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Home My WebLink About04-1176 Olenda Famer Strasbaugh Register of Wills & Clerk of the Orphans' Court Marjode A. Wevodau First Deputy Kirk S. Sohonage, Esquire Solicitor OFFICES OF One Courthouse Square Carlisle, Pa, 17013 (717) 240-6345 FAX (717) 240-7797 giSt r of i tiIl anb of the rpOan ' ( ourt ~:ount~ of ~-ur~rlan~ State of Pennsylvania County of Cumberland SS: BE IT REMEMBERED, that I, Glenda Farner Strasbaugh, Register of Wills of .Cumberland County, Pennsylvania, do hereby commission you, P.W. Weidenboemer, Elk County Register of Wills or one of your Deputy Registers, to administer the Oath of Swearing in the Executor of the Estate of Le Roy D. Cameroni, late of Cumberland County. Said Will bearing the date of April 1, 2004; a copy hereunto attached. By virtue of the Act of Assembly approved July 11, 1917, P.L. 803. IN TESTIMONY WHEREOF, I have here unto set my hand and affixed my seal the 15t~ day of December 2004. Cumberland County PETITION FOR PROBATE and GRANT OF LETTERS alsok.owna -- No. oql-0 -llq_ , To! -~ Deceased. Register of Wills for the Social Security No. ~L6_.~_.~' ~' t~2,._LI County of ~ in the -- Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the~xecut~ r- _ named in the last wilt of the above decedent, dated ~ / _ - and codicil(s) dated _, t'9_2_Oo~ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in --~,~,Ja~_[__~ _ County, Pennsylvania, with last family or principal residence~at ~ I ~ ~ 0oh 5"r~_~.~ ~- a $~_T__~ __ (list street, number and muncipality) Decen.dent, then ~o ~ ~ years o.f age, dted at.~ ~, .... ' ,. ~v, as touows, decedent did not marry wa .... J:-- ~ ~ - - -. ~ , /~ . aster execution of the will offered fo ..... L .... -~ mvorcea aha md not hav~a child born or a opted incomp~em. - ........... ~y;m p~ooare, was not the victim of a killing and was never adj~cated D~endent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters~~-td-r/,q ~ey theron. (testamentary; adnfinistration c.t.a.; a~'~inistration d.b.n.c.t.a.~--~ OATH OF PERSONAL REPRESENTATiVE COMMONWEALTH OF PENNSYLVANIA .COUNTY OF _ ~_ 5 S8 The petitioner(s) above-named swear(s) or affirm(s) that the statements true and correct to the best of the in the foreg~ petition knowledge and belief of petitioner(s) and that as personal repre~- tadve(s) of the above decedent petitioner(s) will well ~d truly admi~ster the estate according to law. Sworn to or affirmed and subscribed bet, ore me this ~7/ da ~ Register Estate ef _ .r~ 0 DECREE GF FROBATE AND GRANT (~' LETTERS ^sD sow ~ '~-~- ~a0~, ir~ consideratio~ of t~,e petit';o~ on IT tS DEC~ED that the instrument(s) aateO ~2 ~ - ~ descried therein be admitted to probate ~d filed of record as ~e l~t will of _ . and Letters ~~ are hereby g~~ ~ ' ~ - FEES Probate, Letters, Etc .......... $.~C). Short Certificates( ) .......... Filed · .I..~. :~.-1.: .~.~.~.~...: .............. ATTORNEy (Sup. Ct. I.D. No.) ADDKESS PHONE his is to certify that the inlbrmation here given is correcdy copied from an original certificate of death duly filed with me as l,ocal Registrar. The original cerlificate will be fi)rwarded to the State Vital Records Office fl)r permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 10935570 Date CERTIFICATE OF DEATH December 3, 2004 A~osti PA 16412 PA 15846 St. Mary,, PA 15857 LAST WILL AND TESTAMENT BE IT REMEMBERED THAT I, LEROY D. CAMERONI, a resident of Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this to be my LAST WILL AND TESTAMENT, hereby revoking any and all Wills and Codicils previously made by me. I declare that I have two (2) children, DAVID J. CAMERONI and ~[EAN M. OTT. II I direct that all my just debts and funeral expenses shall be paid from my residuary estaie as soon as practicable after my decease. III I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. IV I give, devise and bequeath my home situate at 216 Wood Street, Camp Hill, Pennsylvania to RUTH REGAN, per capita. V I give, devise and bequeath the contents of my home and any vehichle that I may own at my death to my children, JEAN M. OTT and DAVID J. CAMERONI, in equal shares, per stirpes. VI I give and bequeath all of my guns to my son, DAVID J. CAMERONI, per stirpes. VII Ail the rest, residue and remainder of my property, whether real or persona/, wherever situate, including any property over which I may have a power of appointment, including any money markets, savings accounts, certificates of deposit and checking accounts, I give, devise and bequeath to my son, DAVID J. CAMERONI and my daughter, JEAN M. OTT, in equal shares, per stirpes. VIII I nominate, constitute and appoint my brother FRANCIS CAMERONI, as Executor of this LAST WILL, to serve without bond. If my brother is unable or unwilling to act in that capacity, then I nominate, constitute and appoint my daughter, JEAN M. OTT, as Executrix of this LAST WILL, to serve without bond. IN WITNESS WHEREOF, I, LEROY D..CAMERONI, have set my hand to this LAST WILL this / ~- day of /~jO ~-, { , 2004. LEROy'/D. CAMERONI Signed, sealed, published and declared by the above-named LEROY D. CAMERONI, as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence, and in the presence of each other, have hereunto subscribed our names as witnesses. ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA : SS. COUNTY OF CUMBERLAND : I, LEROY D. CAMERONI, 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 as my free and voluntary act for the purposes therein expressed. C^/ -RONI Sworn or affirmed to and acknowledged before me by LEROY D. CAMERONI, Testator, this / 5-'~ day of ~ ,2004. Notary Public AFFIDAVIT NOTARIAL SEAL DEBORAH L. RYAN, NOTARY PUBLIC ~CITY OF MECHANICSBURG, CUMBERLAND COUNTY MY COMMISSION EXPIRES JUNE 11,2006 COMMONWEALTH OF PENNSYLVANIA : COUNTY OF CUMBERLAND SS. the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as his LAST WILL, that LEROY D. CAMERONI signed 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 ~L ~hh; TT;~ttaattoO; ~ag~s eadt tthh; W. ill a~s~witnesses; and that to the best of our know[ed~: e ume L ~ years of age or more, of sound mind and" icier no constraint or undue influence. / / / ?