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HomeMy WebLinkAbout02-1028PETITION FOR PROBATE and GRANT OF LETTERS Estate of ~ l~ ~ N ~~-`nL- ~' also known as Deceased. Social Security No. `-~ ~% ~ ' '~~ - 3 ~-~ c~ No. n21- O~ - /Oo2~3 To: Register of Wills for the County of ~ ~-Y~~b~`-~`°'d in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut r ~ ~ named in the last will of the above decedent, dated ~° b ~ , 19 ~(, ~1 and codicil(s) dated (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in C ~~-t~~~~ ' ~t~`~~- County, Pennsylvania, with h~ s last family or principal residence at ~~~ ~' C ca ~ 1 ~ ~ z ~~ ~l ~ ~ ~ k ~ n~ vr,'rk-~~ (list street, number and muncipality) Decendent, then ~ ~~_ years of age, died ~` t.:' ~ Z- ,~' C' ~- , at Cc.-~\tsk. Cl`l~clicck C_c~-r~-~e; Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: ~~ Decendent at death owned 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: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters'.1 (testamentary; a ministration c.t.a.; administration d.b.n.c.t.a.) theron. -~ ~.~ ~v ~" C -p O C .~ ~ '~ CL. ~w ~~ C 00 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF S3 The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estatee according to law. Sworn to or affirmed and subscribed ~ ~~ "~~ ` "'' ~ e re me this ~ day of ~ ~ .~ , , , ~ _. ~, n ti ~o ~~ Register '~ ~r.~ $ 1 ~, c~ ~;~:: $ d ~ ~~ e• c-, c~ _ Estate of Floci~ ~ ~~ ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW ~~~ ~Dl/F~'i8~'R in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated ~FLg Q ,!..~~-,~ described therein be admitted to probate and filed of record as the last will of and Letters are hereby granted to FEES _ Probate, Letters, Etc. ......... ~2~~_ S~o~~~ificates( ) .......... ~ t~- Renunciation ................ $-~~ ~~ TOTAL $~- Filed .... ~!! , /~- O,y . ................. . Register of Wits ~,2.u.~/~J " ATTORNEY (Sup. Ct. LD. No.l ADDRESS PHONE his Ib ru ~ r~f`y rear the i,~fnrralarion here liven is correctly copied from an original certificate of death duly died with me as Local t2 °_;isua;~. Che origina certificate will ~~e forwarded to the Sr.~t:v ~`iral Records Office for per(na)1er r f)iing. WARNING: It is illegal to duplicate this copy by photostat or photograph. ,_•~~ her ;nip cc°rritica~e, tii~'.OU t=-+RiJ11l1it ~ . ~~,A.~-~~ Local Registrar ---~'-- 87.0~~48 _ ^4(3, _ N 0 V _ _14 .2002 __ ~.: rC' H105.1u Rev. 2107 COMMONWEALTH Of PENNSYLVANIA • DEPARTMENT Of HEALTH • VITAL RECORDS INT CERTIFICATE OF DEATH _NT NAME Of DECEDENT (f np. M,ddl. foul n /~{~/ C p STA/E FOIE NUMBER ~ '• FL Uy/J D i/ /OrY C,L TE Ma.Le SO75ECURITY N~AgER JY -3509 DATE aF pEATH,M«gl. wy. may, AGEIIap B+IMay) UNOER,YEAR UNOERtDAY ]~ INov. 12,2002 DATE OF BIRTH B1iRHPLACE (C Mrxan• • D•y Hour • Mimdp ~MOmn. Day. 'Aeerl '~'aq PLACE OF OEA1M ICnetk °"M one-an msruOlgry on oll•er v°sl 66 ~ ~Mle«F«eayr DOUn YI HO$PITAL Y° 3/21/1936 Pa.~nbuxy, Neb. Inpati•M® E OTHER: S • PoryOutpalbM U OOA ^ Nws••, dr••r COUNTY OF DEAR E' 7. ,kMr ^ RnWnu^ CfTY, BORO. TWPOF DEATH FACILRY NAME HI rwl ,ng~ ~• isoacMl ^ Mron, gne prM and numcer~ WAS DECEDENT OF HISPANIC ORIGIN) ,~~ • a Cumbert.~and k Can2.~e2e ~Can.~~32e Med~.ea.2 Centex ~"~"'"°""~~""N/1i1`"` No ~ M. ^ n r•a •P.cM town, DECEDEM'S USUAI OGCUPATKM/ KMD OF BUSINESS/INDUSTRY WAS DECEDENT EVERIN ~`~°•~"Op~"•"° wh•(.te DECEDENT'S EDUCATION k +0• (Gv3•egN~Md wrpkp°yy °yryg rrgllp U.S. ARµE DFORCES) ~ MARITAL $TATUS~Martw° • 1/aTeC J MeC L~an•(.(; ~J( E ^ ode coin as N•S.r "anhd.wmw.d, sURVIVING SPOUSE 9~• Fedena.~ Govt. M.LJ' ,~^ ~+aMS.tandary IHwaa.9"•me°ennvrw, OECEDEM'S MAILING AOOgE53(SkM.CMrtu•n.Stl•. 29 LO41 DECEDENT'S ']' 11. 4338 Caa.~le.2e Rd. AGTUAL 17..Slat. Penndu.~van.~a M1 "• RESIDENCE ~~ ,Ta.t>1 M..dPt.d.M,a.eb D.~Ck.i,n~on a2dnen~s, PA 17324 ~n~,a ~a°;"' Cumbea2and ~^b• " FRNER'S NAME (Fip, Mipp•. Lap) 1]D, brnsnipi No, d•c•0•M MaW ',t p tTa^ wllan aclutl Hmeatl ,a• G1,c.•~bfAh Nance MOTHEWSNAME(Fap,MidOle.Maidar•S«namel °IYID« INFIxiMIW7'S NAMEp(lpypd ~F, „• Anna Leggett M~(.Che•C.(. L' V• LCLCa~S INFORMANT'S MNLIND AC~~RESSI M~E'rNOOOFpsPOSITKxa ]ae 7 yan1222 Ult. .w"~o,eS,~"yr°~I,~ngd, PA 17065 ~y-qp~ DATE OF DISPpSIT10N PLACE OF DISPOSRION BrAW L11, Cnmalbn ^ R•rra3vtl hdn $lar• ^ (Mann, wy, Marl «pwr PhO1 NarM of C•melsry. G•malory LOCATK)N . CM7T«an, $lal•, Z9 Co4 • Darr•lion^ OtIw tSlxcAVl "` ^ ,D. 11/17/2002 ,~1t. Ho.~2 S h~.n ~ Cem. ' SKiNATU OF FUNERAL SE YICELICENSEEORPERSONACTINGASS y p Ho.r'.2y Sph.Cngb, PA 17065 IICENSE NUMBER NAME ANO ADDRESS OF FAC0.fTY C«np"• N•m• flat only adr•n CM b IM wa1 d krgw I]D. •'~` ~ 0115 L ~okk.cngea F.11.~enematonyMt.Ho2.Ly SpnLnge,PA1706S PlryuOiM• a rq1 MaaDl• a11NM of w•m a an0 T "Oge, d•al Cared al IM 1 • ino e ) ce Snlea. LICENSE NUMBER candy CaY•• d Ma1R _ DATE SMSNED H«ro Y42y mum w comW"w W ]]a. ]]D. [/ , ` 7' ? ~~ J` / ~ (MOM. wy, Merl ISaraon 3rDD prOno•eICM WaIA IME OF DEATH ATE O ED OE rC. /V ~J ~J Cl ]x (~°'' M") WAS CASE REFERRED TO MEDICAL EXAMINERICORONER7 ]7. MRT 1: EM" m. rlis••a•a, aM«iaa a tom ]I. ~ M. ]°. z 6 Z M• ^ ~ DkCilwp..Nrn 4o3ed IM seam. Do nol Ini" IM mods of dyirp, Eutn a3 ard'yC or r K. lW only On• Ruse M eiCl1 Nna. ry arreM, Snack «wan laib". r APProaimat• PART H: . IMMEOIrsTE CAUSE (Farel aaeMl D•n.••n OHNr sipnilbaM Condabr" ooMrOMiy a 0••m, M anrr «c«uvron /, I orr•t and aam nol reauHinq b Hr• und•rlyaq wr P.an it PART I. "a"""'ynOSi1AI-~ a__ G /~/~ OR/1 G ~. /Y(.~iV OG~i ~ I c ~ ~ (//[- EM //-J ~ OUE 10~(Of1 ASACONSEOUENCE OF7: H~tl D. S£Ii /.70 ~r7 q5 ~Stii°,.u~n rq • ralw•. Emw IRIDEpLYEq DUE 70(OR AS A CONSEOVENCE OF): r • aYl'allkped •ranp«^Fa'Y ~ <. 1 raswrq n umn) U3T DUE 7p(OR AS A CONSEQUENCE OFy ,. e. ( WA$AN Al/70PSY WERE AUTOPSY FINDINGS MANNER OF DEATH PEAFIMMED7 AMUUBLE PRgR TO DATE OFIWURY TIME OFIWURY COMPLETION of CAUSE ~ IManm, wy. Marl IWURY A7 WORK) DESCRIBE HOWIWURY OCCURRED. OF DERN7 NM«tl Ibma:id• ^ ~b•^+ ^ P•rWNg lnvylyatbn ^ 11• ^ No ^ ... ^ N•~1 Ma ^ Ne ^ srarid. ^ c«daralwaterm,r•ed ^ ]o. ]OD• M• . ~ , PLACE OF I W URY -AI nom•, hrm, meal. tat, ~• ]aa. ~' h. D~ilOl^9. "°.ISpecavl «Y. oMk• LOCATION (Sk GMrtown, Shtel IO:RTIPIER Knack Dray OrrM b•. / 't:ERTNyIN6 PNYSICIAM IPnYSaSan cenlyva)Wrasddeam wean andn"pny3•oan nos pion«rnOty Oealn an°c°mp.laO tl"n y]I SIGNATURE ANA .` Te k4 DMl of mY knowNdW.WM Oecumed dueblM eause(a)and manner ••eta,W ..................................................... ^ OF R,7IFIEW . ~U ],D. l,l/ 'PRONq)NGND AND CERTIFYRKi PHYSICIAN (PIMSCian Dan «Ono„ncsg Oealn and cMeyay to cause of deaml LICENSE NUMBER To dl• De•t M my krowl•dge, deem xeurred at dv llm•, dale, and PI•ee, arM dw t° tM uuae(el and manner n etal•d .......................... ~ ]le. GATE SKiNED Mal OS oo6sr'csf~ „4 /r//z/o • •YEDICAL EJfAMINER/CORONER NAME ANDADORESS OF PERSON WHO COMP E7EDCAUSE aF DEATN On tM Dash of eaaminatlon and/or Ireeatl atbn, In m (Item 27) Typ• «Print~jra,•„y f C• manner as atatW.. , , , 9 Y opinion, de•iD occurred al me time, date, and place, and due t° the uuae(S) and C rQ/!t C OIL. `'~' C~ 0. pEG1$TRAR'$$IGNATURE ANON ~a ]~ GA/JG/f~f ~/~ f~p/3 qa w- • -\\ DATE FILED (MOMn wy. Marl ]]. ~••.