o \.0 N -;C 0- o ('J b :;t: "J:> c;:::::lO c;:::::lO ~ .<.::. G- te' -'"")C u-Ou QOC::' ~ (j);i,": a:: - ". ~i@: OO"w a:: ~" 05 o 717-243-7135 Telephone No. U,l c~) - :.~_ CJ~" ' U,-- (_"".:> Ee'l C:""'j a=:.. '~2\ \~-;-- Capacity: o Personal Representative Qg Counsel for personal representative ~ IN RE: ESTATE OF BLAKE E. WINTERS, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, COMMONWEALTH OF PENNSYLVANIA NO. 2004-01074 ORPHAN'S COURT DIVISION PETITION FOR FAMILY EXEMPTION To the Honorable Judge of said Court: The petition of Amy E. Winters, respectfully requests: 1. Blake E. Winters died on November 12, 2004, and at the time of death the Decedent's last principal residence was 227 West Springville Road, Boiling Springs, Cumberland County, Pennsylvania. 2. Petitioner, who resides at 227 West Springville Road, Boiling Springs, Cumberland County, Pennsylvania, is the spouse of Decedent, and formed a part of the Decedent's household at the date of his death. 3. Petitioner and Decedent were married on May 25, 1984 at Salem Shalters Church in Fleetwood, Pennsylvania, with Reverend Paul L. Rahn presiding. 4. The above-named Decedent died testate, leaving a will dated March 31, 1995, which was admitted to probate on November 23, 2004, by the Register of Wills of Cumberland County. 5. r-...., ("') ~.;:; ,-- (..;"' The names, addresses and relationships of all persons having an inter~~_~e :'~~ estate of the Decedent as beneficiaries are as follows: a. Amy E. Winters Spou!i.e" . ,i ..,,--1 227 W. Springville Road Boiling Springs, P A 17065 ~~_-:1 .:,'-~: t!~~ ") c-~ 1"-' <':1 , I '; f".:..J !. ; J ~~~IJ y~ " , " ";", -"fi - C-) I'll '../) :.'=~ ',~ N Ul b. Blake A. Winters 129 Susan Court Son West Salem, WI 54669 c. Beth Winters 8801 LaCresada Drive, # 1526 Daughter Austin, TX 78749 d. William Winters 227 W. Springville Road Son Boiling Springs, P A 17065 e. Timothy Winters 227 W. Springville Road Son Boiling Springs, P A 17065 6. Petitioner claims $3,500.00 in money, now in the hands of the personal representative, as the family exemption under Section 3121 of the Probate, Estates and Fiduciaries Code. WHEREFORE, Petitioner requests that the said sum of $3,500.00 be set apart unto her immediately. Date: '-/- :z2-0S By: drew . ha , squire Sup. Ct. ID No. 87371 61 W. Louther St. Carlisle, P A 17013 (717) 249-1177 Attorney for Petitioner 2 VERIFICA nON I verify that the statements made in this Petition are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904, relating to unsworn falsification to authorities. Date: Lt - 2-?--0 ~ ~S~iWz IN RE: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, COMMONWEALTH OF PENNSYL VANIA ESTATE OF BLAKE E. WINTERS, DECEASED NO. 2004-01074 ORPHAN'S COURT DIVISION PETITION FOR SETTLEMENT OF SMALL ESTATE To the Honorable Judge of said Court: The petition of Amy E. Winters, Executrix of the Estate of Blake E. Winters, respectfully requests: 1. Blake E. Winters died on November 12, 2004, and at the time of death the Decedent's last principal residence was 227 West Springville Road, Boiling Springs, Cumberland County, Pennsylvania. 2. The above-named Decedent died testate, leaving a will dated March 31, 1995, which was admitted to probate on November 23,2004, by the Register of Wills of Cumberland County. 3. The names, addresses and relationships of all persons having an interest in the estate of the Decedent as beneficiaries are as follows: a. Amy E. Winters 227 W. Springville Road Boiling Springs, P A 17065 b. Blake A. Winters 129 Susan Court West Salem, WI 54669 c. Beth Winters 8801 LaCresada Drive, # 1526 Austin, TX 78749 d. William Winters 227 W. Springville Road Boiling Springs, P A 17065 Spouse r'~ ,) .... ", ....