~pn · Sworn or affirmed to and acknowledged before me this /~-E~- day of ~/Z/~/ ,2004. Notary Public NOTARIAL SEAL DEBORAH L RYAN, NOTARY PUBLIC CITY OF MECHANICSBURG, CUMBERLAND COUNTYm MY COMMISSION EXPIRES JUNE 11, 2006 Name of Decedent: Date of Death: Will No.: To the Register: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) LEROY D. CAMERONI November 30, 2004 21-04-1176 I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on January 6, 2005. David Cameroni 5191 Crane Road Edinboro, PA 16412 Jean Ott 12818 Arbor Street Conneaut Lake, Pa 16316 Ruth Regan 3516 Walnut Street, Apt. D Camp Hill, PA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: COYNE & COYNE, P.C. fLisa/~,larie Coyne, E4quire ~ Market Street l Camp Hill, PA 170114227 (717) 737-0464 Pa. Supreme Ct. No. 53788 Counsel for Personal Representative l~flOO $,NVHdkfO ,..1. ....1 (} I.... ,oj '1 ,'..\ ;'.I? \.1..\ \.,,\ -:::". ., ~ -:r-. -::.- :? ~ ~ ~ =- :r" ~. :;:,.... :;..... :;:,.... -::.-. - -::.- :::-. ('l1J ('lOcs <J?~%-~ ~g~~ ('l)C~9.. '." 5- ~ Z J:>~('l~ ">(potp 'C3(\l'S '>~a <>>C('l <J?o (\l~ a '$ =- :::::' =- - s %~;! :>: "? ~" F- -.;c z _ . )> "- '0' ~~(fl ~~ ~~ ...."',,-.. ~~~'" ..... ~ '-... ~ "0 ~ h . .~\l ~" , . -{' c. 0'J ;~ ) ~ : ., J . ',._--~ -\ ' ~s :c. I ) \ \1 . \\ \.\ , ., \ \ \ '\ '"\, 1 . . !~ f j j. ~- ~ ~ ~ ~ ~ \ \ 1 '\ \ ! , COYNE & COYNE A PROFESSIONAL CORPORATION ATTORNEYS AT LAW Henry F. Coyne Lisa Marie Coyne Austin F. Grogan 3901 Market Street Camp Hill, Pennsylvania 17011-4227 717-737-0464 Fax: 717-737-5161 February 25, 2005 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re: Estate of LeRoy D. Cameroni, Deceased No. 21-2004-1176 Dear Sir or Madam: We represent the Estate of the Late LeRoy D. Cameroni. Enclosed please find check no. 3123 in the amount of $595.00 made payable to the Register of Wills, Agent. Payment of this sum is made on account of the inheritance taxes due for this Estate. Payment is made during the discount period. Thank you in advance for your assistance. If you require any additional information, please contact me. Very truly yours, JJ-TC _ Li~ Mm, Co,"' S LMC/amd Enclosure cc: Mr. Francis Cameroni, Executor, w/encl. \;"--- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX( 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT COYNE LISA MARIE 3901 MARKET ST CAMP Hill, PA 17011 nnnn fold EST A TE INFORMATION: SSN: 186-28-1211 FILE NUMBER: 2104-1176 DECEDENT NAME: CAMERONI LEROY D DATE OF PAYMENT: 02/28/2005 POSTMARK DATE: 02/25/2005 COUNTY: CUMBERLAND DATE OF DEATH: 11/30/2004 NO. CD 004998 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $595.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 3123 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $595.00 GLENDA FARNER STRASBAUGH REGISTER OF WillS .. COYNE & COYNE, P.C. A PROFESSIONAL CORPORATION A TfORNEYS A T LAW Henry F. Coyne Lisa Marie Coyne 3901 Market Street Camp Hill, Pennsylvania 17011-4227 (717) 737-0464 Facsimile (717) 737-5161 May 8, 2006 Office of the Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PAl 7013 Re: Estate of LeRoy D. Cameroni, Deceased No. 21-2004-1176 Dear Sir or Madam: Enclosed please find an original and three (3) Inheritance Tax Returns for the above-referenced Estate. Kindly docket the original and return to this office, two (2) "clocked-in" copies with the enclosed envelope. Also enclose is check no. 1190 in the amount of $15.00 as the filing fee for the Returns. Thank you for your assistance. Very truly yours, COYNE & COYNE, P.C. (---1.;7 IV "-'-']~[A--- /~ Li.. ,. Lisa Marie Coyne j ,---..._----~----- LMC/cmc Encls. Cc: Mr. Francis Cameroni, Executor, w/encl. V .1500 EX+ (6.00) *' REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 2004 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 1176 NUMBER COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE OEPT. 280601 HARRISBURG, PA 17128-0601 .... Z W Q W o w Q DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) CAMERON!, LeROY D. DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) 111/30/2004 08/01/1935 (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) w .... lIl::~cn oa:lIl:: wo..o xgg oo..m 0.. c( ~ 1. Original Return o I5a o o 2. Supplemental Return o o o 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95 l 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) 4. limited Estate 6. Decedent Died Testate (Attach copy of Will) 9. Litigation Proceeds Received AME ~ Lisa Marie Coyne ~ IRM NAME (If applicable) z ~ Coyne & Coyne, P.C. ELEPHONE NUMBER 717/737-0464 1 . Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership'or'Sole-Proprietorship z o i= :i ~ .... 0: c( o w a: 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. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) (r~r--'~ OFFiCiAL USE ONL v I 186-28-1211 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER I ! o 3. Remainder Return (date of death prior to 12-13-82) o 5. Federal Estate Tax Return Required COMPLETE MAILING ADDRESS 3901 Market Street Camp Hill, PA 17011-4227 (1 ) 115,160.00 (2) None (3) None (4) None (5) 40,675.28 (6) 1,490.00 (7) 17,182.35 ~ OfFICIAL. USE.Ot..JL Y I '\''oJ '"") '.: I '; j ;: ) " ;') ; .. ; l-.. ./ r<j , . I (8) 174,507.63 (9) (10) 33,603.52 3,719.36 (11 ) 37,322.88 (12) 137,184.75 13. Charitable and Governmentai Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) (14) 137,184.75 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, 126,604.90 x .00 (15) or transfers under Sec. 9116(a)(1.2) z 9,083.85 .045 (16) 0 16. Amount of Line 14 taxable at lineal rate x ~ c( .... ~ 0.. 