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HomeMy WebLinkAbout04-1163 PETITION FOR PROBATE and GRANT OF LETTERS Estate of To: also known as Register of Wills for the Deceased. County of Cumberland in the Social Security No. 2 0 3- ~ O- 4 6 5 Z Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: years of age older a~ the execut or 19n~d Your petitioner(s), who is/are 18 or in the last will of the above decedent, date~- 3une - ~ , and codicil(s) dated Steven Howell,--E~q~-~'~med as alternate executor in ~8. Madeline C. Bartley having predeceased on 2/25/03. (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h 5 s last family or principal residence at BoFhany VJ ] ] ~go (IIppor A]] on ww~hp) 5225 Wi!=~ Lane, Mechanicsburg, ~'~]=~ o~-~y, Dan .... 1 7055 (list street, number and muncipality) Decendent, then ~q . years of age, died Do~omhor a6; 200~ 19 ., at B~eh=~,, xr~ 1 I aga Exc~~o~s~de~ did not marry, was not divorced and did not have a child horn 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 $ 80; 000: ~0 - (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ 50 e 000.00 situated as follows: Union Deposit Road (Lot) WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) TESTAMENTARY presented herewith and the grant of letters (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) ~l~l ~*~ n~ I 7070 ~ o F't'] rtl OATH OF' PERSONAL REPRESENTATIVE -> o COMMONWEALTH OF PENNSYLVANIA COUNTY OF ~ ~ [~d . } ss The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petiti~(s) anti. at as personal represen- tative(s) of the above decedent petitioner(s) will well and~ estate according to law. Sworn to or affirmed and subscribed / bofo~ me th~ c~K day of [ / ~ ' ~ R,g,ster~~ No. Estate Of GEORGE C. BARTLEY , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW 19 , 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_ June- 7.. I 9~5 described therein be admitted to probate and filed of record as the last will of GEORGE C. BARTLE~ ; and Letters ~'-"~'~X~-~~ TESTAMENTARY are hereby granted to STEVEN HOWELL Of Wil~ Register FEES Probate, Letters, Etc .......... $ .......... Renunciation ................ $. 6 $' ADDRESS TOTAL .. $ 619 Bridge Street New Cumberland, PA 17070 Filed ................................... PHONE (717) 770-1277 Voice (717) 770-1278 Telecopier his is lo certify that Ule i~d'ormafion here given is corrccdv coph:d from :m original cerlificate of death duly filed with me as Local Registrar. The origival certificate will be forwarded t~ the State Viral Records Office for permanent filing. W~I~G: R is illegal to duplicate this cop~ ~ photostat or photograph. /~' - ~ ~X~ Local Registrar ~ ~,' ~ ,~ No. ~~ Date Rev ~87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS '~) *~ 0 --~ CERTIFICATE OF DEATH .-)t~ ~ STATE ~ILE NUMBER ~ e · I.. NAME OF DECEDENT iF .... , ........ , SEX SGCIALSECURI~ NUMBER -~ ) DATEOFO~,Mcn~ ~e~ WERE AU~PSY FINDINGS MIMANNER OF OEATHA~H / DATE OF INJURY TIME OF INJURy INJORY AT ~RK? IOESCR*eE H~ INJURY I · ..0,~......,...,~o.o...o. '"'"'"""'°'"""'d i.O~s *~ .......... '"'" ................................................................................................. ~,,. '~'~- /~ ~o. ~y~ ~r~ LAST WILL AND TESTAMENT GEORGE C. B~TLEY I, GEORGE C. BARTLEY, of Mechanicsburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby revoke all other wills and codicils heretofore made by me. FIRST I direct the payment of my debts not barred by a statue of limitation and expenses of my last illness and funeral from my estate as soon atter my death as conveniently may be done. If there be no cemetery lot available for my interment, owned by me at the time of my death, I authorize my personal representative to purchase such cemetery lot with a contract for perpetual care, using funds from my estate, in such mount as she shall consider necessary and desirable, and I authorize my personal representative to cause title to or ownership of such lot so purchased to be vested in such person as my personal representative shah designate. Further, in this connection, I authorize my personal representative to expend funds from my estate, in such amount as my personal representative shall consider necessary and desirable for the erection and inscription of a suitable marker for my grave. SECOND I give and bequeath all real estate and personal property owned by me at the time of my death, together with all insurance policies naming my Estate as beneficiary, to my spouse, MADELINE C. BARTLEY, if she survives me by thirty (30) days. THIRD Should my spouse, MADELINE C. BARTLEY, fail to survive me by thirty (30) days, I hereby make the following specific bequests to be distributed from the residue of my estate: (a) Fifty thousand dollars ($50,000.00) to the Pennsylvania State University, University Park, Pennsylvania 16802, College of Medicine, Hershey, Pennsylvania, for the purpose of establishing an endowed fund for the granting of scholarships in the names of George C. Bartley and Madeline C. Bartley, to students of the College of Medicine who have demonstrated academic merit and financial need; (b) Fifty thousand dollars ($50,000.00) to the Pennsylvania State University, University Park, Pennsylvania, 16802, College of Agriculture, School of Forest Resources, for the purpose of establishing an endowed fund for the granting of scholarships in the names of George C. Bartley and Madeline C. Bartley, to students of the School of Forest Resources, who have demonstrated academic merit and financial need; (c) Fifty thousand dollars ($50,000.00) to the Harrisburg Area Community College, 3300 Cameron Street Road, Harrisburg, Pennsylvania, for the purpose of establishing an endowed fired for the granting of scholarships in the names of George C. Bartley and Madeline C. 2 09-13-2005 BARTLEY 12-16-2004 21 04-1163 CUMBERLAND 101 APPEAL DATE: 11-12-2005 ( See reverse side under Objections) AIIIoun1: Rl!llli tted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE _ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REy:is47-Ex-AFP-io3:osi-NOTICE-OF-INHERITANCE-TAX-APPRAISEMENT:-ALLOWANCE-OR--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX GEORGE C FILE NO. 21 04-1163 ACN 101 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ~=(''':'rII\!!!l\ICE:iDffl~RITANCE TAX lP""AIllEHa.'F';. 'A.~i,'u~NCE OR DISALLOWANCE llF~llEbUG!i:ONs';AM.It. ASSESSHENT OF TAX 3 0" LODS SE? I' I n \: [PiTE ESTATE OF DATE OF DEATH FILE NUMBER . -COUNTY "ACN ."'1 STEVEN HOWELL ESQ HOWELL LAW FIRM 619 BRIDGE ST NEW CUMBERLAND (" PA 17070 ESTATE OF BARTLEY *' REY-1547 EX AFP (06-05) GEORGE C TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED DATE 09-13-2005 RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Re.1 Estate (Schedule A) 2. stocks and Bonds (Schedule BJ 3. Closely Held Stock/Partnership Interest [Schedule C) 4. Mortgages/Notes Receivable (Schedule DJ S. Cash/Bank Depositsnlisc. Personal Property (Schedul. E) 6. Jointly Owned Property ISchedule F) 7. Transfers (Schedule G) 8. Tot.l Assets 11) (2) (3) (4) (5) (6) (7) 69,648.10 75.327.25 .00 .00 60.325.99 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad.. Costs/Hisc. Expenses [Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tex Return 13. Charitable/Governnental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 33,506.67 7.438.70 (11) (12) (13) 114) NOTE: To insure proper credit to your account, ~it the upper portion of this forB with your tax pay_nt. 205,301. 34 40.Q41i 37 164,355.97 164,355.97 .00 NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. A~unt of Line 14 at Spousal rat. (15) .00 X 00 = .00 16. A.o'--lt of Line 14 taxable at Lin.al/Class A rete (16) .00 X 045 = .00 17. Aeount of Line 14 et Sibling rete (17) .00 X 12 = .00 18. Amount of Line 14 taxable at Collateral/Class Brat. (18) .00 X 15 = .00 19. Principal Tax Due (19)= .00 T T : DATE IlUHBER + INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ( IF TDTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. \ Q/ IF TDTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAY BE DUE ~ V A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. BaRley, to students of the Harrisburg Area Community College, who have demonstrated academic merit and financial need; (d) Fifty thousand dollars ($50,000.00) to Lebanon Valley College, Annville, Pennsylvania, for the purpose of establishing an endowed fund for the granting of scholarships in the names of George C. BaRley and Madeline C. BaRley, to students who have demonstrated academic merit and financial need; (e) Seventy-Five thousand dollars ($75,000.00) to Tuan Tran, who has been like a son to myself and my spouse especially when he was a student at Milton Hershey High School, and now resides at 3712 Colorado Street, West Covena, California, 91792, and if he predeceases me, this bequest shall revert back into the residue of my estate; (f) Fffieen thousand dollars ($15,000.00) to my wife's cousin, Iva Daetwyler Sim~, now of Charlotte, North Carolina, and if she predeceases me, this bequest shall revert back into the residue of my estate; (g) Fifteen thousand dollars ($15,000.00) to my wife's cousin, Betty Daetwyler Kent, now of Pride, Louisiana, and if she predeceases me, this bequest shall revert back into the residue of my estate; (h) Fifteen thousand dollars ($15,000.00) to my wife's cousin, Dr. Calvin Daetwyler, now of Houston, Texas, and if he predeceases me, this bequest shall revert back into the residue of my estate; (i) Fifteen thousand dollars ($15,000.00) to my wife's cousin, Dr. William Cassell, Sr., now of Atlanta, Georgia, and if he predeceases me, this bequest shall revert back into the residue of my estate; 3 (j) Five thousand dollars ($5,000.00) to the Helen Opperman Krause Animal Foundation, Inc. (HOKAFI), Post Office Box 311, Mechanicsburg, Pennsylvania, 17055; (k) Five thousand dollars ($5,000.00) to the Humane Society of Harrisburg, Inc., 7790 Grayson Road, Harrisburg, Pennsylvania; (1) Ten thousand dollars ($10,000.00) to the Salvation Army, 1122 Green Street, Harrisburg, Pennsylvania; (m) Five thousand dollars ($5,000.00) to the Boys Club of Harrisburg, 1227 Berryhill Street, Harrisburg, Pennsylvania; (n) Five thousand dollars ($5,000.00) to the Volunteers of America, 2100 North Third Street, Harrisburg, Pennsylvania; (o) Twenty thousand dollars ($20,000.00) to the Harrisburg Masonic Consistory, Heritage Builders Fund of the Harrisburg Consistory, Ancient and Accepted Scottish Kite of Free Masonry, Harrisburg, Pennsylvania; (p) Five thousand dollars ($5,000.00) to the Harrisburg Symphony Society, 128 Locust Street, Harrisburg, Pennsylvania; (q) Five thousand dollars ($5,000.00) to the Harrisburg Choral Society, Pine Street Presbyterian Church, Harrisburg, Pennsylvania; and (r) Ten thousand dollars ($10,000.00) to World Vision, Pasadena, California, 91131. Each of the beneficiaries named above in ¶ 3 shall receive the entire amount shown UNLESS there is an insufficient amount to accomplish all the bequests. If an insufficient amount 4 SIXTH In addition to the powers conferred by law, I authorize my Executrix, in her absolute discretion: (a) To retain