Loading...
HomeMy WebLinkAbout02-0326PETITION FOR PROBATE and GRANT OF LETTERS Estate of JANET L. O'BRIEN also known as Social Security No. 147-30-9255 , Deceased. No. 21-02-32'6 To: Register of Wills for the County of Cumberland Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut or in the last will of the above decedent, dated and codicil(s) dated in the named June 20, ., 1983 (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland ~ , , County, Pennsylvania, with her last family or principal residence at , 217 Meals Drive, cartiste, PA 17013 (list street, number and muncipality) Decendent, then 62 years of age, died February 9, 192002 at Carlisle, Cumberland County, Pennsylvania ' " Except as follows, decedent did not marry, was not ,divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $. (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters, testamentary theroll. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) Michael O Bnen 410 Walnut Street Boiling Springs, PA 1'/007 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 3 COUNTY OF Cumberland ) 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 petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this ___lst _ __ day of APRI~ ,- / _ 192002 Z / ~// / - ' - Kbvin Michael O'Brien No. 21-02-326 " Estate of ~ANET L. O'BRIEN , Deceased DECREE OF PROBATE AND GRANT OF LETTERS APRIL 2 AND NOW the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s)dated June 20, 1983 described therein be admitted to probate and filed of record as the last will of JANET L. O'BRIEN 192002 , in consideration'of the petition on and Letters testamentary ' are hereby granted to KEVIN MICHAEL 0'BRIEN FEES Probate, Letters, Etc .......... $ 60.00 Short Certificates( ) .......... $..~iZ,_.Q~ ~x-page$ 9.00 KenunclaUon ................ $ la mn JCP Fee $ 5.00 TOTAL $ 76.00 Filed ..... .A.P.R..I .L..2. ,...2.0.Q .2 .............. Thomas. E...Flo~er, Es,c~ire - 83993 ATTORNEY (Sup. Ct. I.D. No.) 2109 Market Street, Camp Hill, PA 17011 ADDRESS (717) 737--3405 PHONE JAMES D. FLOWER IOI-iN E. SLIKE ROBERT C. SAIDIS GEOFFREY S. SHUPF }AMES D. IrLOWER, JR. CAROL J. LINE)SAY JOHNNA J. KOP£CKY KARL M. LEDEBOHM JOSEPH L. HITCHINC~ THOMAS E. FLOWER FORRES'~ N. TROUTMAN II 7177373487 7177373487 SAIDIS SHUFF MASLAND LAW OFFICES 228 PS1 APR 82 '82 10:34 SAIDIS, SHUFF, FLOWER & LINDSAY A PROFESSIONAL CORPORATION 2109 MARKET STREET CAMP HILL, PENNSYLVANIA 17011 TELEPHONE: (717)737-3405- FACSIMILE: (717) 737-3407 EM Al L: attorney@s$fl-law.com CA.....R...LiSLE OFFICE: 26 W. HIGH STREET CARLISLE, PA 17013 TELEPHONE: (717)24.3-6222 FACSIMILE: (717)243-6486 REPLY TO CAMP HILL Ap~12,2002 Attention: Ms. Capozzi Re: Estate of Janet O'Brien To the Register of Wills of Cumberland County: Kindly delete the middle initial "L" from the Petition and Renunciation forms prepared by my office for the estate of Janet O'Brien (a.k.a. Janet L. O'Brien), in order to conform these papers with the decedent'$ signature on her Will. Thank you. Very truly yours, Thomas E. Flower his is to certify that the information here given is correctly copied from an original certificate of death 'duly filed with me as Local Registrar. The original certificate will be' forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 7914148 No. Local Registrar Date 21-02-326 COMMONWEALTH OF PENNSYLVANIA ,, DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH  255 =~- i ~ I Registered Nurse i!1~ ,,u.o~.~ nome I~z 11--~= .... ~3-~'4~s*) I ..... I 2]7 Meals Drive ~u~ .,.aM Pennsylvania ~ ,,..~.~ South Mz~dteton ,~arlisle, Pa 17013 ,,. William C. Templeton Sr. ~Kevin M. O'Brien o~. ~.~ [] Feb. 13, 200~ FD-0]2909-L ,., Edna D. Reynolds ~410 Walnut Street, Boiling Springs, Pa 17007 I,~t. Patrick Cemetery I,~=Hs[e, ma ]7o]3 ~ ~ral ~ 255 Y~ ~. ~lisle Pa 17013 ~52-L ~00 2 TIME OF INJURY 21-02-326 OF JANET O ' BRIEN I, JANET O'BRIEN, Of South Middleton Township, Cumberland County, Pennsylvania, make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my death as will be convenient to my Executor hereinafter named. 2. I give all my property of whatsoever nature and kind and wheresoever situate at the time of my death to my husband, WILLIAM J. O'BRIEN, absolutely. 