17. Amount of Line 14 taxable at sibling rate 1,496.00 x .12 (17) ::e 0 0 S 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 0.00 408.77 179.52 20. ~ CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 588.29 Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) ,~ Decedent's Complete Address: STREET ADDRESS 216 Wood Street CITY Camp Hill I STATE PA I ZIP 1 7011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 588.29 595.00 29.41 Total Credits (A + B + C) (2) 624.41 3. Interest/Penalty if applicable D. Interest E. Penalty B. Enter the total of Line 5 + 5A. This is theBALANCE DUE. (3) (4) (5) (5A) (58) 0.00 36.12 Total Interest/Penalty (0 + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEDVERPA YMENT. Check box on Page 1 Line 20 to request a refund 5. It Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. A. Enter the interest on the tax due. 0.00 Make Check Payable to: REGISTER OF WILLS1 AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. reta~n the ~se or inco~e of the property transferred;............................:...:............................................ 0 ~ b. retain the nght to designate who shall use the property transferred or Its Income;................................ 0 ~ c. retain a reversionary interest; or... ......................... ..__........................ ...n.................. ....... ......... ............ 0 ~ d. receive the promise for life of either payments, benefits or care?........................................................... D ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year ot death without receiving adequate consideration?............................. .............. ...................................................................... 0 [8J 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?............................ .--............................ --........ .................................... ...... ~ D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS ('--,\ Francis Cameroui (;) . ~ V \ """'fA - i I".)....::t! a-1,'u:J..A/' ~~.. \..L. . SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE Box 78, Main Street Kersey, PA 15846 sI8/~G DATE ADDRESS SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE Lisa Marie Coyne ADDRESS DATE 3901 Market Street Camp Hill, P A 17011-4227 For dates of death ( surviving spouse is . ... q94 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the '~ 4\ li)J. ~~ ~ ~ ~ "> ~ ~ ~ ~ (t: ~ r-\ ,......J asters to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116 G-' --:~ ~ . \Pr tc) Ie tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% ,t exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure Ie even if the surviving spouse is the only beneficiary. For dates of deatt' [72 P.S. 99116 (a of assets and filir For dates of de; The tax rate im parent, an ado The tax rate i, 1.2) [72 P.S. The tax rate under Secti.... fers from a deceased child twenty-one years of age or younger at death to or for the use of a natural the child is 0% [72 P.S. 99116 (a) (1.2)J. .msfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116 (a) (1.3)]. A sibling is defined, las at least one parent in common with the decedent, whether by blood or adoption. ~ ~ SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF I FilE NUMBER I 21 - 2004 - 1176 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. CAMERON!, LeROY D. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 115, 160.00 216 Wood Street Property, East Pennsboro Township, Cumberland County (Assessed Value) TOTAL (Also enter on Line 1, Recapitulation) 115,160.00 Detailed Results for Parcel 09-20-1850-227. in the 2004 Tax Assessment Database DistrictN 0 9 Parcel ill 09-20-1850-227. MapSuffix HouseN 0 216 Direction Street WOOD STREET Ownerl CAMERON!, LEROY Owner2 PropType R PropDesc Liv Area 1242 CurLandVal 45000 CurImp V al 70160 CurTotVal 115160 Cur PrefV al Acreage 0.2 CIGrnStat TaxEx 1 SaleAmt 85900 SaleMo 1 SaleDa 3 SaleCe 19 SaleYr 94 DeedBkPage 00368-00862 YearBlt 1960 HF_File_Date 10/19/2004 HF _Approval_Status A http://taxdb.ccpa.net/ details. asp ?id=09-20-185 0- 22 7. &dbselect= 1 Page 1 of 1 2/24/2005 *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CAMERONI, LeROY D. I FILE NUMBER 21 - 2004 - 1176 I 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 DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 Misc. Personal Property Per Attached Inventory 7,482.00 2 Personal In jury Settlement Proceeds 10,000.00 3 PNC Bank -- Checking Account 17,167.01 4 PNC Bank -- Savings Account 5,373.27 5 Cash 653.00 TOTAL (Also enter on Line 5, Recapitulation) 40,675.28 MHR~07-2005 20:52 P~~CBA~'~l< ~~ o PNCBAl\K March 8, 2005 Lisa Marie Coyne 3901 Market Street Camp Hill, PAl 7011-4227 RE: Estate of Leroy D. Cameroni, (Deceased) SSN: 276-02-5057 DOD: 11/30/2004 Dear; Ms. Coyne 412 768 3.158 P.02 In response to your request for Date of Death balances for the customer noted above, our records show the following: Checking Account Account # 5140202213 LEROY D CAMERONI DOD balance: $17,165.53 + $1.48 accrued interest Savings Account ACCOWlt # 5000727026 LEROYQq~RONI DOD balance: $5,370.27 + $3.00 accrued mtereit Safe DeposifBox Account # 40117140 LEROY CAMERONI Located: Established 10/19/1983 Established .11/04/1996 Established 03/22/1994 HAMPDEN 4242 CARLISLE PIKE CAMP HILL PA 17011 717-730~23g5 The decedent Maintained Investment Account (INV # 20600401). For further infonnation you may contact the Brokerage Department at 1-800-762-6111. -2005 20: 52 Pt'~CBA~.u.