in the form received, and to sell either at public or private sale any real or personal property. (b) To manage real estate. (c) To invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principle of diversification. (d) To exercise any option or rights arising from ownership of investments. (e) To compromise claim~ without court approval, and without the consent of any beneficiary. SEVENTH Any and all payment or payments of any sum or sums, whether in cash or in kind and whether from principal or income, shall be made upon the sole receipt of the respective individual to whom the payment is made, and free from anticipation, alienation, assignment, attachment, and pledge, and free from control by the creditors of any such beneficiary. All shares of principal and income herein given shall be free from anticipation, assignment, pledge, or obligation of any beneficiary, and shall not be subject to any execution or attachment. EIGHTH I nominate, constitute and appoint my spouse, MADELINE C. BARTLEY, Executrix of this my Last Will and Testament. I hereby relieve my Executrix from the necessity of posting any security or bond in connection with her duties as such in any jurisdiction in which she 6 may be called upon to act insofar as I am able by law to do so. In the event MADELINE C. BARTLEY is unable or unwilling to serve as my Executrix, I appoint my attorney, STEVEN HOWELL, as my alternate Executor. I hereby relieve my alternate Executor from the necessity of posting security or bond in connection with his duties. may be called upon to act insofar as I am able by law to do so. In the event MADEL1NE C. BARTLEY is unable or unwilling to serve as my Executrix, I appoint my attorney, STEVEN HOWELL, as my alternate Executor. I hereby relieve my alternate Executor from the necessity of posting security or bond in connection with his duties. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of nine (9) type written pages, the first six (6) of which bear my signature in the margin for the purpose of identification, this t7 "~day of ,TO/u/~_ ,1995. BARTLEY ff COMMONWEALTH OF PENNSYLVANIA · · SS. COUNTY OF Cctr~3 e~t~aa0 · I, GEORGE C. BARTLEY, 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 instmmeut as my Last Will, that I signed it willingly, and that I signed it as my free and voluntary act for the purpose therein expressed. /GEOR~E C. BARTLEY/J 7 Sworn or affirmed to and acknowledged before me, by GEORGE C. BARTLEY, the Testator, this ,~-X.-- day of ~ , 1995. Signed, sealed and published and declared b~ ~t"~'~~d for this Last Will and Testament, in the sight and presence, who at his request, in his sight and presence, and in the sight and presence of each other, have hereunto subscribed our names as witnesses. Jw¥ a(s-s t~I~S - COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF~ C_ ct,~4 e,e_A-,vt9 : We, the undersigned, being the witnesses whose names are signed to the attached and foregoing instrument, 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 and Testament, that he signed it willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Last Will and Testament as a witness; and that to the best of our knowledge the Testator was at that time eighteen (18) or more years of age, of sotmd mind and under no constraint or undue influence. '7~ Swol~ or affirmed to and subscribed before me by the above named witnesses, this ay of ~~ ,1995. NOTARIAL SEAL ~RA L SWAU6ER, Notary ~blic Upper AE~nTwp Cumberl~n~ Co PA My Common,mn E:?~r~ ~arch 16. 9 CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) In re Estate of George C. Bartley, Deceased Date of Death: December 16, 2004 Administration Number 2004 - 01163 (21-04-1163) TO THE REGISTER: I hereby certifY that notice of the 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 mentioned estate on January 4, 2005. Name: Janet Stafford, Planned Giving Officer The Pennsylvania State University Office of University Development Office of Planned Giving and Endowments 102 Old Main University Park, PA 16802 (814) 865-0872 or 1-888-800-9170 Office ofthe President Harrisburg Area Community College One HACC Drive Harrisburg, PA 17110 (717) 780-2300 Sue Borelli Planned Gifts Lebanon Valley College 101 North College Avenue Annville, P A 17003 (717) 867-6322 or 1-800-448-3582 (") ~o r:g~o i'~ ~i; h=1 ."E2'5~ ")("-'0 ~,O-n "J(- .. Xi -j Tuan Tran 1134 West Quince Street Ontario, CA 91762 (909) 437-8941 Iva Daetwyler (Deceased) Charlotte, NC ....., = = c.n <- """ :z: I U1 -0 ::;: =~ n'10 (7)0 "'~,"' -.J':J ::.::..-1i'J rei t=-n CUe:> o . ..=-;:1 f:-i;~ (7.>10 - :'i, .: Cl C"l ) I Betty Daetwyler (Deceased) 14722 Pt. Hudson & Pride Road Pride, LA 70770 Calvin Daetwyler 1931 Prism Lane Houston, TX 77043 (713) 461-3230 William Cassell, Sr. P.O. Box 206 Dacula, GA 30019 (770) 945-4751 Helen Opperman Krause Animal Foundation (HOKAFI) P.O. Box 311 Mechanicsburg, PA 17055 (717) 697-3377 Humane Society of Harrisburg Area 7790 Grayson Road Harrisburg, P A 17111 (717) 564-3320 The Salvation Army 1122 Green Street Harrisburg, PA 17102 (717) 233-6755 Boys Club of Harrisburg 1227 Berryhill Street Harrisburg, PA 17104 (717) 234-3268 Volunteers of America Regional Office 2112 Walnut Street Harrisburg, PA 17103 (717) 236-1440 IN RE: GEORGE C. BARTLEY, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS COURT DIVISION NO. 21-04-1163 DOD 12/16/04 SSN 203-10-4652 INVENTORY OF THE ESTATE OF GEORGE C. BARTLEY, DECEASED Personal representative of the above Estatc, deceased, verifies that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and the Decedent owned no real estate outside of the Commonwealth of Pennsylvania cxccpt that which appears in a memorandum at the end of this Inventory. I verify that the statements made in this Inventory are truc and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S.A. Scction 4904 relating to unsworn falsification to authorities. Name of Attorney: Steven Howell, Esquire By: ID Number: 62063 Address: 619 Bridge Street New Cumberland, P A 17070 Telephone: (717) 770-1277 Personal Representative: Steven Howell, Esquire By: Date: July 1, 2005 1. Description of Asset Proceeds from Zeigler Auction Company $1,450.00 (6/9/05 Check) $ 868.86 (5/16/05 Check) $ 123.75 (6/29/05 Check) $2,442.61 Erie Insurance Refund Check (6/16/05) Capital Self Storage Refund Check (5/31/05) Pennsylvania Employees Benefit Trust Refund Check (5/23/05) Real Estate Sale of Hummelstown Lot (4/25/05) Federal Employee Lump Sum Dcath Benefit (4/4/05) Raab Collection (4/4/05) Met Life Insurance Proceeds (4/4/05) Federal Employees Group Life Insurance (3/29/05) PNC Bank (3/21/05) 2. 3. 4. 5. 6. 7. 8. 9. 10. Value $ 2,442.61 $ 90.00 $ 135.83 $ 153.46 $ 69,648.10 $ 4,714.13 $ 3,000.00 $ 1,540.67 $ 3,765.26 $ 1,211.48 II. Met Life Insurance Proceeds (3/10/05) 12. Harman's Coins (3/18/05) 13. Bricker Auction Service (317/05) 14. Cumberland County (2/24/05) 15. Clark Coins (2/24/05) 16. The Sun Newspaper Reimbursement (2/15/05) 17. Janney Montgomery Scott (2/1105) 18. Federal Employees Life Insurance (1/13/05) 19. Janney Montgomery Scott (1/5/05) 20. The Patriot News Reimbursement (1/5/05) 21. PNC Bank (1/5/05) 22. Currency (Cash and Non-Collectible Coins) $ 30.00 (4/4/05) TOTAL $U65.49 (12/28/04) $1,395.49 $ 2,777.74 $ 3,900.00 $ 820.00 $ 100.00 $ 250.00 $ 14.00 $ 1,015.00 $ 30,741.25 $ 74,312.25 $ 177.20 $ 3,096.87 $ U95.49 $205,301.34 Respectfully submitted, BY: St en Dwell, sq Ire 19 Bridge Street New Cumberland, PA 17070 (717) 770-1277 Voice (717) 770-1278 Telecopier Supreme Court ID 62063 Executor and as Counsel for The Estate of Bartley Date: July 1, 2005 ........ REV_l500 EX (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 OFFICIAL USE ONLY INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ..2.. J - -D- -4. J ---.:r -6- 3- COUNTY CODE YEAR NUMBER I- Z W C W () W C DECEDENTS NAME (LAST. FIRST. AND MIDDLE INITIAL) BARTLEY GE R DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) DECEMBER 16, 2004 OCTOBER 22, 1915 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DECEASED W 0- ~::!cn <.>o:x wo..<.> ",00 <.>0:-' 0..<11 0.. .0; SOCIAL SECURITY NUMBER THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 2. Supplemental Return D 48'. Future Interest Compromise (date of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy of Trust) D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) D 3. Remainder Return (date o/death prior to 12-13-82) o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A)lA'acllSch 0) NAME COMPLETE MAILING ADDRESS 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Totel 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 & (0) 12. Ne' Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 0- Z W C Z o 0.. II> W 0: 0: o <.> FIRM NAME Iff ApP''''bI.) HOWELL LAW FIRM TELEI;>r?t~p~tf _ 1 277 [Xkl. Original Return o 4. Limited Estate [Xk3. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received z o !;i; ...J ::) !:: Q" <( () W 0:: 14. Net Value Subject to Tax (Line 12 minus Line 13) 619 BRIDGE STREET NEW CUMBERLAND PA 17070 (1) $ 69,648.10 (2) $ 75,327.25 (3) (4) (5) $ 60, 325 . 99 OFFICIAL USE ONLY (6) (7) (8) $205,301.34 (9) $ 33,506.67 (10) $ 7 , 438. 70 (11) $ 40,945.37 (12) $164,355.97 (13) q:1f\d It;t; q7 $ 0.00 (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ I-' ::) Q" :E o () ~ 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 cellateral rate 19. Tax Due x .0_ (15) x.O_ (16) x .12 (17) x .15 (18) (19) $ 0.00 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Decedent's Complete Address: STREET ADDRESS h · 5225 Wilson Lane CITY , STATE Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) $0.00 Total Credits (A + B + C ) (2) 3. InteresVPenalty if applicable D. Interest E. Penalty TotallnteresVPenalty ( 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) ZIP 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. (SA) (5B) $0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 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 a. retain the use or income of the property transferred;.......................................................................................... 0 b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 C. retain a reversionary interest; or.......................................................................................................................... 0 d. receive the promise for life of either payments, benefits or care? ............. ........................................ 0 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 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 No Xl XJ XJ XJ f] fJ fJ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. SIGNATURE OF PERSON RESP Under penalties of pe~ury, I declare thai I have examined this return, induding accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal repre e is based on all info ticn of which pre parer has any knowledge. 7 oS" ADDRESS 6 Bridge stree , New Cumberland PA 17070 RE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS DATE For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filin9 a tax retum are still applicable even if the surviving spouse is the oniy beneficiary. For dates of death on or after Juiy 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 PS 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 )1. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 PS. 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'1~02 EX+ 16.9. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE . ESTATE OF FILE NUMBER GEORGE C. BARTLEY 21-04-1163 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither berng compelled to buy or sell, both having reasonable knowledge ot the relevant tacts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. VALUE AT DATE OF DEATH DESCRIPTION See Attached Sheets TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) . Estate of George C. Bartley Date of Death 12/16/04 SSN 203-10-4652 File Number 21-04-1163 SCHEDULE A REAL EST ATE Item Description 1. Vacant lot on North Union Deposit Road in Hummelstown, Dauphin County, Pennsylvania 17036 See Attached HUD -1 Settlement Sheet (Exhibit "A-I") TOTAL Value DOD $69,648.10 $69,648.10 . A. Settlement Statement A\ 1r U.S. Department of Housing and Urban Development B. Type of Loan tctgage Insucane. Cas. Numb.c 6 FUe Number 17. Loan Numb.c 10 FH^ 20 FmHA 3 0 Cony Unlns. 4.n VA 50 Conv Ins WAMPLER C. Note- ThIs form IS furnished to give you a statement of actual settlement costs Amounts paid to and by the settlement agent ale shown. Ilems marked "(p.D.C.)" were paid outside the closing; they are shown here for Information purposes and are not Included In the totals. 0 Name and Address of Borrower E. Name and Address of Seller F. Name and Address of Lender Mervin D. Wampler Estate of George C. Bartley Bonnie R. Wampler by Steven Howell. Executor 720 Schoolhouse Plaza North Union Deposit Road Annville, PA 17003 Hummelstown, PA 17036 G. Property Location H. Settlement Agenl North Union Deposit Road Annvllle Land Transfer Company Hummelslown, PA 17036 I. Settlement Dale Tax ParGel No. 56-005-011 Place of Settlement 22 West Main Street 04/21/05 AnnviUe, PA 17003 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION; 100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT OUE TO SELLER 101. Contract sales price 74,000.00 401. Contract sales price 74,000.00 102. Personal property 402. Personal property 103. Settlement charges 10 borrower (line 1400) 1,489.75 403. 104. 404. 105. 405. Adjustments for Itoms paid by seller In advance Adjustments for items paid by seller In advance 106. Municipallaxes to 406. Municipal taxes to 107. County taxes 04/21 to 12/31 243.93 407, County taxes 04/21 to 12131 243.93 lOB. SChOOl taxes 04/21 to 06/30 145.17 408. School taxes 04/21 to 06/30 145.17 109. 409. ~- 110. 410. 111. 411. -- 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 75,878.85 420. GROSS AMOUNT DUE TO SELLER 74,389.10 ~;MOUNTS PAtD BY OR tN BEHALF OF BORROWER 500. REDUCTtONS IN AMOUNT TO SELLER ~CPoSit or earnest money 7,400.00 501. Excess Deposit (see instructions) 202. Principal amount of new loan(s) 502. Settlement charges to seUer (line 1400) 4,741.00 203. Existing loan(s) taken SUbject 10 503. Existing loan(s) taken subject to 204. 504, Payoff of first mortgage loan 205. 505. Payoff of second mortgage loan 206. 506. 207. 507. 208. 508. 2U9. 509. Adjustmenls for Items unpaid by seller Adjustments for Items unpaid by seller 210. Municipal taxes to 510. Municipal taxes to 211. County laxes to 511. County tax.es to 212. School taxes to 512. Schooltax.es to 213. 513. 214 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. -- 220. TOTAL PAID BY I FOR BORROWER 7.400.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 4,741.00 300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER 301. Gross amount due from borrower (line 120) 75.878.85 601. Gross amount due to seller tUne 420) 74,389.10 302. Less amounts paid by/for borrower (line 220) 7.400.00 802. Less reduction amount due 10 seller (line 520) 4,741~ 303. CASH FROM BORROWER 68,4 78.85 603. CASH TO SELLER 69,648.10 . OMB No. 2502-0265 'N TH' 'VENT, RHRORAWN OF THE "XES" NECESSARY WHEN THE TAX BILLS FOR 2005 ARE PREPAREO. THE PARTIES AGREE TO RANDLE SA'O RE~PRORAnoN BE Q;;:W;O:-W~r Ii Ii i I EXHIBIT Ellale or George C. ilartley OOl",leR.warnple.- by Sleven Howell,Execulor P\ - I I File Number: WAMPL~R ....... ...... ,....,~...'....n I Vf- nuu",",,'Ou 1-\.1'11.1 ur;DAN Ul:.Vt;LUI~MI;;.NI SETTLEMENT 81 A TEMENT PAGE 2 L SETTLEMENT CHARGES: pAID FRDM PAID FROM 700 TOTAL SALES/BROKER'S COMMISSION b8$od on price $ @ - BORROWER'S SELLER'S FUNDS AT FUNDS AT Division of commission (line 700) as follows: SETTLEMENT SETTLEMENT 701. $ to 702. $ to 703 Commission paid at Settlement- 704 800. ITEMS PAYABLE IN CONNECTION WITH LOAN P.O.C. 801. l.oan Origination Fee % I 802. loan Discount % I 803. Appraisal Fee to -- 804. Credit Report to - 805. Lender's Inspection Fee to 806. Application Fee to 807 Mortgage Broker Fee- to 808. 809. 810. ---- 811. 812. 813. 814. - 815. --- 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest from to @~ Iday 902. Mortgage Insurance .Premium to -- 903 Hazard Insurance-Premium yrs. to --- 904. 905. - 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Insurance mo. @$ Imo. - @$ 1002. Mortgage Instlrance mo. Imo. 1003. Municipal taxes mo. @$ Irno. 1004 County property taxes ma @$ Imo. , 1005. School taxes mo. @~ Imo. ,1006. mo.@$ /mo. 1007. mo.@$ /mo. 100B. - Aggregate Reserve for Hazard/Flood Ins, City/County Prop}axes, School Taxes &; Mortgage Ins 1100. TITLE CHARGES 1101. Settlement or dosing fee to Steven Howell, Esq. 675.00 1102. Abstract or title search to 1103. Title examination to 1104. Title insurance binder to 1105. Document preparation to 1106. Notary fees to Carol M. Daugherty 5.00 2.00 1107. Attorney's fees to (includes above Item No: ) 110B. Title Insurance to AnnvHle Land Transfer Company 702.75 (inclUdes above item No: 1102,1103.1104,1109,1110 ) 1109. Lender's coverage -- 1110. Owner's coverage 74,000.00 -- 702.75 1111. 1112. 1113. I.A. No. K550028 (Basic) 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording fees Deed S 42.00 : Mortgage $ ; Releases $ 42.00 1202. City/county/stamps Deed $ 740,00 : Mortgage $ 740.00 1203. &tate taxfstamps Deed $ 740.00 ; Mortgage $ 740.00 1204. - 1205. -- 1300. ADDITIONAL SETTLEMENT CHARGES - 1301. Survey to - 1302. Pest inspection to 1303. Auction Fees Ziegler Auction Company. Ud. 3,324.00 1304. ~- --- 1306. 1307. - 1308 1400 TOTAL SETTLEMENT CHARGES (enter on lines 103 and 502, Sections J and K) ~ 1,489.75 4,741.00 '''':;l);';;n;'''~'d 'CjUD-, s'~~""mlJ ,"d', '" b..", my'"'."'" ,"d """"", ''"' '"' ''''',,'' "",m,"'" '" ''','*''''''''",..m,"'' ",",""_",w",,, bYZ" 'h" uan$ ~ rw1tlj~iJ~l tlllavereciVdaCOPYf!-J!1eHlJO-1SetuertSra"L lli.'? ~.x-y~ V/.Ill" . Ill1v"'_ .} Joe,,^, . li'-~ .~ ./"..-p, .c:", r'r ",. ,/Z ~~r;::' Wampler ,:, BOllllie R. Wempler E~lll~~~:nley /'/....-::"tI~vell Howell. t:~eculO( TtulH ('l-tS Ill~llt h'~v,}pj8par lrue accu llcCo1..IIlIOllhjlllrllll~ctjon.lhavecaulle illcaullelhefundlllobedillbl:l(SedlnaCC~nCeWitrllnISSlalemell1. ~ v y-,;1../ -"'<5 T Date '(;'~~N~~3i~ j~~~~d ~,,~~~~8;Yo~ke false slalemellls to Ihe Unl1ed Slates on this or allY otller similar form. Penaities upoo conviction can include a ~ne or imprisonment. For details see. Tilie t8 US RESPA. HB 4305.2 - REV. HUD1/3/861 RCV-1503 EX +,1.97) SCHEDULE B STOCKS & BONDS I COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GEORGE C. BARTLEY FILE NUMBER 21-04-1163 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 See Attached Sheets TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) . Estate of George C. Bartley Date of Death 12/16/04 SSN 203-10-4652 File Number 21-04-1163 SCHEDULE B STOCKS AND BONDS Item Description 1. Janney Montgomery & Scott (Stocks & Bond Portfolio) TOTAL Value DOD $75,327.25 $75,327.25 R8.l1508EX"(191) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERIT ANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GEORGE C. BARTLEY FILE NUMBER 21-04-1163 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH See Attached Sheets TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) File Number 21-04-1163 Estate of George C. Bartley Date of Death 12/16/04 SSN 203- 10-4652 SCHEDULE E CASH, BANK DEPOSITS & MISC PERSONAL PROPERTY Item Description 1. Proceeds from Zeigler Auction Company $1,450.00 (6/9/05 Check) $ 868.86 (5/16/05 Check) $ 123.75 (6/29/05 Check) $2,442.61 2. Erie Insurance Refund Check (6/16/05) 3. Capital Self Storage Refund Check (5/31/05) 4. Pennsylvania Employees Benefit Trust Refund Check (5/23/05) 5. Federal Employee Lump Sum Death Benefit (4/4/05) 6. Raab Collection (4/4/05) 7. Met Life Insurance Proceeds (4/4/05) 8. Federal Employees Group Life Insurance (3/29/05) 9. PNC Bank (3/21/05) 10. Mct Life Insurance Proceeds (3/10/05) II. Harman's Coins (3/18/05) 12. Bricker Auction Service (3/7/05) 13. Cumberland County (2/24/05) 14. Clark Coins (2/24/05) 15. The Sun Newspaper Reimbursement (2/15/05) 16. Federal Employees Life Insurance (1/13/05) 17. The Patriot News Reimbursement (1/5/05) 18. PNC Bank (1/5/05) 19. Currency (Cash and Non-Collectible Coins) $ 30.00 (4/4/05) TOTAL $1.365.49 (12/28/04) $1,395.49 Value DOD $ 2,442.61 $ 90.00 $ 135.83 $ 153.46 $ 4,714.13 $ 3,000.00 $ 1,540.67 $ 3,765.26 $ 1,211.48 $ 2,777.74 $ 3,900.00 $ 820.00 $ 100.00 $ 250.00 $ 14.00 $ 30,741.25 $ 177.20 $ 3,096.87 $ 1.395.49 $ 60,325.99 REV-1511 EX, (12-99) . ~~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF GEORGE C. BARTLEY FILE NUMBER 21-04-1163 ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: 1. See Attached Sheets B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number ot Personal Representative(s) Street Address City State _ Zip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State _Zip Relationship ot Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line g, Recapitulation) $ Debts of decedent must be reported on Schedule I. (If mare space is needed, insert additional sheets of the same size) . Estate of George C. Bartley Date of Death 12/16/04 (SSN 203-10-4652) File Number 21-04-1163 Item AI. A2. BI. B2. SCHEDULE H FUNERAL EXPENSES & ADMINISTRA TIVE COSTS Description W. Orville Kimmel Funeral Home (1/10/05) Romberger Memorials (1/1 0/05) Name of Personal Representative: Steven Howell, Esquire SSN: 193-60-4778 Address: 619 Bridge Street New Cumberland, P A 17070 Year Paid: 2005 Attorney Fees & Executor Fees: Steven Howell, Esquire See Exhibit "H-l" Payments to Steven Howell, Esquire $ 1,649.00 (1/10/05) $ 350.00 (2/11/05) $23,607.60 (7/1/05) $25,606.60 (Does Not Include $675.00 Paid on HUD-l) Amount $ 7,002.06 $ 374.00 $25,606.60 Advances by Steven Howell, Esquire Total $5,081.60 $ 650.00 (Check to Open Grave 12/16/04) $ 300.00 (Check to Dick Cassel- Move Property 12/17/04) $ 299.00 (Check to Register of Wills - 12/20/04) $ 400.00 (Check to Dick Cassel - Move Property 12/23/04) $ 21.53 (USPS Postage 1/4/05) $ 350.00 (Check to Dick Cassel- Auction Expense 2/9/05) $ 2,160.00 (Inventory by Paralegal of Personal Property in lO'x20' Storage) $ 52.00 (P ADept of Health - Add'l Death Certificates) $ 13.61 (Registered Mail to Ancient Coin Dealer 2/2/05) $ 4.00 (Short Certificate to