~u` ~ . ~•. ~o~• 1~. aooa LAST WILL AND TESTAMENT OF FLOYD D. NANCE I, FLOYD D. NANCE, Social Security Number 507-34-3509, of the State of Pennsylvania, declare that this is my LAST WILL AND TESTAMENT and I revoke all other wills and codicils previously made by me. FIRST: I appoint my Wife, SHIRLEY A. NANCE, as my Personal Representative concerning this Will. If she is unable or fails to serve, I then appoint my daughter, MICHELLE N. CONKLIN to serve as my Personal Representative. If MICHELLE N. CONKLIN is unable or fails to serve, I then appoint my daughter, JULIA A.M. NANCE to serve as my Personal Representative. a. I request that my Personal Representative be permitted to serve without bond or surety thereon and without the intervention of any court, except as required by law. I direct that my Personal Representative act in unsupervised administration so as to administer my estate with a minimum of court supervision. If it becomes necessary to have ancillary administration of my estate in any jurisdiction where my Personal Representative is unable or does not desire to qualify as ancillary legal representative, I appoint as such ancillary legal representative such individual or corporation as my Personal Representative shall designate, in writing. b. I direct my Personal Representative to pay the expenses of my last illness, the expenses of a funeral appropriate to my station in life and custom of living (including a suitable monument or marker for my grave), and written charitable pledges which I have made. I grant my Personal Representative the power to extend or renew any debt for such time as my Personal Representative shall deem appropriate. c. All estate, inheritance, succession and other death taxes with respect to all property passing under this my Will shall be paid from and borne by the principal of my residuary estate, without regard to reimbursement, as if such taxes were administration expenses. My Personal Representative may pay such taxes at any time deemed advisable, whether or not then due and payable. d. My Personal Representative is requested to settle my estate as soon after my death as may be practicable, and to pay or deliver every legacy or bequest to my beneficiaries without waiting any time that may be believed to be customary in probate matters. PAGE 1 ~ ,~~ OF 5 PAGES /~" ~ ~ V ~~~~ ,~ e. I have served in the Armed Forces of the United States. Therefore, I direct my Personal Representative to consult with a Legal Assistance Attorney at the nearest military installation and with the Department of Veterans Affairs and the Social Security Administration to ascertain if there are any benefits to which my family members are entitled by virtue of my military service. SECOND: To each of my grandchildren. I specifically give and bequeath ONE THOUSAND AND FIVE HUNDRED DOLLARS. THIRD: I give, devise and bequeath, absolutely and forever, all the rest, residue and remainder of my estate and property of which I may be seized or possessed, or to which I may be entitled, at the time of my death, wherever situated or of whatever nature, be it real, personal, or mixed, to my Wife, SHIRLEY A. NANCE, as her sole and absolute property ifshe shall survive me. FOURTH: In the event that my Wife, SHIRLEY A. NANCE shall not survive me, I give, devise and bequeath, absolutely and forever, all of the rest, residue and remainder of my estate and property of which I may be seized or possessed, or to which I may be entitled, at the time of my death, wherever situated or of whatever nature, be it real, personal, or mixed, to my children, MICHELLE NANCE CONKLIN and JULIA A.M. NANCE and to any child or children that have been or may be born to or adopted by me, in shares of substantially equal value to be divided as they may agree. a. If any of my children shall not survive me, then the share of that deceased child shall go to the descendants of that child, who are to take per stirpes and not per capita. If any of my children shall not survive me and shall not be survived by any descendants, then the share of that deceased child shall be distributed to my surviving children and the descendants of any of my other children who fail to survive me, in the manner set forth above. b. If they are unable to agree, the division among my children and the descendants of any of my children who fail to survive me shall be made by my Personal Representative, in that person's sole and absolute discretion. I empower my Personal Representative to sell any or all of such property, if such property is not distributed in kind hereunder, and to distribute the proceeds among my said children in substantially equal shares. Any determination of my Personal Representative as to what should pass or be sold under this paragraph and to whom it should pass or be delivered or at what price it should be sold shall be conclusive. PAGE 2 OF 5 PAGES~_ ~ ~ FIFTH: If there is a complete failure of takers under the preceding paragraphs, the property undisposed of shall go to my heirs determined at the time of my death, pursuant to the Statutes of Descent and Distribution in effect, in the state of my domicile, at the time of my death. SIXTH: If any beneficiary to any share of my estate which is not subject to the provisions of any trust which may be created by this will is at the time of distribution of his or her share, a minor under the laws of his or her domicile, I direct that the minor's share be converted into qualifying property and delivered to the minor's Guardian as Custodian for the minor under the Uniform Gifts to Minors Act or the Uniform Transfers to Minors Act as may then be in effect in either the state in which the beneficiary or the Custodian resides, or any other state of competent jurisdiction. a. The Uniform Gifts to Minors Act or The Uniform Transfers to Minors Act, as may then be in effect in the state concerned, is hereby incorporated by reference. The property affected by the Act shall be managed, held, and distributed in accordance with the provisions of the Act. b. The financial custodian will serve without bond or surety and without intervention of any court, except as required by law. c. The receipt by the Custodian, for the minor, of any principal or income transferred pursuant to this paragraph shall be a full acquittance and discharge of my Personal Representative or Trustee, as applicable, from liability with respect to such transfer and from further accountability for the principal or income so transferred. SEVENTH: Except as otherwise provided in this Will, I have intentionally failed to provide for any other relatives or other persons, whether claiming to be an heir of mine or not. Insofar as I have failed to provide in this Will for any of my issue now living or later born or adopted, such failure is intentional and not occasioned by accident or mistake. EIGHTH: Any beneficiary who fails to survive until one hundred twenty (120) hours after my death shall be deemed to have predeceased me, and the gift to that beneficiary shall be disposed of accordingly. PAGE 3 ~ OF 5 PAGES ~ ~'~ ~ 1i~ NINTH: Definitions: a. The term "children" as used in this Will includes adopted and afterborn persons. The term "children" as used in this Will shall not include step-children, the natural born or adopted children of a person's spouse who are not the natural born or adopted children of the person. A relationship by or through legal adoption shall be treated the same as a relationship by or through blood for purpose of succession to property under this Will. b. The term "descendants" as used in this Will means the immediate and remote lawful, lineal descendants by blood or adoption of the person referred to who are in being at the time they must be ascertained in order to give effect to the reference to them. c. The term "Personal Representative" as used in this Will means Executor, Executrix, Independent Executor, or any other title of like import which is used to describe such a fiduciary. d. The term "per stirpes" as used in this Will means that whenever