(-) . ~;:-"l Son.. '-, p' " ~-'1 :c.J ~._'~ ; "'. ..~ :,.;,::~ <:'.1 ::;'-~ '...." ,..-:;; , ';-'~:; ," ") r..:.;; r."\ 1'.) ,:..:, ."', :'-'J DaughJec. - . . ( . ... r"'~ . .~ (") , ..- IT1 l./~ :~~:-(?, --, \7 Son \".) (;) ....-::"L Q::> e. Timothy Winters 227 W. Springville Road Boiling Springs, P A 17065 Son 4. The Decedent was survived by Amy E. Winters, who is the Decedent's spouse, and is entitled to the family exemption under 20 Pa.C.S.A. ~ 3121. 5. The total value of the Decedent's personal estate is less than $10,000 and consists of the following assets which have the following values: a. E-Trade Securities $4,920.00 b. 2001 Chrysler Town and Country $2,043.74 c. 1996 Chrysler Cirrus $1,500.00 6. In addition to the above assets, Decedent's estate continues to receive periodic payments on insurance commissions for insurance policies sold by Decedent during his lifetime. Said payments have totaled $4,037.96 since Decedent's death. 7. The commissions payments represented above may continue to be paid for up to 10 years, but at a dwindling rate. Said payments cannot be estimated. 8. The following is a list of paid expenses and the amount of their claims: a. Ronan Funeral Home $ 2,870.00 b. Shalters Cemetery $ 350.00 c. Otterbein United Methodist Church $ 50.00 d. Amy E. Winters (Personal Rep fees) $ 1,000.00 e. Andrew H. Shaw (Atty fees) $ 3,000.00 (actual and estimated) f. Filing fees $ 121.00 g. Advertising fees $ 219.29 2 WHEREFORE, Petitioner requests your Honorable Court to decree the distribution of the Decedent's personal estate to the persons entitled thereto as set forth on Paragraphs 10 and 11 above. Date: t/ -;Q-Or- By: drew H. Shaw, Esquire Sup. Ct. ID No. 87371 61 W. Louther St. Carlisle, P A 17013 (717) 249-1177 Attorney for Petitioner 4 VERIFICA nON I verify that the statements made in this Petition are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904, relating to unsworn falsification to authorities. Date: '1- ~:l-05 Ck~CWM~~ Amy E. W ters CERTIFICATE OF SERVICE I, Andrew H. Shaw, Esquire, do hereby certify that a true and correct copy of the following document, Petition For Settlement of Small Estate, was served this date on the below named, by placing same in the United States mail, first-class, postage prepaid thereon, addressed as follows: Blake A. Winters 129 Susan Court West Salem, WI 54669 Beth Winters 8801 LaCresada Drive, # 1526 Austin, TX 78749 William Winters 227 W. Springville Rd. Boiling Springs, P A 17007 Timothy Winters 227 W. Springville Rd. Boiling Springs, P A 17007 Dave Hippensteel Citicorp Credit Services 7930 NW 11 oth Street Kansas City, MO 64153 Estate Information Services 5330 East Main Street, Suite 200 Davis Professional Buildings Columbus, OH 43213 Representative for Discover MBNA America Estate Recovery Unit P.O. Box 15137 Wilmington, DE 19850-5137 American Express Estate Recovery Unit P.O. Box 297879 Ft. Lauderdale, FL 33329-7879 Date: if.... ~-o~ Paula Tinker Weltman, Weinberg & Reis, LPA 175 South Third Street, Suite 900 Columbus, OH 43215 Attorneys for Bank One A drew H. w, uire Sup. Ct. J.D. No. 87371 61 West Louther Street Carlisle, PA 17013 (717) 249-1177 (phone) (717) 249-4514 (facsimile) Attorney for Petitioner Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 10/16/2007 \---, to,) ,=) SHAW ANDREW H ESQUIRE 1202 PHEASANT DR S -c-, \._", I CARLISLE, PA 17013 -....j RE: Estate of WINTERS BLAKE EARL File Number: 2004-01074 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 11/12/2007 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Wills --_J Date: 10/16/2007 WINTERS AMY " , 227 WEST SPRINGVILLE ROAD BOILING SPRINGS, PA 17007 - . _ ----1 , -- RE: Estate of WINTERS BLAKE EARL File Number: 2004-01074 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing lS due by: 11/12/2007 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, li>/,. . ,X21/,{f(..