( 412 768 3458 P.03 Please note that thi~ office only provides date of death balances for depO~t accounts (IRAs, CDs, Checking and Savings accounts). We do Dot process any (mandal transactions or pro'\Tide $tatements. If you need assistance with any of these items, please call1-888-PNC-BANK. (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely~ ~3JlL Jessica ScheUer 1-800-762-1715 P7 -PFSC-04-F 500 first A \Ie. Pittsburgh P A ) 5219 Member FDIC TOTAL P.03 Page of _ SAFE DEPOSIT BOX INVENTORY INSTRUCTIONS. (l) Cash: Report total only. (2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by name of company, certificate numb~r, date of certificate, name in which stock is registered, and number 'of shares and class c?f stock. (3) Obligations of U. S. Government: Number of items, date of issue, face value, names in which registered and type of ownership, i.e., jointly held, payable on' death, etc. (4) Bonds: Designate by name,a'rnount, serial number, or other designation. (Bearer Bonds) . (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. (6) Jewelry, Coins, Stamps, Manuscripts, etc: li.st and describe as fully as possible. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible. 18) All other contents. ITEM NO. ITEM DESCRJPTION ''D " c.;.! ..1^-JL....,../J-...J VI 0 V.5 () I CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS PERSON RECEIVING COpy OF . CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY: ---'" SIG RE V. ...... SIGNATURE - Jl.~ PRINT NAME AND CHECK APPROPRIATE BOX BELOW: CHECK APPROPRIATE BOX: o ExeclJtor(trix) .0 Administrator(trix) o Estate Representative 0 Joint owner' of safe deposit bO;1( NOTE: Attach additional 8lh" x 11" sheet (s) if necessary or use dlJ~lit'nt&:loc ,..~ +,,"i~ ---: _z. ~~-- .~. A- 111\../~ e- ~- tJ~ PRINT TITLE c~ +&v- E3Jv-~ ClAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1910 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-737-0734 January 11, 2005 Appraisal for the Estate of LeRoy D. Cameroni 216 Wood Street, Camp Hill, PA 17011 LIVING ROOM Oak oval end table Blue table lamp Sofa Glass coffee and end table Floral picture and two sconces 20.00 2.00 40.00 15.00 20.00 Large table lamp - broken Upholstered chair Picture of water Stereo stand Aiwa stereo system 2.00 15.00 8.00 5.00 50.00 Panasonic TV Hitachi VCR Misc. CD's Clock Misc. tapes 40.00 25.00 20.00 2.00 5.00 Elgin clock Rocking chair Plant stand Dog figurines Light! stand 5.00 35.00 10.00 3.00 5.00 Blue recliner Fireplace decorations Picture of mountain top Misc. contents of living room 30.00 3.00 5.00 20..00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1910 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-737-0734 Cameroni appraisal Page 2 of 9 DINING ROOM Wall mirror Remote telephone Oriental figurines Beam bottle Roanoke table, 5 chairs & bench Misc. pictures Misc. crystal Painted comer cupboard Misc. contents of dining room KIT'CHEN Toaster Coffee maker . Sharp TV 7 :Misc. baskets & artificial flowers GE refrigerator Flatware Utensils Misc. everyday dishes Cookware Clock Kenmore microwave Microwave stand GE portable radio AT&T remote telephone - old Trash can Drop leaf table & 2 chairs Misc. contents of kitchen 10.00 8.00 10.00 1.00 150.00 5.00 20.00 9(} 00.. 25.00 1.00 1.00 25.00 5.00 50.00 5.00 5.00 10.00 5.00 1.00 20.00 5.00 3.00 2.00 1.00 45.00 20.00 CLAUDE C. WOLFE & ASSOCIATES . AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1910 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-737-0734 Cameroni appraisal Page 3 of 9 HALL Hoover upright vacuum cleaner Crosman BB/pellet pistol Fire extinguisher Electric broom Linens MIDDLE BEDROOM Misc pictures Zenith TV - old Entertainment center Simmons 9x40 binoculars Telephone Mirror Lamp Lamp/stand Shredder Chair Magazine rack Trash can Recliner Sofa bed VCR tapes Figurines Telephone Desk lamp Radio .. Calculator :Misc. cameras Misc. contents of bedroom 8.00 10.00 5.00 1.00 5.00 10.00 5.00 50.00 30.00 2.00 2.00 1.00 5.00 8.00 1.00 2.00 1.00 10.00 5.00 10.00 2.00 2.00 2.00 1.00 2..00 10.00 25.00 l . CLAUDE C.. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1910 2009 LINCOLN STREET · CAMP Hill, PA 17011 717-737-0734 Cameroni appraisal Page 4 of 9 FRONT - END BEDROOM Nfisc. jewelry 4-Drawer chest Blue table lamp Pair of night stands King size headboard with Queen size bed Pair of table lamps Valor Import .25 semi-automatic pistol Telephone Mirror RCA TVNCR Nfisc. costurnejewelry 5-Drawer chest Pictures Wmchester Model 1400 12 gauge semi-auto shotgun, 2 3/4" chamber, 95% Ruger .22 semi-auto pistol w/Tasco Pro point sight Misc. contents of bedroom REAR - END BEDROOM Lamp/stand 3 -Drawer chest GE TV - old Tuner Gone With The Wind style lamp Table lamp Floor lamp Plant stand ReA TV - old ,Chest 15.00 10.00 1.00 40.00 100.00 5.00 50.00 2.00 5.00 40.00 35.00 30.00 5.00 225.00 175.00 25.00 3.00 35.00 5.00 1.00 10.00 1.00 8.00 5.00 5.00 25.00 CLAUDE C. WOLFE & ASSOCIATES Cameroni appraisal Page 5 of 9 AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1910 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-737-0734 REAR - END BEDROOM - continued Double bed American Kinnan rug 4 7"x71" Stand Table lamp Alarm clock Bushnell Stalker spotting scope R~gton Model 581-S .221r. w/Bushnell Sportview scope -75~~ Marlin :rv1ode1882 .22w:rv1R microgroove barrel, Bushhe113-9 scope Remington Model 700, 22-250 Rem cal., wlLeupold Vari X TIc 4-12 scope Msc. contents of bedroom Misc. contents Pelonis heater Zenith portable TV Telephone Clock Scales Trash can Kenmore washer - old Kenmore dryer - old Canning jars Metal shelving Ironing board BATH BASEMENT BA TH BASEMENT 15.00 30.00 1.00 1.00 2.00 65.00 110.00 ,.100:00 250.00 10.00 5.00 5.00 20.00 1.00 1.00 2.00 1.00 35.00 20.00 1.. 