a distribution is to be made to the descendants of any person, the property to be distributed shall be divided into as many shares as there are (1) living children of the person, and (2) deceased children, who left descendants who are then living, of the person. Each living child (if any) shall take one share and the share of each deceased child shall be divided among his then living descendants in the same manner. TENTH: In addition to any powers granted by the laws of the state in which this Will is probated, I hereby authorize and empower the fiduciaries named in this Will, to the extent of the discretion herein granted, to sell, exchange, convey, transfer, assign, mortgage, pledge, lease or rent the whole or any part of my real or personal estate, to invest, reinvest, or retain investments of my estate, to perform all acts and to execute all documents which my fiduciaries may deem necessary or proper in regard to my property. If any of my fiduciaries elect to receive compensation for services, such compensation will be that allowed by law. ELEVENTH: If any part of this Will shall be invalid, illegal, or inoperative for any reason, it is my intention that the remaining parts, so far as possible and reasonable, shall be effective and fully operative. My Personal Representative may seek and obtain court instructions for the purpose of carrying out as nearly as may be possible the intention of this Will as shown by the terms hereof, including any terms held invalid, illegal, or inoperative. PAGE 4 / OF 5 PAGES ~~~~ ~---~~ , ~'C IN WITNESS WHEREOF, I have at Carlisle Barracks, Pennsylvania, this day of Fy~fj~,~~/'~/ , 19~~, set my hand and seal to this my LAST WILD AND ~E$TAMENT, consisting of 5 typewritten pages, each page bearing my handwritten signature. This document was prepared under the authority of 10 U.S.C. section 1044, and implementing military regulations and instructions, by JOHN T. ROTHWELL, who is licensed to practice law in the State of Arkansas. (SEAL) FLO D. NANCE The foregoing instrument was, at Carlisle Barracks, Pennsylvania, this '~; day of ef31~n , 19~, signed, sealed, published and declared by FLOYD D. NAN E, the testator, to be his LAST WILL AND TESTAMENT in the presence of all of us at one time, and at the same time we, at his request and in his presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses, and we do so verily believe that the said testator is of sound and disposing mind and memory at the date he f. J ~' ~~~~ f~ E) ,~ OF ~~ 2 - OF GOYULDa ~~Z .~- Q ~I 7 OF P5GPAGES ~~ V C~~ ~ ~i COMMONWEALTH OF PENNSYLVANIA CUMBERLAND COUNTY ACKNOWLEDGMENT I, FLOYD D. NANCE, testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. (SEAL) FLOY D. NANCE AFFIDAVIT We, ~ ~Z° ~ y0~~ ~ ~ol~~ ~ ~ ~G- ~n _ , and ~;, ~, ~,~~~~~,-, , the witnesses, sign our names to this rostrum being duly qualified according to law, do depose and say that we were present and saw the testator sign and execute the instrument as his Last Will; that the testator signed willingly and 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 will as a witness; and that to the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no c train r u u 'nfluence. Wi ness Witness Witnes Subscribed, sworn to and acknowledged before me by FLOYD D. NANCE, the testator, and subscribed and sworn to before me by /~/i/7~~' ~' L ~/y'C~'c~ , J~0~3C~R~ J ~ • ~DYV4- ~~~ , and v ,~,'i-(~~ ` cC- ~ i the witnesses, this ~ ~ day of NOTARY PUBI~tC My ssion Expires: ~ ,fl~~~ Notarial Seal ROSalin Juarbe, Notary Public Harrisburg, Dauphin County My Commission Expires Sept. i8, 2000 ember, Pennsylvania Association of Kota es v CERTIFICATION OF NOTICE UNDER RULES 5.6 a Name of Decedent: Floyd D. Nance Date of Death: November 12, 2002 Will No: 21-02-1028 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on December 3, 2002: Michelle D. Lucas 7 Yankee Drive Mt. Holly Springs, PA 17065 Ashley N. Conklin c/o Michelle D. Lucas 7 Yankee Drive Mt. Holly Springs, PA 17065 Morgan Renee Lucas c/o Michelle D. Lucas 7 Yankee Drive Mt. Holly Springs, PA 17065 Julia A.M. Nance 6 Franklin Street Mt. Holly Springs, PA 17065 Domnick C. Nance c/o Julia A.M. Nance 6 Franklin Street Mt. Holly Springs, PA 17065 Dalton Jonathan Lee Barclay c/o Julia A.M. Nance 6 Franklin Street Mt. Holly Springs, PA 17065 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: No exceptions. Date: December 3, 2002 Ronal .Johnson, Esquire 78 W Pomfret Street Carlisle, PA 17013 Phone: 717-243-0123 Capacity: Counsel for personal representatives COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX111-96) N0. CD 002841 JOHNSON RONALD ESQUIRE 301 MARKET STREET LEMOYNE, PA 17043 fold ESTATE INFORMATION: ssN: 507-34-s5os FILE NUMBER: 2102- 1 028 DECEDENT NAME: NANCE FLOYD D DATE OF PAYMENT: 07/25/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 1 / 1 2/2002 ACN ASSESSMENT AMOUNT CONTROL NUMBER TOTAL AMOUNT PAID: REMARKS: MICHELLE D LUCAS C/0 RON JOHNSON ESQUIRE CHECK#105 SEAL INITIALS: AC RECEIVED BY: DONNA M. OTTO REGISTER OF WILLS 54,349.06 DEPUTY REGISTER OF WILLS /~ ion- ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-06D1 RONALD E JOHNSON ESQ ANDREWS & JOHNSON 78 W POMFRET ST CARLISLE PA 17013 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN Amount Remitted REY-1547 E% AFP (O1-OS) 09-15-2003 NANCE FLOYD D 11-12-2002 21 02-1028 CUMBERLAND 101 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETA_IN LOWER POR_TION_ FOR YOUR RECORDS ~ ------------------------------------ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMEWT, ALLOWANCE OR --------------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF NANCE FLOYD D FILE N0. 21 02-1028 ACN 101 DATE 09-15-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 43,986.75 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 28,4 22 22 11. Total Deductions 12. Net Value ofi Tax Return (11) 79.408 97 13. Charitable/Governmental Bequests; Non-elected 9113 Trus (12) ts (Schedule J) ( 96,645.82 00 14. Net Value of Estate Subject to Tax 13) . (14) 96,645.82 NOTE: If an assessment was issued previously, lines reflect figures that includ th 14, 15 andior 16, 17, 18 and 19 will e e total of ALL ASSESSMENT OF TAX: returns assessed to date. 15. Amount ofi Line 14 at Spousal rate (15) •0 0 00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) X _ 96,646.00 X 045 = .00 4,349 06 17. Amount of Line 14 at Sibling rate (17) 00 1 2 . 18. Amount of Line 14 taxable at Collateral/Class B rate (18) . X - 0 0 1 5 .00 19. Principal Tax Due . X - .00 TAX CREDITS• (19)= 4,349.06 DATE ~ NUMBER ~ INTEREST/PEN PAID ( ) I AMOUNT PAID 25 2003 rnnn~aA., TOTAL TAX CREDIT 4,349.06 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE s7nF nr TYTC rno.. ~.... ~...,__.._______ _ (1) 94 ,000.00 NOTE: To insure proper (2) .00 credit to your account, (3) .00 submit the upper portion (4) .00 of this form with your (5) 36 , 132.11 tax payment. t6) 4, 354.47 (n 34, 568.21 (8) 169, 054.79 \j BUREAU OF INDIVIDUAL TAXES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX DIVISION DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX HARRISBURG, PA 17128-0601 STATEMENT OF ACCOUNT REV-1607 EX pFP (O1-OS) DATE 12-15-2003 ESTATE OF EPLEY JANET L DATE OF DEATH 11-17-2002 FILE NUMBER 21 02-1128 COUNTY CUMBERLAND KEITH A HASSLER ESQ ACN 101 9 N BEAVER ST YORK PA 17401 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS __~ _ ------------------------------------------------------------------------------------- REV-1607 EX AFP (01-03) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ~~~ --------- ESTATE OF EPLEY JANET L FILE N0. 