{U. g~>.--l 1>/ ; . 1"<,., "-""1 ., 'c' :(~;1'(/"(/A~ -,;L~"WC;,,"".(~v " ^ ...../ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Blake E. Winters Date of Death: November 12, 2004 File Number: 2004-01074 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: . . . . . . . . . . . . . . . . . . .. [J Yes IZI No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: One year 3. If the answer to No.1 is YES, state the following: a. Did the personal representative file a final account with the Court? . . . . . .. 0 Yes 0 No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account '.f: 11 h ... ? 0 Y InlOrma y to t e partIes In Interest. ............................... es ONo d. Copies of receipts, releases, joinders and approvals of formal or . fil: with the,Clerk of the Orphans' Court and '"7Je attach t ;O'-d-L/v07 al accounts may be report. Date C> o Capacity: DPersonal Representative IZI Counsel o Andrew H. Shaw, Esquire Name of Person Filing this Form I'"' " "J 200 S. Spring Garden St., Suite 11 Address Carlisle, P A 17013 717-243-7135 Telephone FormRW-10 rev, 10.13.06 Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 10/13/2008 WINTERS AMY c7 -' _.n ~~ :_ - o 227 WEST SPRINGVILLE ROAD ~'~-; `.:; BOILING SPRINGS, PA 17007 c,~ ,_ _,' _~ <,a :, `= ,. ~ RE: Estate of WINTERS BLAKE EARL File Number: 2004 -01074 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 11/12/2008 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel ~' Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 10/13/2008 SHAW ANDREW H ESQUIRE 12 0 2 PHEASANT DR S c-~ <~' .~ , ~_.~ CARLISLE, PA 17013 ~-"`~ c~ c; -~ ---,.., ~.~ -- ~ -- .. ,-. _._, , ~ -a .. , RE: Estate of WINTERS BLAKE EARL ;,_ ~~ File Number: 2004-01074 N Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 11/12/2008 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) .~~ Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF ~.Umbe~ I Q~n(~ COUNTY, PENNSYLVANIA Name of Decedent:~~_~ 1 ~(1'~.` 5 Date of Death:~~~~~~P.f ~ o~ , oZ~ ~ File Number: ~(~ y ' ~ ~ ~ 7 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete :.................... ~ Yes 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 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 ~No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts maybe filed with the Clerk of the Orphans' Court and maybe attached to this report. Date I ~ V ~~ O C~ ,_ Signature of erson File this Form C''~ ~. ' E-- °- Capacity: ersonal Representative ~ Counsel ._ r- _. :C, -~~ ~ ..~ . ~- r - Name of Person fling this Form N _ Rd . _1' ~ '' V^ F-- C_1-~ Address C._3 (1. ~ C`7 CC -- i -yW r~ C7 = ~ 11 1 c C_: Telephone Forrn RW-/0 rev. 10.13.06 Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Blake E. Winters Date of Death: November 12, 2004 File Number: 2004-01074 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete :.................... ^ Yes ®No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: One yeaz 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 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 ^ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attach d o this report. Date /~ ~ ~ ~ ~y Si re of Pe n Filing this Form Capacity: ®Personal Representative ®Counsel cr C'r! Gl.. .. '. CT ~ , ' .