3. Should my husband, WILLIAM J. O'BRIEN, fail to survive me I give my entire estate of whatsoever nature or kind and whereso- ever situate at the time of my death to CCNB BANK, N.A., and its successors, IN TRUST, NEVERTHELESS, to invest and reinvest and to use the income and so much of the principal as may be required to provide for the care, support and education of my children. In addition to the authority granted by law, the Trustee shall have the following powers: A. To pay the guardian of the person of my children the expenses of maintenance, medical care and support of such child or children; - 1 - B. To ascertain whether there is medical coverage for my children in case of illness and should the Trustee ascertain that there is not such provision from any other source to make payment out of the funds in trust to provide for the equivalent of Blue Cross and Blue Shield medical care coverage; C. To invade and use the principal, as well as the income to provide for the purpose of this Trust and to provide for higher education for such of my children as may desire it; D. To hold the assets of the Trust in the name of a nominee; E. Upon any child no longer living with or under the supervision of the guardian of the person hereinafter named, to pay the income of the Trust attributable to the share of such child to such child until he becomes Twenty-five (25) years of age. The Trust shall terminate as to the interest of each child in the Trust upon that child attaining the age of Twenty- five (25); F. The Trustee should retain the dwelling house if at all practicable as long as both of our children desire to live there. - 2 - 4. Should my husband, WILLIAM J. O'BRIEN, fail to survive me and my oldest child have attained the age of Twenty-five (25) years, then I direct that there be no trust and I give my entire estate of whatsoever nature and kind and wheresoever situate at the time of my death to my children in equal shares, KEVIN MICHAEL O'BRIEN and TIMOTHY JAMES O'BRIEN. 5. Should neither my husband nor any of my children survive me, then I give my entire estate to SUSAN REYNOLDS of 288 Devon Street, Kearny, New Jersey. 6. I nominate, constitute and appoint my husband, WILLIAM J. O'BRIEN, to be the Executor of this, my Last Will and Testament but should he fail to survive me I nominate, constitute and appoint SUSAN REYNOLDS as Executrix to act in his place and stead IN WITNESS WHEREOF, I have hereunto set my hand and seal this 20th day of June , 1983. ~~e~~ n ~ ( SEA2 Signed, sealed, published and declared by JANET O'BRIEN, the above named Testatrix, as and for her Last Will and Testament, in the presence of us, who, in her presence, at her request and in the presence of each other have hereunto subscribed our names as witnesses. - 3 - COMMONWEALTH OF PENNSYLVANIA ) : COUNTY OF CUMBERLAND ) SS.: I, JANET O'BRIEN, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me, by JANET O'BRIEN, the Testatrix, this 20th day of June 1983. NotarY Pu-b~.ic- - COMMONWEALTH OF PENNSYLVANIA ) : SS.: COUNTY OF CUMBERLAND ) We, JAMES D. FLOWER and JAMES D. FLOWER, JR., 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 Testatrix sign and execute the instrument as her Last Will; that JANET O'BRIEN signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. the Sworn or affirmed to and subscribed to before me by JAMES D. FLOWER and JAMES D. FLOWER, JR. , witnesses, this 20th day of June , 1983. Wiriness- Notary Public NOTARY PUBLIC Carlisle, Cumb~,~lnli -- 4 mm~° z z m 0 0 L-z'J 0 RENUNCIATION 21-02-326 To thc Registcr of Wills o f Curabcrland County, Pennsylvania. The u~det$igned Tr,MOTI-Pf J'. O'BRIEN. Son of the above decedent, hereby renounce(s) rite right to administer the estate and respectfully ask(s) that Letters I'estamentary be issued to KEVIN MICIIA 5i. O'BPdEN ., I9,~. 3g Mcado. wb:'ook £7nt}rl', New Cumberland.. PA (Addrc-~e) r (-q'~gnmureJ (Adcb-ess) . ~ 21-02-326 RENUNCIATION InP. eEstateof ...... ~,/~LI~T J,, 69'/~>t--/et'/ To the Register of Wills of Cumberland The undersigned SUSAN RE'~'NOi_DS, deceased. County, Pennsylvania, of the above decedent, hereby renounce(s) the right to administer the e~tate and respectfully ask(s) that Letter.~ ~estamcnta~3, be i~su~ to ~VIN' M[CILa. EL O'BRIEN hand this~.. Ir7 day of .... 