21 02-1128 ACN 101 DATE 12-15-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-29-2003 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 2,593.39 PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 02-12-2003 CD002161 ~ 129.67 2,500.00 08-12-2003 CD002891 ~ .00 2,593.39 10-07-2003 REFUND .00 ~ 2,593.39- 11-26-2003 REFUND .00 ~, 36.28- TOTAL TAX CREDIT 2,593.39 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 * IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN S1, ' ~ (~.~ NO PAYMENT IS REQUIRED. J IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) i~ . , -,\.; w ~ ~-~ ug:u Woo Xc::-, Ua.'" a. <( /"}-IOI- '/ ,,/ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0801 OFFICIAL USE ONLY REV -1500 INHERITANCE FILE NUMBER TAX RETURN RESIDENT DECEDENT 21-02-1028 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3.Closely Held Corporation, Partnership or Sole-Prop. 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Misc. Personal Prop.(Sch.E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Misc, Non-Propate Prop. 8. Total Gross Assets (total lines 1-7) 9. Funeral Expenses & Administration Costs (Sch H) 10. Debts of Decedent, Mortgage lIabllllies, & Liens 11. Totai Deductions (total lines 9&10) 12. Net Value of Estale (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (13) 14. Net Value Subject to Tax Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amnt of Line 14 taxable at the spousal rale, or transfers under Sec.9116(a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of LIne 141axable al sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due I- Z W C W (J W C DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Nance, Flo d D. DATE OF DEATH (MM-DD-YY) 11/12/2002 (IF APPLICABLE) SURVIVING SPOUSE'S NAME n/a COUNTY CODE YEA" NUMBER DATE OF BIRTH (MM-DD-YY) 3/21/1936 1. Original Return D 2. Supplemental Return D 4a. Future interest Compromise D 7. Decedenl had LIving Trusl SOCIAL SECURITY NUMBER 507-34-3509 THIS MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Return D 5. Fed. Est. Tax Return Req'd 8. Total number of SOB's '~;.~~~~\+.~~Wt~Mt COMPLETE MAILING ADDRESS: Ronald E. Johnson, Esq. Andrews & Johnson 78 W. Pomfret St. Carlisle, PA 17013 ...."r , $94,000.00; $0.01!l OFFI<eL USE ONLY 4. Limited Estate 6. Decedent Died Testate >- z w Cl z o a. '" w c:: c:: o U NAME: Ronald E. Johnson, Esquire FIRM NAME: Andrews & Johnson TELEPHONE NUMBER 717243-0123 $0.00 $36,132.11 $4,354.47 c_ r..=: r--. 1'-) ij'l z o i= S ::J l- ii: 5 w a:: (1) (2) (3) (4) (5) (8) $34,568.21. (8) $169,054.79 $43,986.75 $28,422.22 (11) $72,408.97 (12) $96,645.82 $96,645.82 x.o_ x.045 x.12 x.15 $0.00 $4,349.06 $0.00 $0.00 $4,349.06 (7) (9) (10) z o ~ ::> ... ::; o (J ~ $96,646 $0 $0 (15) (16) (17) (18) (19) ~~llli?h:JilltdkJ.fi Decedent's Complete Address: STREET ADDRESS 4338 Carlisle Road CITY STATE ZIP Carlisle PA 17324 If line 1 + Une 3 is greater than Line 2, enter the difference. This is the TAX DUE. A, Enter the Interest on the tax. due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT ;*?t&.tr.gMtHt.g=&ftr&r-Jw.MrJ&%~%~:.. . >::<:m:.-n : .' "~,~ ,,': ' : '.' "~ ,of' ~.Wa.'it't~%_1<<%".~Wm.M::~~Ff@~1frnttf!#N}~WNJ%Mf?~~.m~ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Did decedent make a transfer and: yes Tax Payments and CredIts: 1. Tax Due 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discounts Total Credits (A+S+C) 3. Interest/Penalty if applicable D. Interest E. Penalty 4. TotallnterestlPentalty (D+E) If Line 2 is greater than Une 1 + Line 3, enter the ditference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. a. retain the use or income of the property transferred: b. retain the right to designate whO shall use the property tfanserred or its income: c. retain a reversionary Interest: or d. retain the promise for Ufe of either payments or care? 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiVing adequate consideration? 3. Did decedent own an "in trust for" or payable upon death banK account or security at his or her death? 4. Did decedent own an IndiVidual Retirement Account, annuity, or other non-probate property which contains a beneficiary dlsignation? (1) (2) (3) (4) (5) (SA) (5B) D D D D D D El $4,349.06 $0.00 $0.00 $4,349.06 $4,349.06 no El ~ El ~ El El D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of pedury, I declare that I ha~ examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. treet, Carlisle, PA 17013 RESENTATIVE DATE DATE Forda1es of death on or after January 1.1995, the tax rate Imposed on the netvaJue oftrar\$flSfS to or for the un oftneWNMr.g spouse is 0% (12 P.S. Sec, 9118{a)(1.1){ii)). The statute does not exempt a transfer to a sulViving spouse from tax. and the statutory requirements for disclosure of assetS and filing a tax return are still applicable even jf 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 deseased child twenty-one years of age or younger at death to or for the use of a natural parent, an adopti~ parent, or a stepparent of the child is 0% [72 P.S, Sec. 9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. See. 9116(1.2) [72 P.S, Sec.9116(a)(1}, Tl\e \all. YoIte imposed on thene\va\ue of nnsfers to or for the use of the decedenfs siblings Is 12% [72 P.S. Sec.9116(a)(1,3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. LAST WILL AND TESTAMENT OF FLOYD D. NANCE ;' I, FLOYD D. NANCE, Social Security Number 507-34-3509, of the State of Pennsylvania, declare that this is my LAST WILL AND TESTAMENT and I revoke all other wills and codicils previously made by me. . FIRST: I appoint my Wife, SHIRLEY A. NANCE, as my Personal Representative concerning this will. If she is unable or fails to serve, I then appoint my daughter, MICHELLE N. CONKLIN to serve as my Personal Representative. If MICHELLE N. CONKLIN is unable or fails to serve, I then appoint my daughter, JULIA A.M. NANCE. to. serve as my Personal Representative. a. I request that my Personal Representative be permitted to serve without bond or surety thereon and without the intervention of any court, except as required by law. I direct that my Personal Representative act in unsupervised administration so as to administer my estate with a minimum of court supervision. If it becomes necessary to have ancillary administration of my estate in any jurisdiction where my Personal Representative is unable or does not desire to qualify as ancillary legal representative, I appoint as such ancillary legal representative such individual or corporation as my Personal Representative shall designate, in writing. b. I direct my Personal Representative to pay the expenses of my last illness, the expenses of. a funeral appropriate to my station in life and custom of living (including a suitable monument or marker for my grave), and written charitable pledges which I have made. I grant my Personal Representative the power to extend or renew any debt for such time as my Personal Representative shall deem appropriate. c. All estate, inheritance, succession and other death taxes with respect to all property passing under this my Will shall be paid from and borne by the principal of my residuary estate, without regard to reimbursement, as if such taxes were administration expenses. My Personal Representative may pay such taxes at any time deemed advisable, whether or not then due and payable. d. My Personal Representative is requested to settle my estate as soon after my death as may be practicable, and to payor deliver every legacy or bequest to my beneficiaries without waiting any time that may be believed to