claim Met Life Policy 2/8/05) $ 25.00 (fED EX to Auctioneer 2/25/05) $ 4.88 (Certified Mail to Met Life 3/1/05) $ 8.60 (2 USPS Priority Mail to Fed Gov't 3/9/05) $ 17.99 (2005 North American Coins & Prices) $ 12.99 (2005 Coin Digest) $ 40.00 (Additional Short Certificates 3/18/05) $ 12.23 (Registered Mail to Document Dealer 3/24/05) $ 8.84 (Certified Mail to DPW 4/13/05) $ 25.00 (FED EX to Annville Land Transfer Comp 4/18/05) $ 12.76 (USPS - 6/14/05 Boxes to Ship Family Photos) $ 40.18 (USPS - 6/14/05 Box to Cassel/Tuan/Daetwyler) $ 23.70 (USPS - 6/15/05 Box to Cassel/Daetwyler) $ 68.69 (UPS - 6/22/05 Box to Walmer) $ 96.00 (Copies) . $ 434.60 (Storage Fee by Law Firm Per RPC Requirements) $ 5,081.60 B4. Patriot News (Advertise Estate)(1112/05) Cumberland Law Journal B7 Additional Probate Fees (Inventory/First & Final/Tax Return) TOTAL $ 188.01 $ 75.00 $ 260.00 $33,505.67 . Estate of George Bartley clo Steven Howell, Esquire 619 Bridge Street New Cumberland, P A 17070 ~- ----------- / -'--. For Professional Services: December 16,2004 Telecon at 3:30 AM regarding client's death; telecon from Tim at funeral home on arrangements; review fax from Pinnacle Hospice and telecon to Cheryl Spaziani on death of client; telecon w/Rev. Felty; telecon to Martin Chronister; telecon to Tran Tuan; telecon to funeral home director; meeting wi funeral home director on obituary, death certificate, service arrangements; telecon to Bethany's medical records to obtain info for death certificate (3.0 Hours) December 17,2004 Telecon from Corinne; telecon from John Bowen; e-mail to Tran Tuan details of funeral; draft memo on funeral plans to FH director, pastor at Bethany for posting on tv channel, head of soc services, and pastor at Mt. Olivet, telecon to Dick Cassel on picking up personal property and placing in storage site; telecon to Dr. Cassel in Dacula, Georgia; review invoice from ambulance company; review invoice from CNA; telecon w/Martin Chronister on estate account; review invoice from ambulance service; short meeting wIDick Cassel on property storage issue (3.0 Hours) December 20,2004 Telecon from funeral home director; telecon from Bethany on newspaper cancellation; telecon from Dr. Cassel; review five PEBTF statements; one BC/BS notice; draft Estate Information Sheet; draft Petition for Letters Testamentary; file and swearing in at Cumberland County Courthouse; telecon to Patriot News; complete HSH consent form and return (4.0 Hours) Telecon from Tran Tuan (.5 Hours) Review PNC account statement; balance checkbook; review CMS Medicare reports; funeral arrangements; review PEBTF statements; draft estate notices to Cumberland Law Journal and Patriot News (4.0 Hours)(lO:OO AM - IPM is Funeral Service and Intermnent) December 23, 2004 Review two BC/BS notices; review pharmacy invoice (.2 Hours) December 21, 2004 December 22, 2004 E EXHIBIT i I H - \ Page 2 December 27,2004 December 28, 2004 December 29, 2004 December 30, 2004 January 4, 2005 January 6, 2005 January 9, 2005 January 10, 2005 January 11, 2005 January 12,2005 January 13, 2005 January 14,2005 Locate discharge papers, telecon and fax to funeral home (.25 Hours) Meeting at Commerce Bank to open estate account; apply for EIN; telecon to Penn State, Lebanon Valley College and HACC for gift offices; telecon from Penn State's director (2.0 Hours) Draft Rule 5.6 Notice; research phone numbers and mailing addresses wlzip codes; prepare notices; review file for addresses (2.0 Hours) Review documents to locate Dept. V A life insurance information; draft Itr to V A along with required documents; review Romberger Memorials order form; two PEBTF statements; one OPM notice and JMS transaction confirmations (2.0 Hours) Review invoice from WOK Funeral Home; review check from Patriot News; review check from JMS and telecon to JMS broker; review 6 PEBTF statements; 3 BC/BS statements; 1 Medicare Summary Notice; review JMS estate account agreement; close out PNC account and deposit checks at Commerce Bank; do final balance ofPNC account; review check book and documents in check package from Commerce Bank (3.0 Hours) Review Estate Account from JMS; te1econ w/Martin Chronister on interest payments due the 15th and 30th of January; review HSH statement; review 8 BC/BS notices (.25 Hours) Telecon to private duty CNA to pick up sling at Bethany Village (.1 Hour) Review Itr from V A; review three BC/BS notices; review coupons and Itr from PEBTF; draft ltr to PEBTF on death of client; 2 PEBTF statements; review JMS account statement; review final statements from Bethany Village; draft check to executor for advance expenses; draft check to WOK Funeral Home; draft check to Alert Pharmacy; draft check to West Shore EMS/ALS; draft check to Romberger Memorials; draft check to private duty CNA (1.0 Hour) Review ltr from Bethany Village; review OPM notice and complete OMB Form 3206-0197; draftltr to OPM w/death certificate and short certificate; draft and file at Post Office official change of address (1.0 Hour) Te1econ from atty for Choral Society; telecon to American Bible Society; review invoice from Patriot News and draft check; review BC/BS notice (.75 Hours) Telecon from Mrs. Rothman (Pres/Symphony); review check from US Treasury on life insurance and deposit; review ltr from PNC Bank on request for EIN/withholding; review EIN Notice; telecon to PNC Bank (.5 Hours) Review Itr from American Bible Society; review paid receipt from WOK Funeral Home; review PEBTF statement (.25 Hours) Page 3 January 18, 2005 January 19,2005 January 21, 2005 January 26, 2005 January 28, 2005 January 31, 2005 February 1,2005 February 2, 2005 February 3, 2005 February 4, 2005 February 8, 2005 February 9, 2005 February 10,2005 February 11,2005 Review Medicare Statement; telecon to Ambulance service on why 12/10 transport paid but not 12/7 ( .25 Hours) Review Itr from Guiding Eyes for the Blind; review publication notice from Cumberland Law Joumal; review USPS confirmation of change of address; review three BC/BS statements (.25 Hours) Review PNC Bank statement and cancelled checks; review PEBTF statements; review three BC/BS statements (.25 Hours) Review USPS Itr; review World Vision Itr; review Itr from Salvation Army; review JMS check; deposit JMS check; review JMS year end tax I099s (.4 Hours) Review SSA 1099; review HACC Foundation Itr; review BC/BS notice; review OPM notice; review Erie Insurance (personal property)(.5 Hours) Telecon w/Erie agent; draft Erie check; telecon to D & S Coins for appraisal; review six PEBTF statements; telecon to Norfolk ancient coint dealer; telecon to Dick Cassel; review documents and contact Met Life on Madeline's life insurance policy (1.5 Hours) Meeting at D & S Coins for appraisal; review tax bill for Hummelstown lot and draft check; draft check for Dick Cassel; review letter from Choral Society; review 1 PEBTF and 1 BCIBS notice; draft Itr to ancient coin dealer; research vacant lot prices in Hummelstown area (4.0 Hours) Telecon to Hummelstown paper for refund; research gold coin values (1.0 Hour) Draft e-mail to ancient coin dealer re registered mail envelope (.1 Hour) Review two PEBTF and one BCIBS notice; review Commerce Statement and balance checkbook; review JMS Central Asset Account Annual Expense Summary; review and complete Medicare Premium Payment form; review CMS Medicare Forms; review MET Life forms (.5 Hours) Review seven PEBTF forms; review paid receipt from tax collector; review MET Life correspondence; complete MET Life forms; review CMS Medicare Forms; telecon to Kimmel Funeral Home for certified copy of Madeline's death certificate; telecon to Register of Wills for one Short Certificate (1.0 Hour) Review six BCIBS statements; review one PEBTF statement; review JMS statements; telecon to Funeral Home on death certificate from New Castle, Pennsylvania; meeting wIDick Cassel (.5 Hours) Review ltr from March of Dimes; review one PEBTF statement; telecon from Guy Clark (ancient coin dealer) telecon to Bob Sheppard about Barley coin collection (.75 Hours) Review coordination of benefits Itr from PEBTF; provide copies of HI cards and complete form; telecon to Jay Zeigler Auctioneer on 2.62 acres and fax relevant info (deed, survey) (1.0 Hour) . Page 4 February 23, 2005 February 24, 2005 February 25, 2005 March 1, 2005 March 2, 2005 March 3, 2005 March 4, 2005 March 9, 2005 March 10, 2005 March 11, 2005 March 14,2005 March 17,2005 March 18, 2005 March 21,2005 March 24, 2005 March 25, 2005 Review documents from Guy Clark and check; review Cumberland County reimbursement check; review PNC statement; review OPM forms and cover ltr to claim death benefits (.75 Hours) Draft 1tr to Ms. Balsarott; on line research for Vital Statistics form to request additional death certificates; complete form for additional death certificates in light ofOPM request and Met Life Policy (.5 Hours) Review auction contracts and disclosure forms; draft Itr to auctioneer w/requested documents; telecon w/auctioneer; telecon from WOK funeral home on death certificate ordered weeks ago (1.0 Hour) Complete Claimant's Statement for MET Life policy w/enclosures (.5 Hours) Review fax from auctioneer; review file and fwd ltr and August school tax bill to auctioneer (.25 Hours) Review check from Chuck Bricker on personal property auction and receipts and check; prepare deposit ticket (.25 Hours) Review Commerce Estate Account statement; balance checkbook (.25 Hours) Draft two completed applications for US Federal Group Life Insurance and any retirement benefits owing the Estate (1.0 Hour) Review MET Life check and prepare deposit ticket; telecon to Kline Village Coin Dealer (.5 Hours) Review Met Life correspondence and tax form; telecon to Martin Chronister to perform year end tax calculations (.25 Hours) Review PEBTF statementS; review 1099 IRS form from JMS; review worksheet from JMS broker on long term capital gains; telecon to local PNC Branch to close out account and fwd balance of$1,211.40 to the Estate (.5 Hours) Telecon from M. Balmer on auction; review tax information from JMS; meeting at coin dealer in Harrisburg to sell gold coins at $825.00 more than New Cumberland dealer; research Lincoln card and contact Raab Collection (3.5 Hours) Telecon and Itr to Register of Wills for additional short certificates; check website for delivery of Federal employee benefits Itrs; review PNC balance check in account; review MET LIFE trust documents and order to sell shares (.6 Hours) Review JMS solictiation; review 3/16105 Itr from Penn State Planned Giving Officer; review PNC monthly account statement; review e-mail from Raab Collection and prepare material for scanning (1.0 Hour) Review e-mail from Steven Raab; draft registered letter w/originals; draft e-mail to Steven Raab; telecon to auctioneer on Tuesday's sale (.5 Hours) E-mail Steven Raab (.25 Hours) Page 5 Mar~h 28, 2005 March 29, 2005 March 30, 2005 March 31, 2005 April 1, 2005 April 4, 2005 AprilS, 2005 April 8, 2005 Aprilll,2005 April 12, 2005 April 13, 2005 April 15,2005 April 18, 2005 April 19,2005 Review check and document from Federal Group Life Insurance; review 2 BCIBS notices; review correspondence