288 Devon Sr--~ '" / C~g~amre) (Addre~) JAMES D. FLOWER JOHN E. SLIKE ROBERT C. SAIDIS GEOFFREY S. SHUFF JAMES D. FLOWER, JR. CAROL J. LINDSAY JOHNNA J. KOPECKY KARL M. LEDEBOI-IM JOSEPH L. HITCHINGS THOMAS E. FLOWER FORREST N. TROUTMAN II LAW OFFICES SAIDIS, SHUFF, FLOWER & LINDSAY A PROFESSIONAL CORPORATION 2109 MARKET STREET CAMP HILL, PENNSYLVANIA 17011 TELEPHONE: (717) 737-3405 - FACSIMILE: (717) 737-3407 EMAIL: attorney@ssfl-law.com CARLISLE OFFICE: 26 W. HIGH STREET CARLISLE, PA 17013 TELEPHONE: (717)243-6222 FACSIMILE: (717)243-6486 REPLY TO CAMP HILL April2,2002 Attention: Ms. Capozzi Re: Estate of Janet O'Brien To the Register of Wills of Cumberland County: Kindly delete the middle initial "L" from the Petition and Renunciation forms prepared by my office for the estate of Janet O'Brien (a.k.a. Janet L. O'Brien), in order to conform these papers with the decedent's signature on her Will. Thank you. Very truly yours, Thomas E. Flower REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA CERTIFICATION OF NOTICE UNDER RULE 5.6(A) Name of Decedent: Janet O'Brien Date of Death: February 9, 2002 Will No. 2002-00326 Admin. No. To the Register: I certify that Notice o£ Estate Administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the £ollowing beneficiaries o£ the above-captioned estate on the 544n day of April, 2002. SalTle Kevin M. O'Brien Timothy J. O'Brien Address 410 Walnut Street, Boiling Springs, PA 17007 38 Meadowbrook Court, New Cumberland, PA 17070 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none Date: Capacity: Thomas E. Flower, Esquire SAIDIS, SHUFF, FLOWER & LINDSAY 2109 Market Street Camp Hill, PA 17011 (717) 737-3405 Personal Representative X Counsel for Personal Representative JAMES D. FLOWER JOHN E. SLIKE ROBERT C. SAIDIS GEOFFREY S. SHUFF JAMES D. FLOWER, JR. CAROL J. LINDSAY JOHNNA J KOPECKY KARL M. LEDEBOHM JOSEPH L. HITCHINGS THOMAS E. FLOWER FORREST N. TROUTMAN, II LAW OFFICES SAIDIS, SHUFF, FLOWER & LINDSAY A PROFESSIONAL CORPORATION 2109 MARKET STREET CAMP HILL, PENNSYLVANIA 17011 TELEPHONE: (717) 737-3405 - FACSIMILE: (717) 737-3407 EMAIL: attomey@ssfl-law.com October 14, 2002 CARLISLE OFFICE: 26 W. HIGH STREET CARLISLE, PA 17013 TELEPHONE: (717)243-6222 FACSIMILE: (717)243-6486 REPLY TO CAMP HILL Register of Wills CUMBERLAND COUNTY COURTHOUSE One Courthouse Square Carlisle, PA 17013 Re.' Estate of Janet O'Brien No. 21-02-0326 Dear Sir/Madam: Enclosed please find the original and two copies of an Inheritance Tax Return for the above Estate, a check in the amount of $15.00 for your filing fee and a check in the amount of $403.60 for the tax due. Will you please file the original return, time-stamp a copy and mail the copy back to us in the envelope provided. If you have any questions, please feel free to contact this office. Very truly yours, TEF/sa Enclosures SAIDIS, SHUFF, FLOWER & LINDSAY REV-I §00 EX (&DO) j~~ COMMONWEALTH Of PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT 1-7 .... FILE NUMBER 21 - 02 COUNTY CODE YEAR DECEDENT'S NAME (LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Z O'Brien, Janet L. 147 - 30 9255 LU t'h DATE Of DEATH MM--DD--YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE O 02-09-02 05-07-1939 REGISTER OF WILLS III (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER N/A - - LU z Z O O X [~1. Original Return D4. Limited Estate [~6. Decedent Died Testate {Attach copy of Will) El9. Litigation Proceeds Received r~2. Supplemental Return r'--] 4a. Future Interest Compromise (dale of death after 12-12-82) E~]7. Decedent Maintained a Living Trust attach a copy of Trust) I~1 0. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95} 03 26 NUMBER 1~3. Remainder Return (date of death pdor to 12-13-82) El5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes I'~11. Election to tax under Sec. 9113(A) attach Sch O0 THIS SECTION MUST BE COMPLETED ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO NAME ~ COMPLETE MAILING ADDRESS Thomas E. Flower, Esq. I ~FIIR¥. ~alalS, ~nulI, mower & Lindsay TELEPHONE NUMBER 121o9 Market Street 717-737-3405 ICamp Hill, PA 17011 1. Real Estate (Schedule A) (1) none 2. Stocks and Bonds (Schedule B) (2) 2,358.66 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) none 4. Mortgages & Notes Receivable (Schedule D) (4) none 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 13,840.3 ] (Schedule E) 6. Jointly Owned Property (Schedule F) (6) none ~l Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) none (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 3,884.43 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule 1) (10} 3,345.87 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Eelata (Line 8 minus Line 11) (8) 16,198.97 (11) 7,230.30 (12) 8,968.67 (13) 00 (14) 8,968.67 13. Charitable and Governmental Bequests/Sec 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) x .o 45 (15) (16) 403.60 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 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 8,968.67 x .12 (17) 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate x ,15 (18) 19. Tax Due (19) 403.60 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < De~edent's Complete Address: STREETADDRESS 217 Meals Drive CITY ISTATE PA I ZIP Carlisle 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit O0 B. Prior Payments O0 C. Discount O0 (1) 403.60 Total Credits (A+ B + C ) (2) O0 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) 4. If Line 2 is greater than Line I + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (3) O0 (4) O0 5. If Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 403.60 A. Enter the interest on the tax due, (5A) O0 B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (513) 403.60 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ................................ [] [] b. retain the right to designate who shall use the property transferred or its income; ............... [] [] c. retain a reversionary interest; or .......................................... [] [] d. receive the promise for life of either payments, benefits or care? ......................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ...................................... [~ [] 3. Did decedent own an "n trust for"d~ayable upon death bank account or security at his or her death? U [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................... [] [] 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 schedulee and statements, and to the best of my knowledge and belief, It is true, correct and complete. Declaration of preparer other than the personal representative ia based on all information of which preparer has any knowledge. SIGNATU E OF PERSON RESPONSIBLE FOR FILING RETURN DATE ~ /2002 ADDRESS Kevin M. O'Brien, 410 Walnut St., Boilin~ Sprin~s, PA 17007 SIGNAT.,~I,I;~'~F PREPARER OT.,P~. ,TJ'~N,~PRESENTATIVE ADDRE"~S Saidis, Shuff, Flower & Lindsay, 2109 Market Street, Camp Hill PA 17011 DATE "~ /2002 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 to the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (I)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 RS. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 RS. §9116(I.2) [72 RS. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1~3EX-(1-9?)(1)~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER O'Brien, Janet L. 21-02-0326 All property jointly*owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. $ 2,358.66 76 Shares Prudential Financial Inc. at 31.035 TOTAL (Also enter on line 2, Recapitulation) $ 2,358.66 (If more space is needed, inse~ additional sheets of the same size) RE'~'A§I I EX-(1-97)(1) SCHEDULE H I COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER O'Brien, Janet L. 21-02-0326 Debts of decedent must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative s Commissions Name of Personal Representative (s) Social Security Number(s) / FIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees ISaidis, Shuff, Flower & Lindsay (attorney's fees) I 1,000.00 3. Family Exemption: (if decedents address is not the same as claimant s, attach explanation) Claimant Street Address City State ~ Zip Relationship of Claimant to Decedent 4. Probate Fees 61.00 5. Accountant s Fees 6. Tax Return Preparers Fees 75.00 Advertisement of Estate - Patriot News 115.20 7. Cumberland Law Journal 75.00 Meals Mobile Home Park, 6 months lot rent ~ $275/mo. 1,650.00 Auto Insurance, State Farm 231.14 Cost of cleaning Mobile Home 250.00 Property Tax not returned at settlement 163.92 PPL, electric service 245.17 Short Certificates 18.00 2,748.43 TOTAL (Also enter on line 9, Recapitulation) $ 3,884.43 (If more space is needed, insert additional sheets of the same size) RE~-1612 EX-(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF O'Brien, Janet L. SCHEDULE ~ DEBTS OF DECEDENT, MORTGAGE LIABILITIES~ & LIENS FILE NUMBER 21-02-0326 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT Members First FCU, loan acct. #35370-01 Members First FCU, Visa credit acct.