00 5.00 1.00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1910 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-737-0734 Cameroni appraisal Page 6 of 9 BASEMENT - continued Electric iron Sears 3/R" drill Craftsman 3/8" rechargeable 8.4V drill Montgomery Wards Power Craft reciprocating saw Craftsman 12v rechargeable 3/8" drill Craftsman 7 1,4" circular saw Craftsman 6" bench grinder Clock Craftsman polisher Craftsman 5/8hp router , .. ''':" . ....';:;.- ..'~ ~ t', -, ::. Sander - old Sabre saw - old Electric screwdriver Soldering gun YOM Battery charger 1 ~ amp Hot air gun Jig saw Misc. hand tools Floor type tool box on wheels Misc. hardware Stool Small stepladder Zenith TV Pro-Form L 18 treadmill Remote telephone Desk lamp Draftsman's lamp w/magnifier Panasonic radio Canon calculator 1.00 3.00 10.00 20.00 15.00 12.00 25.00 1.00 5.00 .35.00 2.00 10.00 5.00 2.00 5.00 4.00 8.00 7.00 100.00 .30.00 10.00 1.00 5.00 30.00 ~O.OO 10..00 2.00 10.00 3.00 10.00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1910 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-737-0734 Cameroni appraisal Page 7 of 9 BASEMENT - continued 2 Desk chairs Desk Smith Corona typewriter Panasonic KX-F1 000 fax/copier 4- Drawer file cabinet Eureka canister vacuum cleaner Fishing equipment M.sc. chairs White..;.. W"estinghouse remgerator - old " Misc. ammo & brass cartridges - 30.06, 22-250 & .22 Craftsman small drill press Shopcraft 10" band saw & bench Craftsman 1 0" table saw Craftsman 6hp shop vac Pedestal fan , Frigidaire dehumidifier Settee Hunting & fishing boots Coleman stove Kerosene heaters 2 Dining room chairs Coolers Misc. contents of basement CARPORT SHED Hydraulic jack Upright vacuum cleaner - old Craftsman blower Misc. garden tools Propane grill Table & benches 2.00 1.00 2.00 35.00 20.00 7.00 15.00 5.00 "-10':-00- 60.00 30.00 60.00 .~o.ob 25.00 10.00 35.00 10.00 20.00 10.00 2.00 3.00 2.00 50.00 10.00 1.00 20.00 15.00 10.00 5.00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1910 2009 LINCOLN STREET · CAMP HILL, PA 17011 717 -737 -0734 Cameroni appraisal Page 8 of 9 OUTDOOR SHED Craftsman air compressor - Shp, 22 gallon Toro CCR2000E snow thrower Craftsman gasoline powered edger LawnBoy 21" mower Murray Select 12hp, 30" riding mower 4 Electric hedge trimmers Aluminum stepladder Aluminum 12' extension ladder v\'heel'barrow Dolly Spreader Stool Weed Eater gasoline blower 6BI22 Weed Eater gasoline string trimmer Misc. hand tools Antique plane Garden tools - shovels ~sc. contents of shed AUTOMOBILES 55.00 325.00 45.00 65.00 150.00 20.00 10.00 15.00 S.DO 5.00 3.00 3.00 25.00 35.00 60.00 35.00 25.00 35.00 1995 Buick Regal4-dr gold sedan. 111,162 miles, full power. AM/F:M/Cassette. Exc. condition 1,750.00 1990 Ford Ranger XL T pickup, 4-wheel drive, 4-speed manual transmission 92,737 miles, extended cab w/side seats L200.00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 1910 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-737-0734 Cameroni appraisal Page 9 of 9 APPRAISAL TOTAL $ 7,487.00 This Fair Market Value appraisal is true and correct to the best of my ability as an auctioneer and appraiser with 35 years experience. Member: Certified Appraisers Guild of America CLAUDE C. WOLFE & ASSOCIATES ~,~_~~ ~r-- w. K. Dusty Chapm~ CAGA . SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CAMERONI, LeROY D. I FILE NUMBER 21 - 2004 - 1176 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Francis Cameroni Kersey, P A Brother JOINTLY OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT or similar identifying number. Attach deed for jointly-held real VALUE OF ASSET INTEREST DECEDENT'S INTEREST estate. 1 A. 08/01/2003 113 Zola Street I 50% 1,490.00 2,980.001 Kersey, PA (Assessed Value) I TOTAL (Also enter on line 6, Recapitulation) 1,490.00 . SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT CAMERONI, LeROY D. I FILE NUMBER 21 - 2004 - 1176 I ESTATE OF This sc e ule must be comp ete an ie i the answer to any 0 questions t roug on page IS yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF Include the name of the transferee. their relationship to decedent and the date of transfer. DECO'S EXCLUSION TAXABLE VALUE NUMBER VALUE OF ASSET (IF APPLICABLE) Attach a copy of the deed for real estate. INTEREST 1 1/2 PNC Bank IRA to Wife 17,182.35 17,182.35 0.00 2 1/2 PNB Bank IRA to Children 17,182.35 I 17,182.35 I I i I I I I I I 1 h d d dfldf f 1 h h4 2. TOTAL (Also enter on line 7, Recapitulation) I 17,182.35 / ,It' ; I /' "4/2005 14:02 7175343231 l4/LUU~/F~1 10:54 AM PNC HERSHEY / /'/;.;-; '1' ~::.~~."~""::.:... ;~;~.,~.~:/ ;~tjt~'-;t: l ;.::' .', t ::-~ :~ ~>{ 1';., t p. ~ : f:'~" ~ . If.'" :-" ESTATE OF LEROY CAMERON! -,- ':~:/:(IX)D VALUAUONNOVEMBEIti30; 20C\4) The information provided in this report is believed to be n;liabIe, but its accuracy cannot he gua~ed A mean price is calculated as an average of the high 2nd low on the valuation date when avaibble~ If these prices are not available, such as on weekends or holida~; the mean price is the inversely weighted 3:v~mge qf ~e AigA and low on the ue~~ ~dates before and. ; a:fter~ when these" prices are available within one week of the valuation ckte. If actual trades are not available, the. nearest bid and ask prices are ._s\11~stituted. ~Note that securities traded on the Toronto Exch3nge arem (1m~l(Jj~n dollars. If an equity is ex-divideud for a cash distributio~ on or before the valuation date but is of record after the valuation date, the dividend is included in the valuation report and is added to the securitis value. ~ is l'epo~,,~. an adjusted value on the ;Cq>q~r" If the date of death is" on or after the ieconi date and the dividend is paYJhle after that date; the accrued dividend is listed separately on the report and added to the portfolio's tOtal, -mue. ' Prices for which daily updates are not av.illable are priced accotding to a Coxpozate Pricing Cycle. These pricing dares occur on the last bus,mess day of the week, and the last business day of the month, unless the end of the week update faDs within three business daJ.1.S or Jess) of.