from Penn State Alumni Assoc; review ten page contract from auctioneer' telecon to auctioneer (.5 Hours) Auction in Hummelstown at 5:00 PM for 2.62 acreas; meeting w/ auctioneer at 4:15 PM and execution of sales contract to successful bidder (4:00 PM - 8:00 PM)(4.0 Hours) Review notice on death benefit of$4,714.13 due from Federal Govnt; draft e-mail on Lincoln autograph; review return e-mail (.3 Hours) Draft 1040X and complete Form 1310 for 2003 federal income tax returns on refund of$366.67; examine three boxes of personal property from storage; telecon from buyer at auction seeking to withdraw; telecon w/Jay Zeigler (2.0 Hours) Draft e-mail to Steven Raab; review check from federal government on survivor benefit; review check from Steven Raab; review check from Met Life; prepare deposit tickets; examine two boxes of personal property from storage (3.5 Hours) Review Medicare CMS Notice; review fax from auctioneer on second highest bidder; telecon from Wampler (successfule bidder) (.5 Hours) Telecon w/auctioneer (.25 Hours) Review Commerce Bank statement; review four page fax from auction buyer's atty on settlement; telecon to Carol at Annville Land Transfer; review BCIBS notice (.5 Hours) Review CMS notice; draft e-mail on selling Jack Dempsey BW autograph (.1 Hour) Draft Itr on Madeline's estate to DPW on possible lien; draft ltr on. George's estate to DPW on possible lien; review DPW website for contact information (.5 Hours) Review BC/BS notice; telecon to Zeigler Auction on remaining personnel property; meeting at Munn's Diamonds to obtain written appraisal for use at auction; telecon to Hasko's Jewelers (2.0 Hours) Telecon to DPW on status ofIien letter (.1 Hour) Draft Itr to buyer's attorney w/encIosures of short certificates, death certificates, EIN, DPW letters regarding lien status, tax bills and proposed deed; telecon to buyer's atty; telecon to Jay Zeigler Auctioneer; review ltr from Atty for buyers (1.5 Hours) Review two letters from DPW; review Itr from Romberger Memorials; telecon to Romberger Memorials; review fax from auctioneer on expenses; review HUD-l from Atty in Annville (.5 Hours) Page 6 April 21, 2005 April 22, 2005 April 25, 2005 May 9, 2005 May 13,2005 May 23, 2005 June 1, 2005 June 7, 2005 June 8, 2005 June 14,2005 June 15,2005 June 16,2005 June 20, 2005 June 22, 2005 June 23, 2005 Real estate settlement in Annville, Pennsylvania; pick up jewelry and appraisal for use by auctioneer (second trip since rings were not yet cleaned on 4/20/05 as promised; review additional faxes from DPW on lien status for medical assistance payments by Dept. (5.5 Hours) Review Itr and color prints from Romberger Memorials on completed inscriptions for clients; review Capita! Self Storage Invoice; telecon to storage site on refund for May and June 05 payments if unit cleaned by 4/31/05; prepare deposit ticket for real estate settlement (.5 Hours) Ltr to auctioneer; telecon to auctioneer; printout directions to storage site; meeting w/auctioneer's movers (.5 Hours) Telecon to Walmers; draft e-mail to Tuan Tran (.25 Hours) Telecon w/rep from Harrisburg Symphony and Boys Club (.2 Hours) Review refund check from PEBTF and deposit (.25 Hours) T elecon J oann at Consolidated Insurance on termination of policy (.25 Hours) Telecon to Jay Zeigler on auction results; authorized new sale for one remaining diamond ring w/revised reserve price (.1 Hour) Review correspondence addressed to Decedents; notify senders of death (.1 Hour) Draft Itr to Mr. Tuan, Dr. Cassell, Dr. Daetwyler; prepare items for each person (1.5 Hours) Prepare second boxes for CasseIl/Daetwyler (.75 Hours) Review Erie refund notice w/check; prepare deposit ticket; telecon to Zeigler Auction on status of proceeds check from 6/4/05 auction (.25 Hours) Review two checks from Zeigler Auction; telecon to Zeigler Auction on remaining sale of one diamond ring; prepare deposit tickets; draft First and Final Accounting Petition (2.0 Hours) Telecon to Register of Wills on additional filing fees; telecon to Maida Conner/HACC, Elaine Rhodes/Penn State and Sue Borrelli at L VC; send two line drawings to Walmers via UPS (1.5 Hours) Prepare decedent's final 2004 federal tax return (.5 Hours) Page 7 June 24, 2005 June 27, 2005 Legal Fees Advance Costs Subtotal Payments Subtotal TOTAL DUE Telecon from Susquehanns Surgeons on overpayment by PEBTF; review fax from HACC Foundation; complete P A-40 income tax return (1.0 Hour) Draft Inventory; draft Pennsylvania Inheritance Tax Return (2.0 Hours) $21,200.00 (84.8 Hours at $250.00 Per Hour) $ 650.00 (Check to Open Grave 12/16/04) $ 300.00 (Check to Dick Cassel- Move Property 12/17/04) $ 299.00 (Check to Register of Wills - 12/20/04) $ 400.00 (Check to Dick Cassel- Move Property 12/23/04) $ 21.53 (USPS Postage 1/4/05) $ 350.00 (Check to Dick Cassel- Auction Expense 2/9/05) $ 2,160.00 (Inventory by Paralegal of Household Contents) $ 52.00 (PA Dept of Health - Add'l Death Certificates) $ 13.61 (Registered Mail to Ancient Coin Dealer 2/2/05) $ 4.00 (Short Certificate to claim Met Life Policy 2/8/05) $ 25.00 (FED EX to Auctioneer 2/25/05) $ 4.88 (Certified Mail to Met Life 3/1/05) $ 8.60 (2 USPS Priority Mail to Fed Gov't 3/9/05) $ 17.99 (2005 North American Coins & Prices) $ 12.99 (2005 Coin Digest) $ 40.00 (Additional Short Certificates 3/18/05) $ 12.23 (Registered Mail to Document Dealer 3/24/05) $ 8.84 (Certified Mail to DPW 4/13/05) $ 25.00 (FED EX to Annville Land Transfer Comp 4/18/05) $ 12.76 (USPS - 6/14/05 Boxes to Ship Photos) $ 40.18 (USPS - 6/14/05 Box to Cassel/Tuan/Daetwyler) $ 23.70 (USPS - 6/15/05 Box to Cassel/Daetwyler) $ 68.69 (UPS - 6/22/05 Box to Walmer) $ 96.00 (Copies) $ 434.60 (Storage Fee Per RPC Requirements) $26,281.60 $ 1,649.00 (1/10/05) $ 350.00 (2/11/05) $ 675.00 (4/21/05) $ 2,674.00 $23,607.60 ~EV-1512 EX ~ (1~97i SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GEORGE C. BARTLEY FILE NUMBER 21-04-1163 Include unreimbursed medical expenses. ITEM NUMBER 1. DESCRIPTION AMOUNT See Attached Sheets TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) Estate of George C. Bartley Date of Death 12/16/04 (SSN 203-10-4652) File Number 21-04-1163 SCHEDULEIDEBTSOFDECEDEN~ MORTGAGE LIABILITIES & LIENS Item Description 1. Bethany Village (1/10/05) 3. Alert Pharmacy (1110/05) 4. West Shore EMS-ALS (1110/05) 5. Mindy Drake (Private Duty CNA)(1110/05) 6. Erie Insurance Group (1/31/05) 7. Dick Cassel (2/1/05) 8. Tracy Cooper Tax Collector (2/1/05) 9. Dick Cassel (2/9/05) 10. George Mushinski (Shrub Clearing for Auction 3/16/05) 11. Munn's Diamond Gallery (4/21/05 - Appraisals) 12. Dick Cassel (4/28/05 - Clean Out Storage Site) 13. Pennsylvania Department of Revenue (2004 Income Tax) TOTAL Amount $4,090.00 $ 47.25 $ 537.36 $ 568.00 $ 122.00 $ 350.00 $ 343.52 $ 350.00 $ 300.00 $ 250.00 $ 300.00 $ 180.57 $7,438.70 REV-1513 EX+ (9-00) '. '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF GEORGE C BARTLEY FILE NUMBER 21-04-1163 . RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(Sl RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions. and transfers under See 9116 (al (1.2)] 1. See Attached : heets ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) Estate of George C. Bartley Date of Death 12/16/04 (SSN 203-10-4652) File Number 21-04-1163 SCHEDULE J BENEFICIARIES Number II A. Non Taxable Distributions The Pennsylvania State University Office of Planned Giving and Endowments 102 Old Main University Park, PA 16802-1501 Amount or Share of Estate $100,000.00 See Paragraph III a and b of Will Copy of the U.S. Treasury Department Letter Attached Hereto as Exhibit "J-1" II B. The Haec Foundation Harrisburg Area Community College One HACC Drive Harrisburg, P A 17110-2999 $ 50,000.00 See Paragraph III c of Will Copy of Department of the Treasury Letter Attached hereto as Exhibit "J-2". II1e. Lebanon Valley College Office of Major Gifts 101 North College Avenue Annville, PA 17003-1400 Balance of Estate * * Estimated as of 7/1/05 to be approximately $14,355.97 without Any deductions for additional legal fees or expenses incurred AfterJuly 1,2005 See Paragraph III d of Will Copy of Department ofthe Treasury Letter Attached hereto as Exhibit "J-3". TOTAL $164,355.97 . ~ i I 't - I .i-' 05 14: 01 FROM- ,;i*ifI!i~rnal Revenue Service 1~~jiI'rstrict Director /;~ ------------------------------------------ ~ T-205 P002/005 F-464 Department of the Treasury P. 0., Box 12070 ' Phila., PA 19105, '. ~'''''(' (~/ ~ JUN 1 8 1885 Employer Identlfieation Numb4r: 23-2353614 Accounting Period Endins: June 30 Fonn 990 Required: ~ Ves 0 No Dat~: c> The Harrisburg Area COllll!!l,Ini t:r College Foundation 3300 Cameron Street Road Hatrisburg, PA 17110 Pernon to Contal:t: WiHiam Kane Contllct Telephone Number: (215)-597-4168 Dear Applicant: RECf:tVt:D JUN 2 5 1986 HAGC fOUffllA Tlon Based,on information sUpplied~ and assuming your operations will be as stated .,in your application tor recognition of exemption. we have determined you are exempt from Federal income tax under section 501(C)(3) of the Internal Revenue Code. We 'have furthe~ dete~mined that you a~e not a private foundation within ~he lIleaning of section 509(a) at the Code. because you are an organization ducr1bed in Section 509(a) (5).. ,;. - it you~ sources ot support. or your purposes, Character, or ~ethod ot operation ch~~ge, please let us know So we can oonsider the etfect of the change on your exempt status and foundation status. Also, you Should intorm us of all changes in your name or addreSS. As of January 1. 1984, you are liable tor taxes under the Federal Insurance Contributions Act(social security taxes) on remuneration of $100 o~ more you pay to each of your employees during a calendar Yea~. You are not liable tor the tax imposed under the Federal Unemployment Tax Act (FUrA). Since you are not a private toundation, you are not subject to the excise taxes uncer Chapter 42 of the Code. However. you are not automatically exem~t from other Federal ~xcise taxes. It yoU have any questions about excise. employment. or other Federal taxes, please let us know. Donors may deduct Contributions to you as provided in section 170 ot the Code. Bequests, legacies. devises. transfers, or gifts to you or tor your use are deductible'for Federal estate and gift tax purposes it they meet the applicable provisions of sections 2055, 2106, and 2524 of the Code. the box checked in the heading ot this letter ShOW5 whether you ~ust tile For~ 990, RetC:l"n of Organi'zat i on Exempt f~ol:l I,.coCle l'~. If Yes is checked, 'you are reGu~red to file for~ 990 only it your sross receipts each year are normally more than 525,000. If a return Ls reQuired, it must be filed by the 15th day of the fifth mo~th ~fter t~e end of your annual accounting period, the law i~poses a nenaltv of SIO a cay, up to a m~~icum of S5,OOO, when a return is filed late, u! ~mrr is reasonable cause fo~ the delay. ~ J .J"-~ (oyed i-/05 14:01 FROM- ,/--.., ~ T-205 P003/005 F-464 . You are not re~uired. to tile Federal 1000=e tax returns unless you are sUbject to the tax on unre~ated busiaess 1000=e under section 511 ot the Code. It.you are subject to this tax, you must rlle ~ income tax return on For~ 990-T, Exempt Organization BuslQess Income Tax Return. In th~s letter, we are not determining whether any of your present or proposed aotivities are unrelated trade or bus~ness as defined in section 513 ot the Code. ! You need an e=ployer identification number eVen it you have no employee;. It an e~ployer identitication number was not entered on your application, a number will be assigned to you and you wlll be advised or it. P~ease Use that number on all returns you file and in al~ corres~ondenoe with the Internal Revenue Servioe. Because this letter oould help resolve any questions about your exempt status and foundation status, you should kee~ it in your perwanent records. If you have any questions, p~ease oontact the person whose name and telephone number are ShOwn in.the heading of this letter. Sincerely YQurs, C~ (}. (4_ Cornelius J .