//412144999835705 $ 256.67 3,089.20 TOTAL (Also enter on line 10, Recapitulation) '~ 3,345.87 (If more space is needed, insert additional sheets of the same size) REV-1513 EX -(1-97) (1) ~ I COMMONWEALTH OF PENNSYLVANIA ~ I INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE SCHEDULE J BENEFICIARIES 11, TAXABLE DISTRIBUTIONS (include outright spousal distributions) Kevin M. O'Brien 410 Walnut Street Boiling Springs, PA 17007 timothy J. O'Brien ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINEI son son 50% 5O% 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11 - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ O (if more space is needed, insert additional sheets of the same size) ROYAL FINANCE Associates, PO BOX 61317 Harrisburg, PA 17106 NAME OF PURCHASER: Co~na D. Bowe~LS SUMMARY OF PURCHASER'S TRANSACTION Inc. CLOSING STATEMENT CLOSING DATE: August 23. 2002 NAME OF SELLER: The estate of Janet L. 0'B~ien Kevi~ M. 0'~en/ execu~o4. SUMMARY OF SELLER'S TRANSACTION GROSS AMOUNT DUE FROM PURCHASER: CONTRACT SALES PRICE $ 10. 500.00 T4.a~Sactio~ Fee 100.00 PHYSICAL DAMAGE INSURANCE PREMIUMS 186.00 FAMILY PROTECTION INSURANCE PREMIUMS TITLE FEES 2 7.5 0 CLOSING FEES 900.00 OTHER: ground rent 70.97 2002 Cty/Twp Tax 12.23 2002/03 School Tax 139.67 GROSS AMOUNT DUE FROM PURCHASER $ i'It936.37 AMOUNTS PAID BY/FOR PURCHASER: DEPOSIT OR EARNEST MONEY $ 1,0 0 0.0 0 AMOUNTOF NEW LOAN 9,291.00 DEPOSIT WITH LENDER APPRAISAL FEE: OTHER: TOTAL PAID BY/FOR PURCHASER CASH (~From ~To) PURCHASER $ 10,291.00 $ 1.645,57 GROSS AMOUNT DUE DUE TO SELLER: CONTRACT SALES PRICE $ 10,500.00 ITEMS PAID IN ADVANCE 2002 Cty/Twp TAXES 12,23 INSURANCE OTHER: Lot Rent 70.97 GROSS AMOUNT DUE TO SELLER: REDUCTIONS IN AMOUNT DUE SELLER: BROKER FEE '.S PAYOFF TO LIENHOLDER ACCRUED INTEREST From to CLOSING FEE POSSESSION DEPOSIT 2002/03 School Tax PRO RATA TAXES PRO RATA LOT RENT OTHER 10,583.20 2,000.00 24.25 TOTAL REDUCTIONS DUE SELLER $ 2,024.25 CASH (El Frcm E2.To) SELLER S, 8. 558.9~5 Purchaser acknowledges receipt of a copy of this statement and auth~izes the disbursement of funds as stated. PURCHASER DATE PURCHASER DATE PURCHASER DATE PURCHASER DATE Seller acknowledges receipt of a copy of this statement and thodzes the disbursement of funds as stated. SELLER DATE SELLER DATE SELLER DATE SELLER DATE Membersl FEDERAL CREDIT UNION INSURANCE DEPARTMENT 5000 Louise Drive P. O. Box 40 Mechanicsburg, PA `17055 `1-800-283-2328 or (7'17) 697-'1 `16`1 REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner CHECKING ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner LOAN ACCOUNT: Account Number/Suffix Date of Disbursement Principal Balance at Date of Death Loan Description Name of Co-Maker Collateral Securing Loan VISA CREDIT CARD ACCOUNT: Account Number Date Account Opened Principal Balance at Date of Death Name of Joint Cardholder Collateral Securing Card 35370-00 10/24/1983 $36.43 $.00 $36.43 None 35370-11 02/25/1994 $701.83 $.00 $701.83 None 35370 -01 05/11/2001 $256.67 Signature None Signature/Contractual Pledge of Shares 4121449998353705 05/17/2001 $3,O89.2O None Signature/Contractual Pledge of Shares Insurance Products Supervisor May 9, 2002 Estate of: JANET L. O'BRIEN Date of Death: February 9, 2002 Social Security Number: 147-30-9255 Prudential Financial Transaction Statement A 0001366143 JANET OBRIEN 217 MEALS DR CARLISLE PA 17013 010000443179 NUMBER OF SHARES CREDITED 76.0000 TRANSFER AGENT ACCOUNT NUMBER 44 3179 CUSIP NUMBER 744320 lO 2 PIN/PASSWORD - PLEASE KEEP CONFIDENTIAL 9715 4764 - I ~' I~'~ January 2002 We're pleased to welcome you as a new stockholder of Prudential Financial, Inc. On December 18, 