~ end-of-month update. Pn:pared: 14 January 2004 PAGE 82 PI 002/003 ~;', '~t, .)~. t- ~ ;'4/~;:):-:/'~:' ,4.12005 14: 02 7115343231 ,.. \~\~.~ ~~~~ OiH~~ <",o~i ~li!\ "~ Q -~ . ~ t) 0 ., it\ e. a ~ e.~1~ tl o v ~ ~ g. tli' ~ it ~ P' ~ ~ .~ ~ ~ d ;r q) ~ ~ ~ ~ ..rl ~~ (I)~ "'a \ t""isn 1\ Cl~ ~1A \ 01 lb ~ li' \\ i\' ~. pNe \-\ERS'r€'l \b ~ " V'I ~ Q:) .. ~ )t\ \\ 0 ~ .QI\. ~ 1tI ~ ('l n \ .0 0- t- o. O'l'" 0- 0' .g 0 0 ...( o o o eo 0- o ~ P QJ 0 0 Q " 0 t;) a ~ ~ It"'4. CI c:) c::=' 0- d e Q .0 ~ Q \"""I r-i \ ;- f; 0 <:> ~ ...r (- -::r C't ,~ Cl'\ ~ t:l ~ ~ .0'\ ~ - ~ a:tpt- a \i eol"- ......o4'tn ..Ool ~~ ~ oQ>~ r;~ \..?~ r' ~ 000- c-: ~~~ ..-l .~ --- ~1-& \~ p>~i~ 4- 00.'" go ~ ....d""" r'i,.-,n ~! ~ t..0 --- -4 - - ~r;1G \ \0 ~ ~ <::::::J "" ,.. ~ e> -- ... \1l u:. ~ ~~~ .... l\P J,.l .(-.t fI'\' ...- .s~g ,~ I;/!J \P ~a~ ~ ..-. ~ ~ nSP ; li fit ~ of. --- ~ ~. ~ p ~.~ m l~ . -::;::::J 0".\01 e .-;:r .-. ~ .~ tl " ::-1 c>>~g ~~ -- a ~ ~ P"~ ..--'" --- ~ 'l \" .. , ,~ . , .: ,- .. , . ' , . . , . . ~, . ".: ...,.' , ,'. . :'... ':,':. ': . .' , .,:.... ... .. - .. , . . i. ." ." .\. i". ..'~" ~,', :'" , '~ .' . .... -". .... : .-; .' ..-} .. -" y. .".... \ ,,": -:< :.:;: ... ", .' . . ..:~.: :'~~~:i~{iJ;~.:.i::;l~ -., - . .--~ *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H RJNERAL EXPENSES & PDIVIINlSTRAllVE COSTS ESTATE OF CAMERONI, LeROY D. I FILE NUMBER 21-2004-1176 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. 1. FUNERAL EXPENSES: Lynch-Radkowski Funeral Home DESCRIPTION B. ADMINISTRATIVE COSTS: 1. Persona' Representative's Commissions Francis Cameroni Social Security Number(s) / EIN Number of Personal Representative(s): 178-20-5480 2. Headstone Engraving 3. Reception Box 78, Main Street Street Address City Kersey Year(s) Commission paid 2005 State ~ Zip 15846 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address 2. Attorney's Fees COYNE & COYNE, P.C. City Relationship of Claimant to Decedent State Zip 4. Probate Fees Cumerland County Register of Wills 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs Postage 2 Marie Cameroni-- Reimburse for Towing of Vehicle Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) AMOUNT 9,478.82 200.00 200.00 7,000.00 7,500.00 116.00 37.00 105.00 8,966.70 33,603.52 . Schedule H Funeral Expenses & Pdninis1ralNe Costs continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER 21 - 2004 - 1176 I ESTATE OF CAMERONI, LeROY D. 3 Patriot News-- Legal Advertisement 100.70 4 Cumberland Law J oumal-- Legal Advertisement 75.00 5 Reserves 2,000.00 6 State Farm-- Homeowners Insurance 650.00 7 PP&L 650.00 8 Claude W olfe-- Appraisal 295.00 9 P A WC-- Water 250.00 10 UGI 945.00 11 Income Tax Preparation Fee 200.00 12 Inheritance Tax Return Filing Fee 15.00 13 Repayment of Union Pension Proceeds 2,542.00 14 Executor Mileage 222.00 15 State Farm Insurance-- Car Insurance 324.00 16 East Pennsboro Township 598.00 17 Income Taxes Owed-- 2004 100.00 Page 2 of Schedule H ... *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE liABiliTIES, & liENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CAMERONI, LeROY D. I FILE NUMBER 21 - 2004 - 1176 Include unreimbursed medical expenses. ITEM NUMBER 1 DESCRIPTION AMOUNT 3,333.00 Coyne & Coyne, P.C. (Contingent Fee for Personal Injury Settlement) 2 Francis Cameroni-- Pro Rata Share of Coal Hollow Property Expenses 386.36 TOTAL (Also enter on Line 10, Recapitulation) 3,719.36 REV.1513 EX+ (9.00) *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I FILE NUMBER I 21- 2004 - 1176 RELATIONSHIP TO AMOUNT OR SHARE DECEDENT OF ESTATE On Nnt L ESTATE OF CAMERONI, LeROY D. I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) Ruth Regan Wife Real Estate and 1/2 of the IRA 2 Jean Ort Daughter 1/2 Residual 3 David Cameroni Son 1/2 Residual Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover she t II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEEr I .t:!!::::::... ____~__, ~ ~ REGISTER OF WILLS CUMBERLAND County, Pennsylvania CERTIFICATE OF GRANT OF LETTERS No. 2004- 01176 PA No. 21- 04- 1176 Estate Of: LEROY D CAMERONI (First, Middle, Last) Late Of: CAMP HILL BOROUGH CUMBERLAND COUNTY Deceased Social Security No: 186-28-1211 WHEREAS, on the 27th day of December 2004 an instrument dated April 1st 2004 was admitted to probate as the last will of LEROY D CAMERONI (First, Middle, Last) la te of CAMP HILL BOROUGH, CUMBERLAND County, who died on the 30th day of November 2004 and WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA FARNER STRASBAUGH Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: FRANCIS CAMERONI who has duly qualified as EXECUTORmIX) and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 27th day of December 2004. '- J::itt.,ylJ.Q. \~.hLtI' ~A \lrbijl}~ I ~ '1L- egister of Wills \;jlJ ^ ~ - C'U. i\- Deputy **NOTE** ALL NAMES ABOVE APPEAR. (FIRST, MIDDLE, LAST) ~' ~ ----------..--- ~'-~- ...." '... ,.