~4 ' ~Y ~ 7f )i - N _- r_ti J.~ c ..~. i Q r L.._ N Andrew H. Shaw, Esquire Name of Person Filing this Form 200 S. Spring Garden St., Suite 11 Address Carlisle PA 17013 717-243-7135 Telephone Form RW-10 rev. 10.13.06 Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 10/20/2009 c7 '~ ~ O ° SHAW ANDREW H ESQUIRE i' n ~ , cv> 200 SOUTH SPRING GARDEN STREET <7 '^!` ~ , `-'--`~ ,n N ,,y, CARLISLE, PA 17013 -~ <~-.,,~} r. _ a ,-, ._ j O ~ art tiJ RE: Estate of WINTERS BLAKE EARL File Number: 2004-01074 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 11/12/2009 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, /' 1~2~~~r//GftaV Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) V~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 10/20/2009 WINTERS AMY 227 WEST SPRINGVILLE ROAD BOILING SPRINGS, PA 17007 RE: Estate of WINTERS BLAKE EARL File Number: 2004-01074 Dear Sir/Madam: N n o o .o '~~,C7 ~~ O rti ~":~ u - ~''; ~ L ~ n . o r- ~ `-~"~ -. fT'~ f'i't ~ ~_. ` ' O zJ r' ' - s:, ; ~..;~ ~,. - , a t - { v r~ '- . ^'i v This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 11/12/2009 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, /~,~i~e~1~4.~1~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: BLAKE E. WINTERS Date of Death: November 12, 2004 File Number: 2004-01074 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete :.................... ^Yes ®No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: December 31.2010 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 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 ^ No d. Copies of receipts, releases, joinders and approvals of formal informal accounts may be filed with the Clerk of the Orphans' Court and ay be a o this re~ork. Dare November 3, 2009 Signature ojPerson Filing this Form '~ ' - ~r ! ~ ~ Capacity: ^Personal Representative ®Counsel rt~ ~ ' =• ~ = •~ ~ Andrew H. Shaw ~ Ct" : ~~ T ' CQ Name ojPerson Filing this Form ~..a ti~ ~,~ - QQ ~ [~ ~ 200 S. Spring Garden Street, Suite 11 ~ _ ~~ :J? ~ t ~ w Address r~ o Carlisle, PA 17013 ,__, ~~, Z L e._' C3- '-- 0 717-243-7135 N Telep3+one Form RW-10 rev. 10.13.06 ~ ~ t' "iV U 1 ,.. _ „~ , ter Of W~_lls I Cumberland ~ou.nty ~egis~ One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 10/25/2010 SHAW ANDREW H ESQUIRE 200 SOUTH SPRING GARDEN STREET i CARLISLE, PA 17013 RE: Estate of WINTERS BLAKE EARL File Number: 2004-01074 Dear Sir/Madam: ~~ -,~., ~ -.:, ~ ' rJ :~ y_`rn ~" %~ ~ ~~: -r1 ~ This .notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, '1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a :Status Report of completed or uncompleted administration. This filing is due by: 11/12/2010 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, 1~ Glenda Farner Strasgh Clerk of the Orphans' Court cc: File Personal Representative(s) ~ . _ _ _ __,; s~.,~ .... _ _ __ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:{717) 240-6345 n~ ~ ~„ Date: 10/25/2010 C~ G ~ ~, ~, r c-~ WINTERS .AMY ?~ rn tv r ~~ '~~; ~i i f.. 227 WEST SPRINGVILLE ROAD _ ~~~ -v ~` BOILING '..SPRINGS, PA 17007 ~ ' =~ ~~`~' =`' - - - J, . ~ , ~., ~; RE: Estate of WINTERS BLAKE EARL File Number: 2004-01074 Dear ,Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date .' As per t1~e AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME ~OURT RULES DOCKET NO, 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a status Report of completed or uncompleted administration. This filing is due by: 11/12/2010 Please feel free to contact this office with any questions you may have., If you have already filed your Status Report, please disregard this notice. Sincerely, ~ . ~-vu:~- _a.e.