be customary in probate matters. dAy/1 /9J ;.J r;v.4Jl- PAGE 1 Y;o OF 5 PAGES Of r/J (j)rY ~ e. I have served in the Armed Forces of the united States. Therefore, I direct my Personal Representative to consult with a Legal Assistance Attorney at the nearest military installation and with the Department of Veterans Affairs and the Social Security Administration to ascertain if there are any benefits to which my family members are entitled by virtue of my"military service. SECOND: To each of my grandchildren. I specifically give and bequeath ONE THOUSAND AND FIVE HUNDRED DOLLARS. THIRD: I give, devise and bequeath, absolutely and forever, all the rest, residue and remainder of my estate and property of which I may be seized or possessed, or to which I may be entitled, at the time of my death, wherever situated or of whatever nature, be it real, personal, or mixed, to my Wife, SHIRLEY A. NANCE, as her sole and absolute property ifshe shall survive me. FOURTH: In the event that my Wife, SHIRLEYA. NANCE shall not survive me, I give, devise and bequeath, absolutely and forever, all of the rest, residue and remainder of my estate and property of which I may be seized or possessed, or to which I may be entitled, at the time of my death, wherever situated or of whatever nature, be it real, personal, or mixed, to my children, MICHELLE NANCE CONKLIN and JULIA A.M. NANCE and to any child or children that have been or may be born to or adopted by me, in shares of substantially equal value to be divided as they may agree. a. If any of my children shall not survive me, then the share of that deceased child shall go to the descendants of that child, who are to take per stirpes and not per capita. If any of my children shall not survive me and shall not be survived by any descendants, then the share of that deceased child shall be distributed to my surviving children and the descendants of any of my other children who fail to survive me, in the manner set forth above. b. If they are unable to agree, the division among my children and the descendants of any of my children who fail to survive me shall be made by my Personal Representative, in that person's sole and absolute discretion. I empower my Personal Representative to sell any or all of such property, if such property is not distributed in kind hereunder, and to distribute the proceeds among my said children in substantially equal shares. Any determination of my Personal Representative as to what should pass or be sold under this paragraph and to whom it should pass or be delivered or at what price it should be sold shall be conclusive. ~l'f iJA//.1A//f!. PAGE 2 .:If (\ OF 5 PAGES U) ;J ());V ~ FIFTH: If there is a complete failure of takers under the preceding paragraphs, the property undisposed of shall go to my heirs determined at the time of my death, pursuant to the Statutes of Descent and Distribution in effect, in the state of my domicile, at the time of my death. SIXTH: If any beneficiary to any share of my estate which is not subject to the provisions of any trust which may be created by this will is at the time of distribution of his or her share, a minor under the laws of his or her domicile, I direct that the minor's share be converted into qualifying property and delivered to the minor's Guardian as Custodian for the minor under the Uniform Gifts to Minors Act or the Uniform Transfers to Minors Act as may then be in effect in either the state in which the beneficiary or the Custodian resides, or any other state of competent jurisdiction. a. The Uniform Gifts to Minors Act or The Uniform Transfers to Minors Act, as may then be in effect in the state concerned, is hereby incorporated by reference. The property affected by the Act shall be managed, held, and distributed in accordance with the provisions of the Act. b. The financial custodian. will serve without bond or surety and without intervention of any court, except as required by law. c. The receipt by the Custodian, for the minor, of any principal or income transferred pursuant to this paragraph shall be a full acquittance and discharge of my Personal Representative or Trustee, as applicable, from liability with respect to such transfer and from further accountability for the principal or income so transferred. SEVENTH: Except as otherwise provided in this Will, I have intentionally failed to provide for any other relatives or other persons, whether claiming to be an heir of mine or not. Insofar as I have failed to provide in this will for any of my issue now living or later born or adopted, such failure is intentional and not occasioned by accident or mistake. EIGHTH: Any beneficiary who fails to survive until one hundred twenty (120) hours after my death shall be deemed to have predeceased me, and the gift to that beneficiary shall be disposed of accordingly. ;=-..4 ~ Ii) A ~ ~,,~ PAGE 3 Y'f/! Jl. OF 5 PAGES ~ IV' WP .iJfL NINTH: Definitions: a. The term "children" as used in this will includes adopted and afterborn persons. The term "children" as used in this will shall not include step-children, the natural born or adopted children of a person's spouse who are not the natural born or adopted children of the person. A relationship oy or through legal adoption shall be treated the same as a relationship by or through blood for purpose of succession to property under this will. b. The term "descendants" as used in this Will. means the immediate and remote lawful, lineal descendants by blood or adoption of the person referred to who are in being at the time they must be ascertained in order to give effect to the reference to them. c. The term "Personal Representative" as used in this Will means Executor, Executrix, Independent Executor, or any other title of like import which is used to describe such a fiduciary. d. The term "per stirpes" as used in this Will means that whenever a distribution is to be made to the descendants of any person, the property to be distributed shall be divided into as many shares as there are (1) living children of the person, and (2) deceased children, who left descendants who are then living, of the person. Each living child (if any) shall take one share and the share of each deceased child shall be divided among his then living descendants in the same manner. TENTH: In addition to any powers granted by the laws of the state in which this will is probated, I hereby authorize and empower the fiduciaries named in this Will, to the extent of the discretion herein granted, to sell, exchange, convey, transfer, assign, mortgage, pledge, lease or rent the whole or any part of my real or personal estate, to invest, reinvest, or retain investments of my estate, to perform all acts and to execute all documents which my fiduciaries may deem necessary or proper in regard to my property. If any of my fiduciaries elect to receive compensation for services, such compensation will be that allowed by law. ELEVENTH: If any part of this Will shall be invalid, illegal, or inoperative for any reason, it is my intention that the remaining parts, so far as possible and reasonable, shall be effective and fully operative. My Personal Representative may seek and obtain court instructions for the purpose of carrying out as nearly as may be possible the intention of this will as shown by the terms hereof, including any terms held invalid, illegal, or inoperative. FlklJJ LB NCW.L2. .., OF PAGE 4 ;J 5 PAGES 3>j'l/A ~ Af;iJ q this each IN WITNESS WHEREOF, I have at Carlisle Barracks, Pennsylvania, day of r;tll({f~ ' 19512..1 set my hand and seal to my LAST WIL AN ESTAMENT, consisting of 5 typewritten pages, page bearing my handwritten signature. this This document was prepared under the authority of 10 U.S.C. section 1044, and implementing military regulations and instructions, by JOHN T. ROTHWELL, who is licensed to practice law in the State of Arkansas. F-<~ fi) J1/~ FLO D. NANCE (SEAL) The foregoing instrument was, at Carlisle Barracks, Pennsylvania, this q'Tll day of 1Fr.?