(Jletuan Dlst~lot Director * This letter supersedes Our letter dated March 14, 1986, . . J'.~ '. '05 14:02 FROM- ~ :~ T-205 P004/005 F-464 . {(lternal Revenue Service Department of the Treasury r;J (,;)r,:lr~ "............ r~ P. O. Box 2508 . ~ ll.J.L::ID.ll.lLLL i Cincinnati,OH 45201 DEe ;'~3 2001 J Person to Contact: 0 r-c Michael Dutcher 31-074 [J L..-.I Customer:Ser;vlce Specia1isr--".-~-" .----.----- . ToIIF.ree Telephone Number: 8:00 8.m. to 9:30 p.m. EST 877-829-5500 Fax Number: 513-263-3756 Federal Identification Number: 23-2353614 Date: November 27, 2001 Harrisburg Area Community College Foundation' One HACC Drive . . Harrisburg, PA 17110-2903 Dear Madam: This letter is in response to your correspondence of November 9, 2001, requesting an update of your organization's advance ruling date. We have made the corrections, and your final determination letter 947 remains in effect. . . Our records indicate that a determination letter issued in June 1988 granted your organization exemption from fedoral income tax under section 501 (c) (3) of the Intemal Revenue Code. That letter is still in effect. Based on information subsequently submitted, we classified your organization as one that is not a private foundation within the meaning of section 509(a) of the Code because It is an organIzation described In section 509(a){3). Tbis classification was based on the assumption that your organization's operations would continue as stated in the application, If your organization's sources of support, or its character, method of operations, or purposes have changed, please let us know so we can consider the effect of the change on the exempt status and found~tion status of your organization. Your organization is required to file Form 990, Return of Organization Exempt from Income Tax, only If Its gross receipts each year are normally more than $25,000. If a return is required, It must'be filed by the 15th day of the fifth month after the end of. the organization's annual accounting perloq. The law impos9sa penalty of $20 a day, up to a maximum of $10,000, when a return is filed late, uhle'ss there is reasonable cause for the delay. All exempt organizations (unless speCifically excluded) are liable for taxes under the Federal Insurance Contributions Act (socIal security taxes) on remuneration of $100 or more paid to each employee during a calendar year. Your organization is not liable for the tax imposed under the Federal Unemployment Tax Act (FUTA). Organizations that are not private foundations are not subject to the exoise taxes under Chapter 42 of the Code. However, these organizations are not automatically exempt from other federal excise taxes. Donors may deduct contributions to your organization as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to your organization or for its use are deductible for federal estate an d gift tax purposes jf they meet the applicable provisions of sections 2055,2106, and 2522 of the Code. ~---------------------------------~---------------------------------- ,.' 05 14: 02 FROM- ?""' T-205 P005/005 F-464 f' -2- Harrisburg Area Community College Foundation 23-2353614 Your organization is not required to fife federal income tax returns unless it is subject to the tax on unrelated business income under section 511 of the Code. If your organization is subject to this tax, it must file an income tax return on the Form 990- T, Exempt Organization Business Income Tax Return. In this letter, we are not determining whether any of your organization's present or proposed activities are unrelated trade or business as defined in section 513 of the Code. The law requires you to make your organization's annual return available for public inspection without charge for three years after the due date of the retum. If your organization had a copy of its application for recognition of exemption on July 15, 1987, it is also required to make available for pUblic inspection a copy of the exemption application, any supporting documents and the exemption letter to any individual who requests such documents In person or in writing. You can charge only a reasonable fee for reproduction and actual postage costs for the copied materials, The law does not require you to provide copies of public inspection documents that are Widely available, such as by posting them on the Internet (WOrld Wide Web). You may be liable for a penalty of $20 a day for each day you do not make these documents available for pUblic inspection (up to a maximum of $10,000 in the case of an annual return). Because this letter could help resolve any questions about your organization's exempt status and foundation status, you should keep it with the organization's permanent reCOrds. If you have any questions, please call us at the telephone number shown in the heading of this letter. This letter affirms your organization's exempt status. Sincerely, .fl~g~ John E. RiCketts, Director, TElGE Customer Account Services Internal Revenue Service Department of the Treasury P. O. Box 2508 Cincinnati, OH 45201 Date: December 4, 2000 Person to Contact: Gordon Schnur 31-02345 Customer Service Specialist Toll Free Telephone Number: 8:00 a.m. to 9:30 p.m. EST 877-829-5500 Fax Number: 513-263-3756 Federal Identification Number: 23-1352354 Accounting Period Ends: June 30 Lebanon Valley College 101 N. College Ave. Annville, PA 17003-1404 Dear Sir or Madam: This is in response to your request for a letter affirming your organization's exempt status. In October 1942 we issued a determination letter that recognized your organization as exempt from federal income tax under section 101 (6) of the Internal Revenue Code of 1939 (now section 501 (c)(3) of the Internal Revenue Code of 1986). That determination letter is still in effect We classified your organization as a publicly supported organization, and not a private foundation, because it is described in sections 509(a)(1) and 170(b)(1)(A)(vi) of the Code. This classification was based on the assumption that your organization's operations would continue as stated in the application. If your organization's purposes, character, method of operations, or sources of support have changed, please let us know so we can consider the effect of the change on the organization's exempt status and foundation status. Your organization is required to file Form 990, Return of Organization Exempt from Income Tax, only if its gross receipts each year are normally more than $25,000. If a return is required, it must be filed by the 15th day of the fifth month after the end of the organization's annual accounting period. The law imposes a penalty of $20 a day, up to a maximum of $10,000, when a return is filed late, unless there is reasonable cause for the delay. As of January 1, 1984, your organization is liable for taxes under the Federal Insurance Contributions Act (social security taxes) on remuneration of $100 or more the organization pays to each of its employees during a calendar year. There is no liability for the tax imposed under the Federal Unemployment Tax Act (FUTA). Organizations that are not private foundations are not subject to the excise taxes under Chapter 42 of the Code. However, these organizations are not automatically exempt from other federal excise taxes. If you have any questions about excise, employment, or other federal taxes, please let us know. E EXHIBIT , I ~-3 . . LAST WILL AND TESTAMENT OF GEORGE C. BARTLEY I, GEORGE C. BARTLEY, of Mechanics burg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby revoke all other wills and codicils heretofore made by me. FIRST I direct the payment of my debts not barred by a statue ofIimitation and expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. If there be no cemetery lot available for my interment, owned by me at the time of my death, I authorize my personal representative to purchase such cemetery lot with a contract for perpetual care, using funds from my estate, in such amount as she shall consider necessary and desirable, and I authorize my personal representative to cause title to or ownership of such lot so purchased to be vested in such person as my personal representative shall designate. Further, in this connection, I authorize my personal representative to expend funds from my estate, in such amount as my personal representative shall consider necessary and desirable for the erection and inscription of a suitable marker for my grave. (J~.{3. SECOND I give and bequeath all real estate and personal property o\Wed by me at the time of my death, together with all insurance policies naming my Estate as beneficiary, to my spouse, MADELINE C. BARTLEY, if she survives me by thirty (30) days. THIRD Should my spouse, MADELINE C. BARTLEY, fail to survive me by thirty (30) days, I hereby make the following specific bequests to be distributed from the residue of my estate: (a) Fifty thousand dollars ($50,000.00) to the Pennsylvania State University, University Park, Pennsylvania 16802, College of Medicine, Hershey, Pennsylvania, for the purpose of establishing an endowed fund for the granting of scholarships in the names of George C. Bartley and Madeline C. Bartley, to students of the College of Medicine who have demonstrated academic merit and financial need; (b) Fifty thousand dollars ($50,000.00) to the Pennsylvania State University, University Park, Pennsylvania, 16802, College of Agriculture, School of Forest Resources, for the purpose of establishing an endowed fund for the granting of scholarships in the names of George C. Bartley and Madeline C. Bartley, to students of the School of Forest Resources, who have demonstrated academic merit and financial need; (c) Fifty thousand dollars ($50,000.00) to the Harrisburg Area Community College, 3300 Cameron Street Road, Harrisburg, Pennsylvania, for the purpose of establishing an endowed fund for the granting of scholarships in the names of George C. Bartley and Madeline C. 2 17. >>~ ----.._--~-_.