~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File. Counsel -- ., !' °, ~~ 1 ~ ~ ~- ~~,~ ~m h O w ~ N y 'V ~. Al ~ rw p~ K m ~' ~ a ® e ~ N N ~T ~~ O ik'~ N ~ - C o , H W ~a N ~ C ~ c ,-, ;-_ Ci ~y CI7 TJ C~ ~; ~. ~ = C``' r "J -L7 _ ` ._? i:7 --: f f -i ~~~1. _v CJl ~ r ® ' buffo ~F+Z~ O HEIIn - N ~ ~ ~'~, rOL10 ~" = mr _~ o-~x = m ~o H -~a<~ C o m*i A ~~ ~ =~ -f NZ ~ ~ =~aan ~ ? ~ 19 ~ ~ :,= m U -t Z O Z~ _ o w m `~ ~ O N ~~ _ ~, w m'o /~r~[ J n~ i ~ ~~~ r ~ I y ~ ~M r ~~g ~ a 0 0~ -. Woo } -___ Register of Wills of Cumberland County .~A S REPORT UNDER RULE 6.12 Name of Decedent: Blake E. Wmters Date of Death: November 12, 2004 Estate No.: 2004-01074 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the fallowing with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes ^ No ~ 2. If the answer is No, state when the personal representative reasonably beli~ve~ that the administration will be complete: Gne Year !, 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 C1 No ^ b. The separate Orphans' Caurt No. (if any) for the personal representativje's account is: c. Did the personal representative state as account informally to the partids in interest? Yes ^ No ^ c. Copies of receipts, releases, joinders and approval off 1 or infol accounts may berefipoled with the Cl~of thyle Orph~s' C urt and ma~+ bb attached to this rt. ;` ,~ ) Date: October 28, 2~0 ~ Andrew H. Shaw ~ .. ~ ~ 1 ~- r r- Name _ ~- _ ,__ _ ~ ~ 200 S. Spring Garden Street, Suite 11 - ~ ~ - `~ ` ~' ` "" Carlisle, PA 17013 _ ~, ~ '.~ :-~, Address ---' "-- cr.. v ~ ~ cx 243-7135 _ - ~~ ~_:_ =- ~ o ~ Telephone No. ., Capacity: ^ Personal Representative Counsel for personal representative ~. ~ G ~~ ~; _; . i:: ,^ ~t ~ - ~_ ~~ - G ^a 1 ..,, t-1. :_., CJ r ~..,. : ; ~., _~ z~ -- .,.-;- ~ c, O ~- _ ~ wOJ'Uew~~a.M'MMM .LSD wdZ?-web 1eS ~J' `wdS-weg ~~,~ °wdq-weg sany.L-uoW (Xe3) 980b £9£ (91 Z) LLSO-b8L(008)IOOI-S89(9IZ) 6001-£[?bb HO `pue~ana~~ OOZ a?inS'anuand ap~sa~e~ £Z£ / / / `~la.[a~Ul~ aa~~~u[ s[q~ u[ uo;~~aadooa ano,~ ao~ n~~~' xu~[l,~ •asodand l~q~ ao~ pasn aq ll~n~ pauie~go uo[~~uuo~ui nine pue ~uaila ano ao~ sigap asay~ ~aalloa o~ ~uiiduia~~ ao?aalloo ~qap ~ s~ uia~ Mil s«{d, •paaanaao ~u[paaaoad a?goad aq~ aaagn~ asnoy~[noa ~C~unoa aq1 le siq~ alit as~ald •u~i~17 aq~ o~ ~u~?~laa ssaupa~gapu~ ll~ Puy ~Cun uaoa3 an~~e?uasaada~ l~uosaad pug ale?s~ aye sasralaa ~Cgaaay pug aa~uua paauaaa~aa-anoge aqi ui pal~i uxio17 a[{~ pas[u~oaduaoa ao paluas asimaay~o sry ao uoi?a~~}si~~s u~ ?uau~~C~d paniaaaa sgy anogp pa~s~l ~u~ua~~l~ aq,l• •u~i~l~ s~ao~ipaa~~o as~ala~ pug uoi~a~•}si~~S ~ se aai~ou siq~ idaaa~ aspald u~~peW ao ads a~a4 991?lLlb'dl`Iahdanp £ [ Sbxxxxxxxxxx `off ~unoaad Lni7n~-[ Ind, :n!.T asps ~•~ `~ueg assy~ u~~aoWdf :?ueu~i~l~ saalui~n, ~ a~lnle :•}o aze~s~ :a21 £ [ OL l b'd `alsila~~ aaenbs asnoyuno~ aup slllM 30 aa~si~a~{ [ l OZ `Z l ~[nf 556E h£h zth gS~ngs»td oo5t 665 Stz a?gd?.~pel?qd oo9z [og ht9 ~1?.1 anoa~ oozy ohL h56 a?epaap~nel •13 oot9 z9~ ghz ~u„du _~ ,~ ~J aainbsg `n~egs H n~aapud :aa •d•~ `~ue8 as~u~ u~~aoWdf ao~ an~~~~uasaada~ paz~aoq~ny b l [ -589 ~9 [ Z) s~aH ~ ~aaqu~ M `uzu~?IaM aa~~u~W a;goad `a;ioyl •d e~aiai~d a~1,4ra.S,~o s.a~af (J8 zLzL gzz ht9 snquxn~oa ooot Sg9 9tz pue~ana?~ oozz £zL E[S ~~euu?JUr~ 9L96 zg1 ztE oSea?q~ coc5 6EL 9tz s~H u~t?~ooag MV1 a.v Sn3NNOJ.a.b ~d'I `'o, SI3}i ~ ~Ii3Si~TI31,A. `1~INIIII,.L'I31fA. -~ . Cumberland. County - Register O.f Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 - .