/2+1n~ ' 19H, signed, sealed, published and declared by FLOYD D. NAN E, the testator, to be his LAST WILL AND TESTAMENT in the presence of all of us at one time, and at the same time we, at his request and in his presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses, and we do so verily believe that the said testator is of sound and disposing mind and memory at the date he f. (1)lIl1l?1~ f D.dd ~ OF rJI (fj)))~(A-5 . 1;J(j, ff/Yt'UJ 4~(/1 ftuA'L4" IJ~-'Y,$ OF OF , F..EJ yd If) AJ~1J PAGE 5 .0 OF 5 PAGES ;('1' p- (j)()e q-[) " '. COMMONWEALTH OF PENNSYLVANIA CUMBERLAND COUNTY ACKNOWLEDGMENT I, FLOYD D. NANCE, ~estator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. EP"I fi2 l1J'aAu fL FLOY D. NANCE (SEAL) We, ! tJon/t' f Uoclcl ~~~~~ , the witnesses, sign our names to this irlstrum , being duly qualified according to law, do depose and say that we were present and saw the testator sign and execute the instrument as his Last Will; that the testator signed willingly and 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 will as a witness; and that to the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no c train r u' fluence. 'Thf/A'(J /J /Judd. ~ ness AFFIDAVIT G41?em R Lw fr 7n. , , and w~f&j4~~ Subscribed, sworn to and acknowledged before me by FLOYD D. NANCE, the testator, and subscribed and sworn to before me by /"h7lld! I. ;)c/r:/ , VUl?t7l:r f{. LpN/,..- """J(L. , and 4r.ft.t J ~.J7,{ffi'> , the witnesses, this 1'flJ day of rei5anM7 'Zo~ n ~~ NOTARY PUB~ My commission Expires ~d Nolarial Seal RosaJln Juarbe. Notaty Public Harrisburg. Dauphin County My Commission Expires Sept. '8,2000 ember, Pennsylvania Association of fa es SCHEDULE A REAL ESTATE FILE NUMBER ESTATE OF Floyd D. Nance (Property jointly-owned with Right of Survivorship must be disclosed on Schedule F) All real estate should be reported at fair market value with is defined as the price at which property would be exchanged between a willing buyer and a willing seller, nei1her being compelled to sell, both having reasonable knowledge of1:he relevant facts. ITEM DESCRIPTION NUMBER 21-02-1028 VALUE AT DATE OFDEATII ALL that certain tract ofland with the improvements thereon erected sitnate in Dickinson Township, Cumberland Connty, Pennsylvania Having thereon erected a two-story dwelling house known and nmnbered as 4338 Carlisle Road, Gardners, Pennsylvania 17324 BEING the same premises DD&M Corporation, a P A corporation, by its deed dated Jnne 3, 1974, and recorded in the Office of the Recorder of Deeds in and for Cumberland County in Deed Book Q, Volume 25, Page 329, granted and conveyed unto Floyd D. Nance and Shirley A. Nance, his wife, The said Shirley A. Nance died on November 9, 200 I, thus vesting full fee simple title in Floyd D. Nance, the decedent. Property sold (see settlement sheet attached) $94,000.00 TOTAL (also on line I, Recapitulation) $94,000.00 A. Settlement Statement U.S. Department of Housing " ,.. ~,. nu""_ 1. OFHA Z. OFmHA 3. i1Conv. Unins. I 6. FilcNumber !7.LoanNurnber I 8. Mortgage Insurance Case Number 4. nVA ' nc_. . ,_ OOOOTI>r C. Note: 1~.0IfI'l\a \o~l!:':'YW"\IlI.menl~!~cl;uJI..lIItni.nlco'\a.~~~p'dlo~~, ,".III.m~I'g.nl... lIWI'l. ltemlmlrklld"(p.o.t.)"w... p81dOOllld.lh.dollng:lh.y....hownh.l1Iforlnlormllion ~".and""noIlnC/l1d'd in\ll'lotala. WARNING: 11,. <;rim. to knowlngly mike f.I.. 'tlttmmll \o~ United Sl8\es on thI, or I allier a1mlllrform. PlnaI1illllpon D. NAME. OF BORROWER: ~eon~: G~~l;bm and Lisa M. G~rbill ,n ., 178" E. NAME Of SELLER: Estate of Floyd n.'.JN~~:~_. ,n" .n. r.,,,.,; On, " 17114 F. NAME OF LENDER: NO~~.~:~t ~::ings Bank I A 1. 1011: 1 . e tre:' Warr~" P 6':lH G. PROPERTY ADDRESS: 43~8 ~arlisle ~~~!:~ Gardners, PA 17324 , w H. SETTLEMENT AGENT: Campbell & White, Telephone: 717-334-9278 Fax: 7l7-334~1371 "'AC' "" ' <1 ;'.If, ,,;_,.,..,.. D' 1712' 07,..noO' Jell Rn~~n'^'E~'e T~^Ne^rTlnN. K. RllMMA~v , ER'e T~ANe^(,"ln". ,no ,no '"' Cn.'~"' .. 000.00 ~, 94 Goo.on ,no .no '" 2 745.28 ~, 'M '"' ,no ... ..~. .."". - -~.""- '"' 07 '18 '03 12'31'03 1.41 .". 07/19/031.112/31 '03 1.41 ,,,, 07/19/03 12131'03 97.35 .", c_. 07/18/03.~ 12131 (03 91.35 ". 07/18/03'~ 06/30/04 1 112.50 07/18103 06'30/04 1 112.50 ,,,. '''0 "''' HO '"' " '" <on ~on.. .u", '"' n, .< <o"u '7 956.54 "" ~on<. .u", "" no Ok Tn ... , <0. 95 211.26 ?nO '0610 RY('o. <no ..~ ,,, . 000.00 '01 ~, 75 200.00 .", ....00 22 071.32 ~. M' ...". .~ ,.. M' ~, ~ ~. 'M ,"' ~. ~" ~ .,--,- --,. .--'" .~,,- _'A ,.. '" ,.. ,.. ,.. ,.. ,,. '" ,., '" '" ,.. ",,, '" 220. MTM 7' 200.00 "''' ,nn, , "'''''"T 22 071.32 ,nn t'A<" AT ._"u. BOD. ~, .7 956.54 M. .5 211.26 m, ---. 7' 200.00 22 071.32 303. ,. 756 54 ~ 73 139.94 SUBSTITUTE FORM 111119 SELLER STATEMENT: The ItlfOl'l'NUOll conlainecl hereln Is ~ lax Inflllm&llon a"Id II belllll fUrnished to !he lnlemal Revenue Sei'\lce. lfyCIU are required Iome a fellRn. ~~o:'::c:::e:'p.~:,~~d:~~~lernls~lobel'8plll1ednllleIRSdelemirlet\halllhelnolbeenflpClfted. n.eConlrad$altlPflcedll8Clibe<lon =~~~~~~~r:~=~;=;~~=~b~o':monr~1j~SMDf"ExdlangegfPflnclpllResi~.IDfIn)'gak'l,wllI1yourlncQmllDflIh.m:lorolhlrlrl1lSIClkros, X=.~'=V~~~I~=~pII1lI~~~~~:Undlrlllnal_Ilf\lI::v~~~=~:':~~~~~~~~~=ce11011 TIN: SEllER(SJSIGNATU~S): SELLER(S) NEW MAIUNG ADDRESS: TitleExpress Settlement System Printed 07l1812003.t 10:10 REV. HUD-I (3/86) U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT File Number: 9009 SETTLEMENT STATEMENT "cp, ,- PA.IO FROM PAID FROM 700 7n7M 79 025.00 A 6.000 ~ 4 741.50 BORROWER'S SELLER'S nM., "0"" FUNDS AT FUNDS AT 7m. . 2 310.15 In CllmtuZ'V 21 Ne:l.ahborhood Real tv. Inc. SETTLEMENT SETTLEMENT ,,, . 2 370.75 B-H z'''en ",. GMAC Real Estate "7 ,..",., ,"' 4 741.50 BOO ITOM. 'IT" I nAN .0. % 00' ~ '" Ii> Northwest AD'Draisal Services fP.O.C. \ 275.00 Buver '" The Credit Bureau Ino. IP.O.C. 50.00 Buver .0. 00' .0. .. Fidelitv National Flood Sarv.;oe8 IP.O.C. \ 9.00 Buver "'" In Northwest Sav:l.nas Bank 250.00 0<0 '" OM ,......., "m'N 00' 0,", ..,.. 07/18/2003 08/nl/2003 ~. 11.2300 ,.._, 14 Davs 157.19 00' .. "'" ,"" 1 vear In (P.O.C.l 300.00 BUVIllr 00' ,~, 4 ~. 25.00 ,- 100.00 ,'''' 'm ,~, ~. ,- .To.~ 'mo ". 17.78 1m 106.fi8 ,~. ~, .>T. 2 ~. 88.63 1M 177.26 In Northwest Savina. Bank 121.10 ""' .~ ....~" ""' "0' .,~ "0. no .,-. In Cash 9.00 "n, , "n. .... Cam bell & Wh te 822.75 1103. 1104 , ,,~ 75 200.00 - 94 000.00 - 822.75 '''' 'o"~ 'MMn '0'000 In Camvb.l1 & White 150.00 "" CRmnball & White P.C. 15.50 C bell , White 35.00 "00' 38.50 ."- 64.50 .P. .. 103.00 '70' n.. u.940.00 '"n"o,~' 940.00 n......u: 940.00 ,"~". 940.00 .70 ,,,. ''"0, .= Caro1vn R. McOuillAn Coll 5.00 "M Ca.rolvn R. McOUillen Coll. 1 409.82 '''''''~., C "",hAll , White P.C. 14 975.00 '''' "AA 1400 'M' ,'M o~,. .."m...~'. ~ 2 745.28 22 071.32 HUD CERTIFICATION OF BUYER AND SCLLER. 'AA~~"",~_..HUD.' ...._, S._' ,"d .....""'''''~_,,.'''' ....,".....'"d"*"..~"''''.,~'..'''''...,_~".~d''"''''~~"'..,~ In\hlslrOlns8dlan.I'urthllrcertlfy""tlh8.-.rlIClIlvedaCQpyDflheHt)O.ISelllemenC~L ~ 1.t1<,,-,~ 00-. M ~}'''.