~- ------- -=-- LAST WILL AND TESTAMENT BE IT REMEMBERED THAT I, LEROY D. qAMERONI, a resident of Cumberland County, " ., Pennsylvania, being o( sound mind, mem(ny and understanding, do make, :publish and declare this to be my LAST WILL AND TESTAMENT, hereby revoking any and all Wills and Codicils previously made by me. I declare that I have two (2) children, DAVID J. CAMERONI and JEAN M. OTT. II I direct that all my just debts and funeral expenses shall be paid from my i \ residuary estate as soon as practicable after my decease. III I direct that all taXes that may be assessed in consequence of my death, ,of whatev~r nature and by. whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. IV I give, devise and bequeath my home situate 'at 216 Wood Street, Camp Hill, Pennsylvania to RUTH REGAN, per capita. V I give, devise and bequeath the contents of my home and any vehichle that I may own at my death to my children, JEAN M. OTT and DAVID J. CAMERONI, in equal shares, per stirpes~ VI I give and bequeath all 9.f my guns to my son, DAVID J. CAMERONI, per stirpes. ' (") ~~ ~~~o ~~CD z c6;;? c)"OQ (j O-n oc : :D ::0-1 ..P-" ~ <;:::) = ..J-- CJ rt1 n N -..J ::d :::0' p-, ss8 ~~e3 ~-n rTl ::0 CJ co $-,. .-T-l :;:.; B ern 00 -n -0 =:K: ~'? CJl Ul .' -,'\ i" i , 'i I i j i i I 'j i '. \ 1 i i ! ! I I , i , I ! _..._.._...,..._.~---.--...~..,..;;........__..;.-~...;..,_.__._..._........,~-....----- VII All the rest, residue and remainder of my property, whether real or personal, ,wherever situate, including any property over which I may have a power of appointment,' including any money markets, savings accounts, '\" - - certificates of deposit and checking accounts,"r give, devise and bequeath to my r' .- son, DAVID J. CAMERON! and my daughter, JEAN M. OTT, in equal shares, per stirpes. VIII I nominate, constitute and' appoint my brother F~NCIS CAMERONI, as Executor of this LAST WILL, to serve without bond. If my brother is unable or unwilling to act in that capacity, then I nominate, constitute and appoint my daughter, JEA~ M. OTT, as Executrix of this LAST WILL, to serve without bond. IN WITNESS WHEREOF, I, LEROY D. CAMERONI, have set my hand to this LAST WILL this I $;1- day of fl F) ~-T' { , 2004. ~ '___ b- e~-R-~~ ~, LERO D. CAMERONI , Signed, ,'sealed, publish~d and declared by the above-named LEROY D. CAMERONI, as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence, and in ,the presence of each other" have hereunto subscribed our names as witnesses'j J, ~/ / j/ /fi( f/. '--- !1rl(1L! ~Ih~f P 4_~------ ~.. -I+-"...--.-.------;.,-:--.~.......:...- , ,._._,_._-~-_._-_.,<~......-,.- ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND '\ I~ LEROY D. CAMERONI, Testator, wh~se name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby ackn9wledge that I signed and executed the instrument as my LAST WILL; that I signed it as my free and voluntary act for the purposes therein expressed. ;Cq )). ~~ LEROY . CAMERONI .... " Sworn or affirmed to and acknowledged before me by LEROY D. CAMERONI, Testator, this / "Sf day of a~ ,2004. ~--'- t/ ~a, Notary Public NOTARIAL SEAL DEBORAH l.. RYAN, NOTARY PUBLIC CITY OF MECHANICSBURG. CUMBERLAND COUNTY MY COMMISSION EXPIRES .IUNE 11, 2006 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND ,.... We, II (//2;21;;[ R .,cYA Lf77t rg---' and U:'3o- ~, ~,J~ J , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as his LAST WILL, that LEROY D. CAMERONI signed 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 Gy the Testator signed the Will as witnesses; and that to the best of our knowleq-ge, the Testator was at the time 18 years of age or more, of soun~ mi.i 7der no constramt or undue mfluence. iktfld1" . /7YIJtJ<J /-'~dn-0!? (/. Sworn or_affirmed to and acknowledged before me this /'>..L day of ~ . , 2004. J0tdJ !I?'IJ~ Notary Public NOT AAIAL SEAL DEBORAH L. RYAN, NOTARY PUBLIC CITY OF MECHANICSBURG, CUMBERLAND COUNTY MY COMMISSION FXPIRF~ .IlINF 1'1 ?nnR cumberland County - Register Of WJllS One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 11/09/2006 COYNE LISA MARIE 3901 MARKET STREET CAMP HILL, PA 17011-4227 RE: Estate of CAMERON I LEROY D file Number: 2004-01176 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing lS due by: 11/30/2006 please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, Glenda Farner St Clerk of the Orphans' Court cc: file Personal Representatlve(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 phone: (717) 240 - 6345 Date: 11/09/2006 CAMERONI FRANCIS MAIN STREET BOX 78 KERSEY, PA 15846 RE: Estate of CAMERONI LEROY D File Number: 2004-01176 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing 1S due by: 11/30/2006 please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sinc~rely, Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File l'nllTlRel STATUS REPORT UNDER RULE 6.12 Name of Decedent: LEROY D. CAMERONI Date of Death: NOVEMBER 30,2004 Will No. 21-04-01176 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I re~port the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes No X 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: FEBRUARY 2007 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 N/A account is: c. Did the personal representative state an account informally to the parties in interest? Yes No d. Copies of receipts releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Dated: If J,~)tJf, / / (\, ,~ LIS~ M 3901 et Street Camp Hill, PA 17011-4227 (717) 737-0464 Counsel for Estate , " . , ,,". -- 'f'''' (j I--'~ ~ COYNE & COYNE A PROFESSIONAL CORPORATION ATTORNEYS AT LAW Henry F. Coyne Lisa Marie Coyne 3901 Market Street Camp Hill, Pennsylvania 17011-4227 717-737-0464 Fax: 717-737-5161 November 15, 2006 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 Re: Estate of LeRoy D. Cameroni, Deceased Dear Madam: We represent the Estate of the Late LeRoy D. Cameroni. Enclosed are an original and one copy of the Status Report. Kindly docket the original and return to this office a "clocked-in" copy with the enclosed envelope. Thank you for your assistance. If you have any questions, please contact me. Very truly yours, I COYNE & COYNE, P.C. ~ lL,--C Lis,a~rie Coyne ) - LMC/amd Enclosure cc: Mr. Francis Cameroni, Executor, w/encl. '-' :',.1 ~ I.;..