~, Date: 10/17/2011 SHAW ANDREW H ESQUIRE 200 SOUTH SPRING GARDEN STREET CARLISLE, PA 17013 RE: Estate of WINTERS BLAKE EARL File Number: 2004-01074 Dear Sir/Madam: -. __, ~- ~ ~ -- ,._,. r , n, This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 11/12/2011 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, Glenda Farner Strasba~g~ Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of_ Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 ;. ,~,,-- _ .~. Date: 10/17/2011 WINTERS AMY 227 WEST SPRINGVILLE ROAD BOILING SPRINGS, PA 17007 RE: Estate of WINTERS BLAKE EARL File Number: 2004-01074 Dear Sir/Madam: (. "~i -- This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET N0. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 11/12/2011 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, Glenda Farner Strask~~'gh Clerk of the Orphans' Court cc: File Counsel ,~ ~ ~~~ ~+ ~ ~~ a' ~ ~` ca ~' - W o ° ' ~ ~ ~ c~ ~ w ~, - ~ t~ Ct 4 -, ~, t~ 0 4 ~ __.. _. ~ WC3Q Di ' Z W 4 ; 49 4 ,.. - i ~hQi~ .. . d°~+r! ~_' , QWO E- ~~ ~a~ ~.. r-y ~ C ~''~"' ~ J F ~] Z f4 W to ` ~..~. t~ ~ ~ 01 ~' ~ ~t? ~ W [0 N 'j og. ~ ~ r r r ~ 'L J ri E ! H ' 4 ~ ~~~ t + ~ l ! i4 J ~ g'i 1 .. ~ ) ~ ~ Q ~_ J /~ ` ~ F_ ~0 1. ._- ty W Q -i ~` ~. a 4 ~` i ~~ t' •• ~~ """~ _ _ Lt ~ `4rnl' W .. (_ '~ - .-~ i l _~~ a:J f :.., .. ~ _ ~T ~ `~ U ~Y ! ),,I~j 1~ ri t# ~ LGJ F~~' [~ t.,j Q O 'j O €'~.. W ~a o ~ r-i H ~ ~ H ~ ~ as ~ m o o N ~ C7 H Z ~ ® ,o ~ \ a H .~ d ~ o °~ ~y ~M ~ ,~ ~+ a rx via d d~~ ~ ~o ~ O ~ ~ H _ _ ~~E3va P,' W~ i ° N •• W 3 H p y ~ ~ : = J-) Zi L~ H ~ oU ~ Q 3 N ~ ~ 0 L d m iY! Md I'~~ qtr r'~ '" -'C (,+w ~.- ~ ,~, r~ .. {" _ Gl ir~..f= ~ ~ .;?_ i~~ ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF In Re: Estate of CUMBERLAND COUNTY WINTERS BLAKE EARL PENNSYLVANIA NO. 2004-01074 NOTICE OF FAILURE TO FILE STATUS REPORT Personal Representative: WINTERS AMY Counsel for Personal Representative: SHAW ANDREW H ESQUIRE Date of Decedent's Death: 11/12/2004 The Orphans' Court record indicates 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, is hereby given that you have ten (10) days to file the Status Report. If the required 6.12 form is not filed in accordance with Rule 6.12 the Court will be notified of such delinquency and the undersigned will request 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: Distribution r ~La- ~ a.-z `_~~,,./'k~~rsK-.rran' ~`I''~ ~m v~vf".:. f 'e 12/1/2011 ~~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court Personal Representative Counsel for Personal Representative Estate File ~r ~.. "~f'~C ~`'i~_ i. . In Re: Estate of WINTERS BLAKE EARL ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 2004-01074 NOTICE OF FAILURE TO FILE STATUS REPORT Personal Representative: WINTERS AMY Counsel for Personal Representative: SHAW ANDREW H ESQUIRE Date of Decedent's Death: 11/12/2004 The Orphans' Court record indicates 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, is hereby given that you have ten (10) days to file the Status Report. If the required 6.12 form is not filed in accordance with Rule 6.12 the Court will be notified of such delinquency and the undersigned will request 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. y r ~ ~ s.. ., Date: 12/1/2011 . ~ ,,,~, , ~ _.- ~aW ,. _' p , -~~ 5,~.