~ Lecn Ii' UtaM.Grayblll' Estate D.Nance By: TitleElIpTessSettlementSvstem Prinled07/18/200Jall0:10 REV. HUD.l (3/86) SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANIOUS PERSONAL PROPERTY FILE NUMBER ESTATE OF 21-02-1028 Floyd D. Nance (All property joint1y~owned with Right of Survivorship must be disclosed on Schedule F) ITEM DESCRIPTION NUMBER I VALUE AT DATE OF DEATH 2 3 4 5 6 7 8 9 IO II Checking account no: 1982567-Adams County National Bank Interest accrued to date of death (see letter attached) $4,789.32 $2.00 Savings account no: 9618775-Adarns County National Bank Interest accrued to date of death (see letter attached) $53.20 $0.03 Savings account no: 5l48l54-Adarns County National Bank $40.00 US Savings Bonds - redeemed $22,948.36 1993 Chervolet Astro Minivan - sold $1,800.00 1985 Chevrolet Celebrity Stationwagon - sold $700.00 1992 Chevrolet SolO pickup truck - sold $3,000.00 Nationwide Insurance Co -- refund on car insurance $79.20 Misc. household property, furnitore and personal items $1,500.00 Comcast Cable TV - refund $8.74 Leon 1. and Lisa M. Graybill - reimbursement for real estate taxes (see settlement sheet attached to Schedule A) $1,211.26 TOTAL CaI", on line 5, Recapitulation) $36,132. II .~ ADAMS COUNIY NATIONAL BANK December 9, 2002 Andrews & Johnson Attorneys at Law 78 West Pomfret Street Carlisle, PA 17013 Re: Estate of Floyd D. Nance Dear Mr. Johnson: The following information is being provided as per your request: Acct. Type Acct. Acct. Ace. Int. Ownership Date Number Principal to D.O.D. Opened On D.O.D. Checking 1982567 $4,789.32 $2.00 Individual 1-1-74 Savings 9618775 $53.20 $.03 Jt. wi Shirley 1-1-74 Savings 5148154 $40.00 N/A Individual 11-1-92 IRA 4604709-2 $2,340.87 $9.44 Individual 3-9-99 IRA 4604709-4 $2,322.54 $13.24 Individual 11-26-01 Loan 8612765 $13,900.08 $25. 13 Jt. wi Shirley 7-30-98 Loan 8635897 $11,381.61 $67.35 Jt. wi Shirley 3-13-00 These loans may be covered by Life Insurance held with the banle Please contact Sue Saylor at (717) 338-2255. Inquiries concerning ACNB Corporation stock information should be directed to the Registrar and Transfer Company at 1-800-368-5948. If you need any additional information, please feel free to contact me. Sincerely, 'I1t;to (1. K ~ Lois A. Kime Deposit Services SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Floyd D. Nance Joint Tenant (8): NAME 21-02-1028 ADDRESS RELATIONSHIP TO DECEDENT A B C Julia A.M. Nance 6 Franklin Street, Mt. Holly Springs, P A 17065 Daughter Jointlv-owned DIonertv: ITEM LEITER DATE DESCRIPTION OF TOTAL DECD'S DOLLAR VALUE OF NUMBER FOR MADE PROPERTY VALUE % INT. DECEDENT'S JOINT JOINT OF ASSET INTEREST TENANT 1 A 1998 1988 DeRose Mobile Home- 14' x 70' (see NADA appraisal attached) $8,708.93 50% $4,354.47 TOTAL (also 00 line 6, Recapitulation) $4,354.47 N.A.D.A. APPRAISAL GUIDES (THIS IS NOT AN APPRAISAL FORM) BOOK VALUE FORM Date: 1/1412003 Reference Number: 011I08 LoealIon: H8rr1oburg, ~A Guide Edlllon: Sep-Dee 2002 VoorMfII'd 1888 MlnufllCturer DE ROSE Trad. Nome AMHERST (sgl) eve Quellty: i lUXUry ! Oetuxe I~ Standard [" Economy 1:J Commerclal Model.": i Park MOdel Floor Are.. (Slngl..Wlde) Main Ftoor ChorINe 289 "'~lh length 14 X 70 $8,378.00 2. Stale Location Acljultmonl: .u_m._.._m.........._.......u.mm_......_._m......_u_m._.....m.m.um_. X NlA $8,37S.DD 99% $8.284.22 105% $8.7011.93 1. a... Book Val... ..___..........n................_n____................_......._u...._................_..........0 3. Total GuIde Book Retail Value (in awrage condltlon): . ...... .n........... .n...._.... ... ........__..... ..._00" 4. Condition Adjustment: ..._.~..~~~~~_tn_.~.~mJL~~_....~).':~l~n........~~!......_'__~~__.... X 5. COndItlOn AdJUl1Ild Value: h..........n....n.............uu............n..................n......._............ 5. Community Altustment: JJ._~~~~.~_._l-J..~~.t.J.!.~~....u._:..!..!r....m.~~~~..u!..."!I~.._... X 7. COmmunity Adjusted Value: __o____........_n....._........___...__._..___.................no_...............___.... 8. Total AdJuoted v..ue of Homo __.....n...Oun.......................................--....n......._........... $8,701.83 9. COmponents $0.00 10. Acceasorles $0.00 11. AOdlllveValues so.oo 12. Total AlII.atod V.tue of Home end Optlol1lll Equipment $8,708.8$ 13. Wholes.1e Value C Conllgnmenl I PurcheaG i Moved fer Resale '0{' NIA Comman1s: COmplel8d By: Mlryanne PII1< CDpyright Cl2OO2 by Nltlol\al Appr81..1 GuIde.. Inc Form "1CD Updated 1100 V.P. Page 1 of 1 SCHEDULE G T ANSFERS ESTATE OF FILE NUMBER Floyd D. Nance 21-02-1028 This schedule to be completed and filed if the answer of the auestionon the reverse oCtile cover is yes. ITEM DESCRlPTION EXCLUSION TOTAL VALUE DECD.% DOLLAR VALUE NUMBER OF ASSET !NT OF DEeD. !NT I IRA-Scudder US Gov't Securities Fund-A-transferees are Michelle D. Lucas (50%) and Julia A.M. Nance 50% (see statement attached) $22,342.52 100.0% $22,342.52 2 IRA-Scudder Total Return Fund-A- transferees are Michelle D. Lucas (50%) and Julia A.M. Nance 50% see statement attached) $12,203.01 100.0% $12,203.01 3 IRA-Adams County National Bank 4604709-2(see letter attached to Schedule E and letter attached to Schedule G for beneficiary - Julia A.M. Nance) $9.44 100,0% $9.44 4 IRA-Adams County National Bank 4604709-4 (see letter attached to Schedule E and letter attached to Schedule G for beneficiary-Julia A.M. Nance) $13.24 100.0% $13.24 TOTAL (also on line 7, R.capitulatiOll) $34,568.21 . ~ :- ~ '" ~ g 'R .. . I~ , :::: ;J> l! ~ n n <(2"11 ~i~~iff 0 c: ... III Il~ " ::, r r ~ ~ ~g~~jfl < "/l! i co I'l 1~lD: 93,.......JJ Ie:: ~ .. "'en 0 ""'" f ~ ; ..!. ,.., ~fii~~~iJ ~ ~ B ~~ tl '" :;j ;r;Jt:l !:!l til' I " " " i::llI Ii 0:> ~[\lJil-" r'!i~~ ~ i lD_ ~ ~ ~=S i "'Z - l!l ~ t:; f "'< ~ lif ~:..~~ r !~ < ... - Z .. lir !Ii; " k'l~ ~,f -< S ." ~. n - :l lot i ~ g' llm i CD ~~ i~ ~ -1& .g' I , > ii' CD II! if 0 f! ~ 3'1~ I ~. 3 !i p;~ [ II if I: ~~ . " ~ '0 _ -c: ~~ iii..:: 'n~ III !!. 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[ fIi Ja If ! \ l'l l'l !!l ~ ; ~ f:'l . !l - n '\ S II " 0 88 1!i II ~ 8 i Q I r ~ . i - K . . S . . . .. " . . l ~ i " . . . !Il:1 . .. ~ . 0 8 g ~ .., .... "J ~ ~ '" l: ~ '" ':;, " s 0, ~ ~ ., h e ~ ~ ~, ~, g - ,:Il lia c :3 H '0 Il;' '" '" l~ -;g: ~I[ I\~ :~ '::X: &IJl -,~ :!;il::! !i il -~ :g ':!- i- ,a !~ l~ - - ~ ... ~ ,,, ~ ~, (. i i _ ITI i :f f if ~ g ~~ ~ tl ~( I, i- h ~ il! ~ [ oi ~ ;. ~ l ~ ~ ' <ll j !i~l ~ifo ~..t U" J. r It ~-'" "'.. """,,- -~' -.:: i~~~1 i fill ..,ri I ~.. "t i i~~~ i ~~ ~ I i S?~~Eilf ~~~~i;i m~;!l"iiF~f ~!!i~ilgi t,. :: m g ~ ~iii:l I ~ ~ ~ ~ ~~ i ! ~ ~> ~ t . ~ 2 n a- lii " -i 2ii i ~.. i I S; cl ~ i ~ "c: ~Si! i!rli ,,= il Om ~~ ill: i.~ "'tfj . >' a:I (") ;. ! II: ~ I ::. .l! ~ ct Ili:= I! <: i: g , ,. " " g .. <: ., c- n r;r '< o '" " i - 5!, I~ Vi,iOll - BenefIciary & Contribution Details ~'''1 '\ " J~ \ 1:-_ 11. MV Asgts T ~v Jlt:tdfo-li'Os. .:[';.,.~,,;;n. MrA$~'S~ ':'.'!"'-<:n.<<t-'S~~':;"'IX.(io;.lllti)v&"..ae.. Benef'lCiillY .. Contribution Details SGIDlER INVESlMENTS - "II C&MNYfoIl(f _b ~~"'. ~~ -'ra~.~ ~1t'lt.H\CItn ~fY a. ee.t.......... ...... 2DD2 Tall: c.........!:I: >91.1:.. -..... ~-'lIIIu'A. .&ciaMtnt _: $f~6C24 .. .-: 6lPlm.n1AET1 ~ID/$SII:. SD1-34.-:u.aJ ..illr....n:: .fICl.JtllEFlvt..5T COMPANl" Ctl$T IItIoAJCFl.D'i'QO.........a: 433B C4AUSU:AO GlIlRDl'ERs'PA 173af-8!lQf Retirement Ac::count Detail. Sha-rdlgldlY..rItI O;llt.e: fl3f"D't900 ~M~Stiltll!i:~ Retil'r....cnt Aaaunll'nle: I8N529 Uatailiul:ilm: ~.AmoorJt Beneficiaries .. _~.. 1......1....'... ....... MICHElLE 0 L.UCAS .lJUA A AI HAtJCE TO SHARE 50 PERCENT EACH _... Secondary beneficiary inlonnaton ie q Oft 'file. Flnancfat SURlmary Contri...