-._----------._------~ Bartley, to students of the Harrisburg Area Community College, who have demonstrated academic merit and financial need; (d) Fifty thousand dollars ($50,000.00) to Lebanon Valley College, Annville, Pennsylvania, for the purpose of establishing an endowed fund for the granting of scholarships in the names of George C. Bartley and Madeline C. Bartley, to students who have demonstrated academic merit and financial need; (e) Seventy-Five thousand dollars ($75,000.00) to Tuan Tran, who has been like a son to myself and my spouse especially when he was a student at Milton Hershey High Schoo~ and now resides at 3712 Colorado Street, West Covena, California, 91792, and ifhe predeceases me, this bequest shall revert back into the residue of my estate; (f) Fifteen thousand dollars ($15,000.00) to my wife's cousin, Iva Daetwyler Sims, now of Charlotte, North Carolina, and if she predeceases me, this bequest shall revert back into the residue of my estate; (g) Fifteen thousand dollars ($15,000.00) to my wife's cousin, Betty Daetwyler Kent, now of Pride, Louisiana, and if she predeceases me, this bequest shall revert back into the residue of my estate; (h) Fifteen thousand dollars ($15,000.00) to my wife's cousin, Dr. Calvin Daetwyler, now of Houston, Texas, and ifhe predeceases me, this bequest shall revert back into the residue of my estate; (i) Fifteen thousand dollars ($15,000.00) to my wife's cousin, Dr. William Cassell, Sr., now of Atlanta, Georgia, and ifhe predeceases me, this bequest shall revert back into the residue of my estate; 3 t1l (j) Five thousand dollars ($5,000.00) to the Helen Opperman Krause Animal Foundation, Inc. (HOKAFI), Post Office Box 311, Mechanicsburg, Pennsylvania, 17055; (k) Five thousand dollars ($5,000.00) to the Humane Society of Harrisburg, Inc., 7790 Grayson Road, Harrisburg, Pennsylvania; (1) Ten thousand dollars ($10,000.00) to the Salvation Army, 1122 Green Street, Harrisburg, Pennsylvania; (m) Five thousand dollars ($5,000.00) to the Boys Club of Harrisburg, 1227 Berryhill Street, Harrisburg, Pennsylvania; (n) Five thousand dollars ($5,000.00) to the Vohmteers of America, 2100 North Third Street, Harrisburg, Pennsylvania; (0) Twenty thousand dollars ($20,000.00) to the Harrisburg Masonic Consistory, Heritage Builders Fund of the Harrisburg Consistory, Ancient and Accepted Scottish Rite of Free Masonry, Harrisburg, Pennsylvania; (P) Five thousand dollars ($5,000.00) to the Harrisburg Symphony Society, 128 Locust Street, Harrisburg, Pennsylvania; (q) Five thousand dollars ($5,000.00) to the Harrisburg Choral Society, Pine Street Presbyterian Church, Harrisburg, Pennsylvania; and (r) Ten thousand dollars ($10,000.00) to World Vision, Pasadena, California, 91131. Each of the beneficiaries named above in ~ 3 shall receive the entire amount shown UNLESS there is an insufficient amount to accomplish all the bequests. If an insufficient amount 4 ~ C. l)- exists, , 3 shall act as an order of abatement and the beneficiaries listed shall receive distribution in full following the order presented in , 3 until the estate is exhausted. FOURTH In the event there exists a sum of money in my estate after distribution is made in full to all ofthe beneficiaries listed in , 3, I then direct that such reminder be distributed IN EQUAL SHARES to the following: (a) Harrisburg River Rescue, Inc., III South Cameron Street, Harrisburg, Pennsylvania; (b) Guiding Eyes for the Blind, York Town Heights, New York, 10598; and (c) The Rough and Tumble Engineers' ffistorical Association, Inc., Box 9, Kinzers, Pennsylvania, 17535; (d) American Bible Society, 1865 Broadway, New York City, New York; (e) March of Dimes Birth Defects Foundation, Central Pennsylvania Chapter, 4008 Jonestown Road, Harrisburg, Pennsylvania; and (f) Covenant House, 346 West 17th Street, New York City, New York, 10011-5002. FIFfH I direct that any and all Inheritance, Estate and Transfer Taxes imposed upon my estate passing under my Will or otherwise, shall be paid out of the principal of my residuary Estate. 5 M ;(). ye SIXTH In addition to the powers conferred by law, I authorize my Executrix, in her absolute discretion: (a) To retain in the form received, and to sell either at public or private sale any real or personal property. (b) To manage real estate. (c) To invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principle of diversification. (d) To exercise any option or rights arising from ownership of investments. (e) To compromise claims without court approval, and without the consent of any beneficiary. SEVENTH Any and all payment or payments of any sum or sums, whether in cash or in kind and whether from principal or income, shall be made upon the sole receipt of the respective individual to whom the payment is made, and free from anticipation, alienation, assignment, attachment, and pledge, and free from control by the creditors of any such beneficiary. All shares ofprincipal and income herein given shall be free from anticipation, assignment, pledge, or obligation of any beneficiary, and shall not be subject to any execution or attachment. EIGHTH I nominate, constitute and appoint my spouse, MADELINE C. BARTLEY, Executrix of this my Last Will and Testament. I hereby relieve my Executrix from the necessity of posting any security or bond in connection with her duties as such in any jurisdiction in which she 6 ~~"". may be called upon to act insofar as I am able by law to do so. In the event MADELINE C. BARTLEY is unable or unwilling to serve as my Executrix, I appoint my attorney, STEVEN HOWELL, as my alternate Executor. I hereby relieve my alternate Executor from the necessity of posting security or bond in connection with his duties. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of nine (9) type written pages, the first six (6) of which bear my signature in the margin for the purpose of identification, this '7 f<lday of .::TU/V e , 1995. it ~ 1':'-tJ'~ (SEAL) GEORG C. BARTLEY COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF C~Mf.\ ~tLLA-NO I, GEORGE C. BARTLEY, 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 purpose therein expressed. JfC~ff~ IG~C. BARTLEY, 7 Sworn or affirmed to the Testator, this J7V4L- day of acknowledged before me, by GEORGE C. BARTLEY, 1995. .;...... -'.".-/' ~: - '/~ /L~ l'.t.: iAI~iA,L SEAL OEB!1\ l ~"'.\I>'.":'1 (!"(~ry Pub"c upp;, AI!~n ';';;;p ~i;-,:;j;ib,;'1~nd Co .. PA S. d 1 d d blish d d d 1 db) .tf.v CQmiTIlS,ll0n ~:.ni a I c 16. 1008 d fior Igne , sea e an pu e an ec are )1.t.Il.eJlW\.I . this Last Will and Testament, in the sight and presence, who at his request, in his sight and presence, and in the sight and presence of each other, have hereunto subscribed our names as witnesses. '- .." ~jJ~~ .-wI SS ~~~ ::&~fpA) TNESS COMMONWEALlli OF PENNSYLVANIA COUNTY OF YORK c. UIl( t3 e I'L A-N 0 SS. We, the undersigned, being the witnesses whose names are signed to the attached and foregoing instrument, 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 and Testament, that he signed it willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Last Will and 8 Testament as a witness; and that to the best of our knowledge the Testator was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. .~y:J~ Address: ~/Y7Y1/~.IPA) ......WITNESS Address: O~ tJ~ AJz~ '/IlfUwm;:di;uHg/ III /itl55 ~ sw~ or affirmed to and subscribed before me by the above named witnesses, thi!; '7 day of ~ ,1995. 6 , ,,~.... " -', . ~-- -"_/ "-=- - ./: - .+"--- ... -~ - , ,'~- -~ '-.. NOTARIAL SEAL DEBRA l SWAUGER. Notary Public Upper Allen Twp Cumberland Co PA My CommiSSIon ExP~S March 16. 1998 -', 9 000:;0 ;l:<ze::i:':! :;Oi:':!3G'l H OJH L'Oi:':!en H 0:;0 >,3 ene::L'i:':! L':;O;l:<:;O ~:~~~ -4 ;l:<5l8::<: ~i:':!e::H --.j ZL' ocn>,3t'" ~1O><en we:: ;1:<(') :;00 i:':!e:: :;0 >,3 :I: o e:: en i:':! 0-3 o .. ~ z "' :;; o c '" m "' '" ~ co ,. m z " o Ei " Cl "' "' Z Ul Z --< Ul " -< "' ... "' -< --< ,. Z ,. " o " o I C ...(:.. \ I ~ I'!j ~ -. .-- ~ -n -- -I (/) ... o - Q) en (/) 3: Q) -- - @ ", .~ ~ ~ ~ <0 u~ g ~ ~ l\~ ~~ - - tA- ~ t.AJ ~ i..c ~ c..n z: m x: <? oc.... c:: c: :::i~p-~ "" oN -....Jm-c. -OOOC:D::I>"'tJ We3~~j;Oc:J ~C;; e ~ ~Ul =-0 ~ :J> m INRE: GEORGE C. BARTLEY, IN THE COURT OF COMMON PLEAS! OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS COURT DIVISION NO. 21-04-1163 FIRST AND FINAL ACCOUNT OF STEVEN HOW~LL AS; , 'C:"-:;' EXECUTOR OF THE ESTATE OF GEORGE C. BARJLE~ DECEASED ~,~2 -u '\ r,,) o .' ...,--.... DATE OF DEATH: DATE OF EXECUTOR'S APPOINTMENT: DATE OF ADVERTISEMENT OF APPOINTMENT: 12/16/04 12/20/04 ACCOUNTING FOR THE PERIOD: PURPOSE OF THE ACCOUNT: w U1 12/31/04 (Cumberland Law Journal) 117/05 (Cumberland Law Journal) 1/14/05 (Cumberland Law Journal) 12/25/04 (Patriot News) 1/1/05 (Patriot News) 1/8/05 (Patriot News) 12/16/04 - 9/20/05 Steven Howell, Esquire as Executor offers this Account to acquaint interested parties of the transactions which have occurred during his administration of the Estate. The Account also sets forth the proposed Distribution of the estate. NOTICE TO INTERESTED PARTIES: It is important that the Account be carefully examined. Requests for additional information or objections or questions may be addressed to: STEVEN HOWELL, ESQUIRE 619 BRIDGE STREET NEW CUMBERLAND, P A 17070 (717) 770-1277 VOICE (717) 770-1278 TELECOPIER 1 (.) ::<j r-~ J c-) (50 C:J - ;--1 j~':~J ,-, C) i 'i"' -u C-') r-rl 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. I. RECEIPTS OF PRINCIPAL: 1. Description of Asset Proceeds from Zeigler Auction Company $1,450.00 (6/9/05 Check) $ 868.86 (5/16/05 Check) $ 123.75 (6/29/05 Check) $2,442.61 Erie Insurance Refund Check (6/16/05) Capital Self Storage Refund Check (5/31/05) Pennsylvania Employees Benefit Trust Refund Check (5/23/05) Real Estate Sale of Hummelstown Lot (4/25/05) Federal Employee Lump Sum Death Benefit (4/4/05) S. Raab (4/4/05) Met Life Insurance Proceeds (4/4/05) Federal Employees Group Life Insurance (3/29/05) PNC Bank (3/21/05) Met Life Insurance Proceeds (3/1 0/05) Harman's Coins (3/18/05) Bricker Auction Service (3/7/05) Cumberland County (2/24/05) Clark Coins (2/24/05) The Sun Newspaper Reimbursement (2/15/05) Janney Montgomery Scott (2/1/05) Federal Employees Life Insurance (1/13/05) Janney Montgomery Scott (1/5/05) The Patriot News Reimbursement (l/5/05) PNC Bank (1/5/05) Currency (Cash and Non-Collectible Coins) $ 30.00 (4/4/05) TOTAL $1,365.49 (12/28/04) $1,395.49 II. INCOME RECEIVED: Value $ 2,442.61 $ 90.00 $ 135.83 $ 153.46 $ 69,648.10 $ 4,714.13 $ 3,000.001 $ 1,540.67 $ 3,765.26 $ 1,211.48 $ 2,777.74 $ 3,900.00 $ 820.00 $ 100.00 $ 250.00 $ 14.00 $ 1,015.00 $ 30,741.25 $ 74,312.25 $ 177.20 $ 3,096.87 $ 1,395.49 $205,301.34 The Executor received no income during his administration of the Estate. III. DISBURSEMENTS OF PRINCIPAL: 1. 2. 3. 4. 5. 