~ ,,:`f . Glenda Farner Strasbaugh Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: BLAKE EARL WINTERS Date of Death: November 12, 2004 Estate No.: 2004-01074 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes ^ No Q 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 1 year 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 ^ 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 ^ No ^ c. Copies of receipts, releases, joinders and approval of o 1 r informal accounts may be filed with the Clerk f the Orphan Co rt nd may be attached to this report. ~ Date: ~' ~^ ~- Signature Andrew H. Shaw ~_ ~~ i 1.M1 =..._ .P - ._. , ~• ~ V F_ CL (y- Ll_ _ -. - -~__ ~~> `,~. - _ , _~ Y cr., _- - ~u i ~ __~ ~ - ~_ - Q -. " ~~ _ - -. . -. U Name 200 S. Spring Garden Street Carlisle, PA 17013 Address 243-7135 Telephone No. Capacity: ^ Personal Representative Q Counsel for personal representative Cumberland County - Register Of Wills One Courthouse Square r r„-•- . ~,- ,,-,E Carlisle, PA 17013 ~ECOr,;..''-~~-~ ``J._Cly .~- ~ .,^ ill Phone: (717) 240-6345 ~~~ ~~~ ~; ,,I~ << CCT i 5 Ate 9~ f 7 f~t-~~L. _i';.,e ,: CSI Otl~i I~r'UV~v V~i~~~ CUMBERLAND CO.. PA Date: 10/15/2012 SHAW ANDREW H 200 SOUTH SPRING GARDEN STREET CARLISLE, PA 17013 RE: Estate of WINTERS BLAKE EARL File Number: 2004-01074 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 11/12/2012 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: Blake Earl Winters Date of Death: November 12, 2004 Estate No.: 2004-01074 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: l . State whether administration of the estate is complete: Yes ^ No Q 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: One year 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 C1 No Q 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 ^ No ^ c. Copies of receipts, releases, joinders and approval of fo al or informal accounts may be filed with the Clerk of the Orp o rt and may be attached to this report. ~ Date: / ~~.'~(~ "~®L ignature Andrew H. Shaw, Esquire Name 200 S. Spring Garden Street, Suite 11 Carlisle, PA 17013 Address u~ V G i to ,_. - 717-243-7135 7 ='^~ -... ~ cv s-~•. r ~ -nv '~ Telephone No. 4-L.. : - t- ~f' Capacity: ^ Personal Representative j ~~a~~ - ~ ^X Counsel for personal representative w ~ O ~ ~ 1..--. «- N - '~ O , { (-~ ~, V Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: Blake Earl Winters Date of Death: November 12, 2004 Estate No.: 2004-01074 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes ^ No Q 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 1 year 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 ^ 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 ^ No ^ G1 ~~ ~ ~_ ,~ ~~ - -4'> s r -r-- '._!.. i l _~_J c.. i ~._. c~ ~ ~-~ ..+ , ~x. Date: 11/21/2012 t71 ci N a =~. ~., ;:, ~_ a- ~._~ U -`` y~~. =~ -._.: cr- "-LL cx:a v c. Copies of receipts, releases, joinders and approval off al or informal accounts may be filed with the Clerk of the Orphans' rt and may be attached to this report. ~-.; Signature Andrew H. Shaw Name 200 S. Spring Garden Street Carlisle, PA 17013 Address 717-243-7135 Telephone No. Capacity: ^ Personal Representative X^ Counsel for personal representative ~~ ~` Y Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: Blake Earl Winters Date of Death: November 12, 2004 Estate No.: 2004-01074 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes Q 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 Q 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 Q No ^ c. Copies of receipts, releases, joinders and approval of fo a or informal accounts may be filed with the Cler of the Orpha u and may be attached to this report. Date: ~' ~ -- ~~ Signature Andrew H. Shaw :3.~ ;~; Name ~' `~ ''~ -° 200 S. Spring Garden Street -. Carlisle, PA 17013 ~ ~`' ~~`' ~ ` ~ ~, Address ~ ~ ;- `~: ~~ ~' 717-243-7135 ~> ., ... _=~~ ~"P ,:.;..~ f `.i '~ ,~ .~,a ar Telephone No. ~ ,,, ~ `_ cz . - ~ w =~ ~ ~ Capacity: ^ Personal Representative ,e,- ~= ~ ry ©~ XQ Counsel for personal representative _= v ~c~