~s: -Em"""<er! .Em~Qyl!l!. C".attltal~, Di"'den-lH: 'lNlthc:trawal-s; -ltlJntAlI:ii1t1te: .T~~k:; IVttht)al1l1ncJS: 1 I ..._ QI: SCUIlOEfI NYe;TlUr;:NTS . A e-c J, "'" un ".... ......; 5C\IDDeR USOOVERNIIfNl SECURITiES-RhD. A V~_f\lM4I_~ FtINI Codr. 1il1 TkUr. KlJ&I,X. ......... SII8Mr. .0IlCD CUS.: 1I11ft..10!li ~ftt "-'- .co_l>> TINI"-Tc-Daw 51HIO SIIOll ro.oo S!l9'2 so'" so 00 so 00 https:J/www3,financiaJtrans,comltfNision'?&urlseq=5 R$ticn!if1. Tme IOISSN 0"', 181-G2-0939 P.lgt' J of 2 ...../ scuan;.a. X..ft5T1IEIITS _ ... C. "NY "NT -- OIl&gnillfll ~ -..,- D."........ lrIa::ptiatl-T,,-o.te ~ltSy_ $lIto s;!I.12f.57 so.oo "'.00 so 00 51;134.15 so.oo $000 ..00 5115/2003 May 29, 2003 Andrews & Johnson Attorneys at Law 78 West Pomfret Streeet Carlisle, PA 17013 Re: Estate of Floyd Nance Dear Mr. Joh.'lSon: In response to your letter concerning the above named estate, the amount of interest that was reported for the 8avings Bonds for 2003 was $19,667.11. The primary beneficiary of the IRA was Shirley Nance and the secondary beneficiary was Julia Nance. If you need any additional infonnatioIl, please feel free to con'!act me. Sincerely, 'it tJ1A (1. f) ~ Lois A. Kiroe Deposit Services SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES ESTATE OF Floyd D. Nance (All property jointly-owned with Right of Survivorship must be disclosed on Schedule F) ITEM NUMBER A. I 2 B. I 2 3 4 5 6 7 8 9 IO II 12 13 14 15 16 17 18 19 DESCRIPTION Funeral Expenses: Hollinger Funeral Home & Crematory, Inc. Administrative Costs: Personal Representive Commissions to Michelle D. Lucas Social Secority Number of Personal Representative: Street Address: 7 Yankee Drive City: Mt. Holly Springs STATE: PA ZIP: 17065 Attorney fees to Andrews & Johnson Family Exemption Claimant Relationship: Address of Claimant at decedent's death: Street: City: State & Zip Probate Fees to Register of Wills Accountant's Fees Tax Retnrn Preparer's Fee to Patricia Rosendale, CPA-fiduciary retnm Andrews & Johnson - reimbursement for cost of short certificates Members 1st FCU - check charge Triple H. Farms - trash removal from real estate Met Ed - electric bill Nationwide MutnaI Fire Insurance Co. - homeowners premium B-H Agency - real estate commission Centnry-21 - real estate commission Recorder of Deeds - I % transfer tax Carolyn R McQuillen, Tax Collector - county/twp/school taxes & certification Septic replacement and roof repairs (for items 12-16 see settlement sheet attached to Schedule A) Met Ed - electric bill Register of WilIs-P A Inheritance Tax Retnm - filing fee ReselVe for closing and accounting TOTAL (also on line 9, Recapitulation) FILE NUMBER 21-02-1028 AMOUNT $7,418.40 $6,200.00 $6,200.00 $269.00 $200.00 $30.00 $7.25 $845.00 $20.14 $265.50 $2,370.75 $2,370.75 $940.00 $1,414.82 $14,975.00 $45.14 $15.00 $400.00 $43,986.75 SCHEDULEr DEBTS OF DECEDENT MORTGAGE LIABllJTlES AND LIENS ESTATE OF FILE NUMBER Floyd D. Nance 21-02-1028 ITEM NUMBER DESCRIPTION AMOUNT Cumberland County Tax Claim Bureau - delinquent 2002-03 school r.e. taxes $1,216.90 2 Met-Ed - outstanding electric bill $630.33 3 Corneas! - outstanding TV Cable bill $59.33 4 Sears - outstanding credit card bill $898.86 5 Dept. of Veterans Affairs - outstanding medical bill $231.63 6 Carolyn McQuillen, Tax Collector, 2002 personal school tax $11.00 7 Adams County National Bank loan number 8612765 Interest accrued to date of death (See letter attached to Schedule E) $13,900.08 $25.13 8 Adams County National Bank loan number 8635897 Interest accrued to date of death (See letter attached to Schedule E) $11,381.61 $67.35 TOTAL (also on line 10, Recapitulation) $28,422.22 SCHEDULE J BENEFICIARlES ESTATE OF FILE NUMBER Flovd D. Nance 21-02-1028 ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE NUMBER OF ESTATE I MicheUe D. Lucas daughter 50% of residue 7 Yankee Drive, Mt. HoUy Springs, PAl 7065 2 Julia A.M. Nance daughter 50% of residue 6 Franklin Street, Mt. HoUy Springs, PA 17065 3 Ashley N. Conklin grandchild $1,500.00 7 Yankee Drive, Mt. Holly Springs, PA 17065 4 Morgan Renee Lucas grandchild $1,500.00 7 Yankee Drive, Mt. Holly Springs, P A 17065 5 Dornnick C. Nance grandchild $1,500.00 6 Franklin Street, Mt. Holly Springs, P A 17065 6 Dalton Jonathan Lee Barclay grandchild $1,500.00 6 Franklin Street, Mt. HoUv Snrinus, P A 17065 ITEM NAME AND ADDRESS OF BENEFICIARY NUMBER AMOUNT OR SHARE OF ESTATE B. Charitable and Governmental Bequests: TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (also enter on line 13, Recapitulation) $0 Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 12/01/2004 CONKLIN MICHELLE N NKA 7 YANKEE DRIVE MT HOLLY SPRINGS, PA 17065 RE: Estate of NANCE FLOYD D File Number: 2002-01028 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. 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 will become delinquent on: 11/12/2004 Your prompt attention to this matter will be appreciated. Thank You. Si~fcerely~~ ~ GLENDA FARNER STP_ASBAUGH REGISTER OF WILLS cc: File Counsel Judge Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 10/10/2005 CONKLIN MICHELLE N NKA 7 YANKEE DRIVE MT HOLLY SPRINGSr PA 17065 RE: Estate of NANCE FLOYD D File Number: 2002-01028 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULESr NO. 103 SUPREME COURT RULES DOCKET NO. 1r for decedents dying on or after July 1r 1992r the personal representative or his counselr within two (2) years of the decedent's deathr shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 11/12/2005 Your prompt attention to this matter will be appreciated. Thank You. SincerelYr I~E V ~~..L~-U~~ GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Counsel Judge 'L-. {r JRD/June 30, 1992/)7858 DEe 1 2 2005 In Re: Estate of Floyd D, Nance Late of Dickinson Township pn ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA t.oOl. NO. 21-2600:1028 Estate No.: 21-2002-1028 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: Michelle N. Conklin nka Michelle D. Lucas Counsel for Personal Representative: Date of Decedent's Death: 11/12/1999 Date of Delinquency Notice: 11/12/2005 The undersigned, Glenda Farner-Strasbaugh, Clerk of Orphans' Court, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on October 10,2005, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 12/12/05 "h/~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File A hearing is scheduled for February 27, 2006 at 11:00 a.m. in Courtroom No.2. If the Status Report is filed prior to the hearing date, the hearing will automatical~ cancelled. ~ ~.;:., ~ ;;~:;, .,.rt~'...).., !."{ ..." \A ~~ ~y ~ ~ __~__h'L___,.,c _,..Jt""':'t""'T"~l1ii_ -..1f:.n.....,____'E_.--....,il---...:;:r 0__....""'l--'-c-_ ~\~:::;Jl.:3li,.ltlr lIJIJl. '1/"1 JUllL:'5i \(Jill I!.JIULlUJ.JlIUlItJC.Il.i::ilJ1JJ.u. 'LAUJiU.ii.li.U.j Name of Decedent: STATUS REPORT UNDER RULE 6.12 t- \ o~A \~ \\ Cvrv-" CJ::__ \ ~. ~OO~}-- I Date of Death: ~ [) \..) ~ ~{) (' Estate No.: ;) \ - Od. - \ oJ t=) . Pursuant to Rule 6.12 ofthe Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State wh~r administration ufthe estate is complete: Yes [g" No 0 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 ~sonal representative file a [mal account with the Court? Yes b:::J No 0 b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the person~ r5Presentative state an account informally to the pCL.'iies in interest? Yes l::::::r No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. ~\,\\~\~ \~~~B~cu-o-) Signature Date: \ d-~Q -OS: '!" '0\ \ ~ ~ -e.- \ \ <: -\::) l G--c 0-c2--" Name ~ \J-JV\ \(ee \:) (' ~l\1 \~l~~r(N ( llo~ ~ Address ~ l\ 9\0 - y ti q 1 Telephone No. Capacity': @Personal P,-epresentative o COllTISel for perso:nal rep:reserlt~ti\le \(~.