~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX Z80601 HARRISBURG PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA ~I roC D.I;PARTMENT OF REVENUE ....r-r' r,< r-h _\' I... ,'~0C<K\ 1tU Vr, i~:.... : INHERITANCE TAX \",C\)J"~ Qr "!'I$~ATEMENT OF ACCOUNT *' LISA MARIE COYNE COYNE & COYNE 3901 MARKET ST CAMP HILL t\ 2" 2.0 1~~b SE.P - \ P " C\.E~K OCOt UR\ r.o~S 0 ~f\ dJJrotP,L~ND C ,.' REV-1607 EX AFP (03-05) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-31-2006 CAMERONI 11-30-2004 21 04-1176 CUMBERLAND 101 LEROY D Allount Rellitted PA 17011 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE REV-1607 EX AFP (03-05) --------------------------------------------------------------------------- --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- *** INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF CAMERONI LEROY D FILE NO.21 04-1176 ACN 101 DATE 07-31-2006 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-17-2006 PRINCIPAL TAX DUE: 588.29 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-25-2005 CD004998 29.41 595.00 07-17-2006 REFUND .00 36.12- TOTAL TAX CREDIT 588.29 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX Z80601 HARRISBURG PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA ~~~PARTMENT OF REVENUE ...,,-'1',' "r- \ \ (j('.'- ~TICE OF INHERITANCE TAX APPRAlSEHENT ~ ALLOWANCE OR DISALLOWANCE _;OF DEDuCTIONS AND ASSESSHENT OF TAX 07-24-2006 CAMERONI 11-30-2004 21 04-1176 CUMBERLAND 101 APPEAL DATE: 09-22-2006 ( See reverse side under Objections) AIIaunt R_ittedl 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 .... --------------------------------------------------------------------------.---------------- REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX LEROY D FILE NO. 21 04-1176 ACN 101 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN lj:"tq( L \j'l,j\1 r) () L,U \\: 2.b LISA MARIE COYNE COYNE I COYNE 3901 MARKET ST CAMP HILL PA 17011 ESTATE OF CAMERONI * REV-1547 EX AFP (06~05) LEROY D TAX RETURN MAS: (X) ACCEPTED AS FILED DATE 07-24-2006 APPROVED DEDUCTIONS AND EXEMPTIONS: 33~603.52 9. Fune~l EXP8nses/A~. Costs/Hlsc. Expenses (Schedule H) (9) 10. Dabts/Hortgage Lleblllties/Llens (Schedule Il (10) 3.719.36 11. Totel Deductions (11) 12. Net Velue of T_ Return (12) 13. Cherlteble/Gove~tel Bequests; Non-elected 9113 Trusts (Schedule ~) (13) 14. Net Value of Estete Subject to T_ (14) 1- NOTE: I~ an asses..ent was issued previously, lines 14, 15 and/or 16, 17, 18 and reflect ~igures that include the tatal of ALL returns assessed to date. ASSESSMENT OF TAX: 1S. ~unt of Line 14 et Spousel rete (lS) 16. A.ount of Line 14 t_able .t Llneal/Cless A rate (16) 17. A.ount of Line 14 et Sibling ~te (17) 18. Aaount of Line 14 taxable et Col1ateral/Cless B rate (18) 19. Prlncipe1 Tax Due RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel Estate (Schedule A) 2. Stocks end Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Hortgeges/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Hlsc. Personal Property (Schedule E) 6. ~intly OM.d Property (Schedule F) 7. Transfers (Schedule G) 8. Totel As_ts ( ) CHANGED (1) (2) (3) (4) (S) (6) (7) 115~160.00 .00 .00 .00 40.675.28 1.490.00 17.182.35 (8) 126.604.90 X 9.083.85 X 1.496.00 X .00 X DATE 02-25-2005 07-17-2006 NUttBER CD004998 REFUttD INTEREST/PEN PAID (-) 29.41 .00 AItOUNT PAID 595.00 36.12- I ! LTE: To insure proper t:edit to your eccount. lsub_i t the upper portion of this for. with your itex pey-.nt. 174.507.63 37.322 88 137.184.75 .00 137.184.75 19 will 00 = 045 = 12 1= 15 1= (19'= .00 408.77 179.52 .00 588.29 TOTAL TAX CREDIT 588.29 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ) ( IF TOTAL DUE IS LESS THAN $I. NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU HAY BE DU A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Leroy D. Cameroni Date of Death: November 30, 2004 File Number: 21-04-01176 Pursuant to Pa. O.c. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: . . . . . . . . . . . . . . . . . . .. 0 Yes fiaI No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: FEBRUARY 2008 3. Ifthe answer to No.1 is YES, state the following: a. Did the personal representative file a final account with the Court? . . . . . .. 0 Yes 0 No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ............................... 0 Yes 0 No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attac d to this report. Date 10/24/07 ---- fi2j Counsel Lisa Marie Coyne, Esquire Name of Person Filing this Form 3901 Market Street Address Camp Hill, Pa 17011 (717) 737-0464 6 I : 2 'LJ I' , Telephone -. I.~' .. _' L, Form RW-JO rev. 10.13.06 ~ ,J ~. t~c c:'u, LLi . J C"" Ci: l~ C~ Q LL' C-) c.:c C) G LLI Cr: Pa. o.e. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Leroy D. Cameroni Date of Death: Nov. 30,2004 File Number: 21-04-1176 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion ofthe administration of the above-captioned estate: 1. State whether administration of the estate is complete: . . . . . . . . . . . . . . . . . . .. IZ.I Yes D No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is YES, state the following: a. Did the personal representative file a final account with the Court? . . . . . .. ClYes IZ.I No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ............................... IZlYes DNo d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk ofthe Orphans' Court and may be attached to this report. Date J\/2"5/tJ7 I I .J DPersonal Represen IZ.I Counsel Lisa Marie Coyne, Esq. Name of Person Filing this Form ..:1' M 3901 Market Street ::sr: f-Q. a::. :c ---, 0.. l.L.. n 0(:..5 \.0 ~ cn ~ a:~: ~::::?,c ;::a... 0:t'1. o 0...... 2': 0: '. . ~ 0':::; t:::) 0 ForJl"mv-JO rev. 10.13.06 .. - Address Camp Hill, PA 17011-4227 717-737-0464 Telephone ~