6. Payee Bethany Village (1/10/05) W. Orville Kimmel Funeral Home (1/10/05) Alert Pharmacy (Ill 0/05) West Shore EMS-ALS (1/10/05) Romberger Memorials (Ill 0/05) Steven Howell, Esquire (Ill 0/05) 2 Amount $ 4,090.00 $ 7,002.06 $ 47.25 $ 537.36 $ 374.00 $ 1,649.00 $ 650.00 (Advance to Funeral Home to Open Grave) $ 300.00 (Dick Cassel/Transport Property) $ 299.00 (Register of Wills) $ 400.00 (Dick Cassel/Transport Property) $1,649.00 7. Mindy Drake (Private Duty CNA)(1/1 0/05) 8. Patriot News (Advertise Estate)(1/12/05) 9. Erie Insurance Group (1/31/05) 10. Dick Cassel (2/1/05) 11. Tracy Cooper Tax Collector (2/1/05) 12. Steven Howell, Esquire (2/11/05) $ 350.00 (Dick Cassel/Transport to Auction 2/9/05) 13. George Mushinski (Shrub Clearing for Auction 3/16/05) 14. Munn's Diamond Gallery (4/21/05 - Appraisals) 15. Dick Cassel (4/28/05 - Clean Out Storage Site) 16. Steven Howell, Esquire (Legal Fees/Executor Fee/Advances) 17. Pennsylvania Department of Revenue (6/27/05) 18. Steven Howell, Esquire (Legal Fees/Cost Reimbursement) 19. Register of Wills (Inventory/PA Tax Return/Add'l Probate) 20. Steven Howell, Esquire (Legal Fees) TOTAL IV. RECAPITULATION: Total Principal Received Less Disbursements Available Balance $205,301.34 $ 41,436.87 $163,864.47 V. PROPOSED SCHEDULE OF DISTRIBUTION: 1. 2. 3. 4. 5. Payee The Pennsylvania State University The HACC Foundation Lebanon Valley College (LVC) Register of Wills (First & Final Accounting Fee) Steven Howell, Esquire (Postage/Copy Costs to Serve Account) TOTAL * Amount paid to Lve subject to change if additional estate expenses are incurred. $ 568.00 $ 188.01 $ 122.0(1) $ 350.0@ $ 343.52 $ 350.00 $ 300.0Q $ 250.00 $ 300.od $ 23,607.6d $ 18051 $ 862.50 $ 65.00 $ 250.0Q $ 41,436.8~ Amount $100,000.00 $ 50,000.00 $ 13,575.82 $ 230.00 $ 58.65 $163,864.47 Steven Howell, Esquire as Executor ofthe Will ofthe Decedent, George C. Bartley, hereby declares under oath that he has fully and faithfully discharged the duties of his office; that the foregoing First and Final Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the Estate have been paid in full; that to his knowledge there are no claims now outstanding against the Estate; and that all taxes presently due from the Estate have been paid in full. 3 Respectfully submitted, BY: St n Howell, squire 19 Bridge Street New Cumberland, P A 17010 (717) 770-1277 Voice (717) 770-1278 Te1ecopier' Supreme Court ID 62063 Executor and as Counsel fdr The Estate of Bartley Date: September 20, 2005 Subscribed and sworn to by Steven Howell, Esquire before me this 20th day of September, 2005. By: (3~~ Notary Public My Commission Expires COMMONWEALTH OF PENNSYLVANIA Notarial Seal BerIf T. Howell, Notary Public New Ct.mbeltand Boro, a.nbertand County My Corm1Ission ElCpires May 10, ax>> Mell'lber, Pennsylvania AssocIation of Notariea 4 CERTIFICATE OF SERVICE I hereby certify that on the date set forth below a true and correct copy of the foregoing documents was served by postage prepaid, first class United States Mail on all interested parties or counsel of record at the addresses set forth below. Elaine Rhodes The Pennsylvania State University Office of Planned Giving and Endowments 102 Old Main University Park, PA 16802 Maida Connor, Executive Director The HACC Foundation & Resource Development Harrisburg Area Community College One HACC Drive Harrisburg, PA 17110-2999 Sue Borelli Planned Gifts Lebanon Valley College 101 North College Avenue Annville, P A 17003 Tuan Tran 1134 West Quince Street Ontario, CA 91762 Calvin Daetwyler 1931 Prism Lane Houston, TX 77043 William Cassell, Sr. P.O. Box 206 Dacula, GA 30019 Helen Opperman Krause Animal Foundation (HOKAFI) P.O. Box 311 Mechanicsburg, P A 17055 Humane Society of Harrisburg Area 7790 Grayson Road Harrisburg, P A 17111 5 1 ' The Salvation Army 1122 Green Street Harrisburg, PAl 71 02 The Salvation Army Legal Department P.O. Box C-635 West Nyack, NY 10994-1739 Boys Club of Harrisburg 1227 Berryhill Street Harrisburg, P A 17104 V olunteers of America Regional Office 2112 Walnut Street Harrisburg, P A 17103 Harrisburg Masonic Consistory Heritage Builders Fund of the Harrisburg Consistory Ancient and Accepted Scottish Rite of Free Masonry 2701 North 3rd Street Harrisburg, P A 17110 Harrisburg Symphony Society 800 Corporate Circle Harrisburg, PA 17110 Harrisburg Choral Society c/o Ann E. Ariano, Esquire 6121 Chatham Court Harrisburg, PA 17111 Wodd Vision Legal Department P.O. Box 9716 Federal Way, WA 98063-9716 Harrisburg River Rescue, Inc. 111 South Cameron Street Harrisburg, PA 17101-2806 Guiding Eyes for the Blind, Inc. Attn: Planned Giving 611 Granite Springs Road York Town Heights, NY 10598 6 1 ' I . . The Rough and Tumble Engineers' Historical Association, Inc. P.O. Box 9 Kinzers, P A 17535 American Bible Society Legal Department 1865 Broadway New York, NY 10023-9980 Wanda Beverly March of Dimes 1275 Mamaroneck Avenue White Plains, NY 10605 Covenant House Planned Giving 346 West 17th Street New York, NY 10011-5002 Office of the Attorney General Charitable Trusts and Organizations Section Strawberry Square Harrisburg, PAl 7120 Date: September 20, 2005 7 I' , INRE: GEORGE C. BARTLEY, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS COURT DIVISION NO. 21-04-1163 NOTICE OF PRESENTATION OF THE ACCOUNT AND PROPOSED STATEMENT OF DISTRIBUTION REQUIRED BY LOCAL RULE 6.3-1 Notice is hereby given that the First and Final Account of Steven Howell, Esquire as Executor of the Estate of George C. Bartley, Deceased, shall be presented for confirmation on Tuesday, November 22,2005 at 9:30 AM in Courtroom Number I of the Cumberland County Courthouse, Carlisle, Pennsylvania 17013. Any objections must be filed in writing no later than 9:00 AM on the date fixed for confirmation. This Notice as well as a copy of the First and Final Account was served by first class, postage prepaid U.S. Mail on September 20th 2005 upon the following interested parties: Elaine Rhodes The Pennsylvania State University Office of Planned Giving and Endowments 102 Old Main University Park, P A 16802 Maida Connor, Executive Director The HACC Foundation & Resource Development Harrisburg Area Community College One HACC Drive Harrisburg, PA 17110-2999 Sue Borelli (Planned Gifts) Lebanon Valley College 101 North College Avenue Annville, P A 17003 (-) c) ~ ~:.:h ,-:..~i' ::-"1 Tuan Tran 1134 West Quince Street Ontario, CA 91762 (') ;- 1 -,) r,,) C) ') C) Calvin Daetwyler 1931 Prism Lane Houston, TX 77043 c...) r .~ '-' . William Cassell, Sr. P.O. Box 206 Dacula, GA 30019 I' Helen Opperman Krause Animal Foundation (HOKAFI) P.O. Box 311 Mechanicsburg, PA 17055 Humane Society of Harrisburg Area 7790 Grayson Road Harrisburg, P A 17111 The Salvation Army 1122 Green Street Harrisburg, PA 17102 The Salvation Army Legal Department P.O. Box C-635 West Nyack, NY 10994-1739 Boys Club of Harrisburg 1227 Berryhill Street Harrisburg, P A 17104 V olunteers of America Regional Office 2112 Walnut Street Harrisburg, PA 17103 Harrisburg Masonic Consistory Heritage Builders Fund of the Harrisburg Consistory Ancient and Accepted Scottish Rite of Free Masonry 2701 North 3rd Street Harrisburg, P A 17110 Harrisburg Symphony Society 800 Corporate Circle Harrisburg, P A 17110 Harrisburg Choral Society c/o Ann E. Ariano, Esquire 6121 Chatham Court Harrisburg, PA 17111 World Vision Legal Department P.O. Box 9716 Federal Way, WA 98063-9716 Harrisburg River Rescue, Inc. III South Cameron Street Harrisburg, PA 17101-2806 Guiding Eyes for the Blind, Inc. Attn: Planned Giving 611 Granite Springs Road York Town Heights, NY 10598 The Rough and Tumble Engineers' Historical Association, Inc. P.O. Box 9 Kinzers, P A 17535 American Bible Society Legal Department 1865 Broadway New York, NY 10023-9980 Wanda Beverly March of Dimes 1275 Mamaroneck Avenue White Plains, NY 10605 Covenant House Planned Giving 346 West 17th Street New York, NY 10011-5002 Office of the Attorney General Charitable Trusts and Organizations Section Strawberry Square Harrisburg, PA 17120 Date: September 20, 2005 i . - 0 o J IS 'j ~ i - I! i ~It HBJJ,I U!~HRI s ,!!? ~ ~ - t j ~f. " c co 6 VJ c f:" ", i='Ci. ~ "', 0 .; S: :~~ .C'., '" i: : - :'i " ,~ ~.: ~: - -,: iJU11l1Ii ",./<-' ..1-/ JiiJf:? S~~. ~ " .-" cc:IS" ggg,i't /1 (,):JO. "' <~a.J ~ z:; 1/], l..,'tl=g .;' ,I' ~ - /<"-~~ 1;:'7 'tl - --'/' ~C:Ql~"-- .\ lISgE './ .A ~~ ~ v (~l Ql ~" ./..' t:l:; 8 _ "11 ,,..,,'0 U 0 'I ~i;~ a ; t f I J , ~ ;-j( - - 0 i is lij- !I~di - . r . Hi d l ~ ':.. .,~_' :)~ C:" ,11 ~. '- .;:. 'j ;,-; ,,5 ::} '~ .' _'~~ < . ' 'J --,." ~ .i5':2~t..o-~~ ~:;; ;~aSjjs~i~ =~!1~ i~i8 -- al.c.oc( _ c C o <p 0 OHI> t:: :t:: 0 ~ c: ~ ::l 'C - <p c: - ~-a8~a5o.ro?-' <p ~ ,2: CD E .~ -5"8~- Ot-E~<;:: ~ig~~~~j +::+::'i.g~>Q)(5 j~Hi.ih ~~.8~ il~ iiiO- CD -5 -g 'i ~ :2 . i ,E ~cc~~1 il).x t::';i~gi~!O ~ ~ ! ~ .~ ~ g .~ ~ ~<coti c1ii~ Cl) CDOCl);>-~CDo .c ~ .c ... 'is' ~ b ~ .~ __~SOQ)~:E~ ~ o I' o I' ~ ~ ~~I-~ <( W .J O.J~>-I' I- I- (/) I' ~<((/)ZN ~>-wZ'7 Z W t:J ~ ~ ~~ecir:- o a: Z I' I- m <( - r,..,l-m.JI' i""t<(-a: 8 <0 ~ rJ1 :;: :J U ~ W Z STATUS REPORT UNDER RULE 6.12 Name of Decedent: George C. Bartley Date of Death: December 16, 2004 Will No. 21-04-1163 Admin No. 21-04-1163 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 .L No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: Not Applicable. 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: Not Applicable. c. Did the personal representative state an account informally to the parties? Yes No K 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 attached to this report. See Attached. ') Respectfully submitted, BY: St n H e 1, qui e 19 Bridge Street New Cumberland, P A 17070 (717) 770-1277 Voice Supreme Court ID 62063 Capacity: -L Personal Representative ~ Counsel for the Personal Representative Date: \a (a1 (l>~ ~t ^- ....... ~OMMbNWEAL TH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss: NOVEMBER 22. 2005 I, Glenda Farner Strasbaugh, Register for probate of Wills and granting Letters of AdministratIon for the County of Cumberland, in the Commonwealth of Pennsylvania, do hereby certify thc foregoing to be true and accurate copies ofthe FIRST AND FINAL ACCOUNT OF STEVEN HOWELL, EXECUTOR POR THE ESTATE OF GEORGE C. BARTLEY, LATE OF UPPER ALLEN TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED. as the same were passed and advertised and remain on file and of record in this office. IN TESTIMONY WHEREOF, I have hereunto set my hand and official seal on the date above. d r ~ t l <I " '7.P',. ,f, (t; Glendi~~~~et~trcf~M~~ie~~i~111~<':' ..I~ (' ~~~~~~~~~~~~~~qqqq~~~~~~~~~~~~~~~~~ NOW TO WIT, NOVEMBER 22,2005 came into Court STEVEN HOWELL, EXECUTOR and presented an account and statement of proposed distribution, which were examined, passed, approved, and confirmcd with a balance in his hands of $ 163,864.47 and the accountant was directed to distribute said balancc in accordance with the statement of distribution filed. ~:~. . ~( '~. f.-. ~, .,1 .f ' . I" I , ..'~_" it ~/ ,~~_/ " >i4~.J .~;.... ," '.j " - Glenda Farner Strasbaugh, Clerk of the Oh)hans' Court ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ COMMONWEAL TH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND I, Glenda Farner Strasbaugh, Clerk of the Orphans' Court, in and for said County, do hereby certify the foregoing to be a true copy of the account and statement of proposed distribution of STEVEN HO WELL, EXECUTOR. ' as full and entire as the same remain on file and record in this office. IN TESTIMONY WHEREOF, I have hereunto set my hand and official seal at Carlisle, this 22ND clay of NOVEMBER, 2005. Docket No: 21-2004-1163 ~ C.P' ~' f" 'T . "7.l.-'" !,. I ~~ l.~..$U )ldfA~e~4""~;'AIlt Glenda Farner Strasbaugh, Clerk oftIt~~rphans' Court