2001, Prudential completed its conversion fi'om a mutual company to a stock company. As part of our conversion, we are issuing stock to eligible owners of the company. This includes anyone who owned an eligible policy or annuity contract as of December 15, 2000. You have received the number of shares listed above. Compensation for all of your policies eligible for stock is included in this statement. This does not affect your insurance policy or annuity ill ali)' way. Stock ox~mership is a benefit of holding an eligible policy or contract. It does not replace your policy or contract, or change your benefits, cash values, eligibility for policy dividends or guarantees. You do not have to give anything up to receive stock. Ilow your allotment of shares was determined. Company actuaries and external advisors developed a plan tbr dividing the value of Prudential among its owners. Factors such as the type of life, annuity or health policy or contract you owned, the face value, and how long you owned it detemfined how many shares you received. Your shares are registered on the books of Prudential Financial, Inc. Prudential has engaged EquiServe Trust Company, N.A., a provider of shareholder services, to hold your shares at no cost to you. A stock certificate is not required to continue holding yom' shares in book-entry form. The enclosed brochure explains how to hold shares, transfer or sell shares, or obtain a stock certificate, tln'ough EquiServe. Note: lfyou would like EqniServe to continue holding your shares at no cost, no actio.n is required. A commission-h-ce sales and purchases program will be availahle lbr certain shareholders in the future. To participate, you must own 99 sh,xres or Ii:wet and hold your shares in book-enU-y fbrm as they are now. See back for more intbrmation. What you should do now. 1) Ke~p this statement for your records. 2) Read the enclosed brochure for intbrmation on how you can hold, transfer or sell your shares thro~ugh EquiServe's Sales Facility, or obtain a stock certificate. SEE BACK FOR ADDITIONAL INFORMATION. Questions? Call 1-800-305-9404 weekdays from 8:00 a.m. to 7:00 p.m. (ET). For hearing impaired, call 1-800-619-2837. Or visit prudential.equiserve.com Historical Prices Page 1 of 1 'T !FINANCE Search -Finance Home - Yahoo! - Help Historical Prices - PRU (Prudential Financial Inc) More Info: Quote I .C__h_a_~ I News I Profile I Research J Msgs As of Feb-11-02 End: IFeb 111 12002 I Daily Weekly Monthly Dividends Ticker Symbol: Feb-08-02 I 30.57 131.03 130.551 31.03 I 1,399,300 Adj. Close* 31.76 31.03 Download Spreadsheet Format * adjusted for dividends and splits please see FAQ. Aren't Lit'e's Little Momems Questions or Comments? Copyright © 2002 Yahoo! Inc. All rights reserved. Privacv Policy -Terms of Service Historical chart data and daily updates provided byCommoditv Systems. Inc. (CSI). Data and information is provided for informational purposes only, and is notintended for trading purposes. Neither Yahoo nor any of its data or content providers (suchas CSI) shall be liable for any errors or delays in the content, or for any actions taken in reliance thereon. = gl. http://table.finance.yahoo.com/d?a= 1 &b=8&c=2002&d= 1 &e= 11 &f=2002&g=d&s=pru 10/04/2002 OF JANET O ' BRIEN ~, JANET O'BRIEN, of South Middleton Township, Cumberland County, Pennsylvania, make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my death as will be convenient to my Executor hereinafter named. 2. I give all my property of whatsoever nature and kind and wheresoever situate at the time of my death to my husband, WILLIAM J. O'BRIEN, absolutely. 3. Should my husband, WILLIAM J. O'BRIEN, fail to survive me I give my entire estate of whatsoever nature or kind and whereso- ever situate at the time of my death to CCNB BANK, N.A., and its successors, IN TRUST, NEVERTHELESS, to invest and reinvest and to use the income and so much of the principal as may be required to provide for the care, support and education of my children. In addition to the authority granted by law, the Trustee shall have the following powers: A. To pay the guardian of the person of my children the expenses of maintenance, medical care and support of such child or children; - 1 - B. To ascertain whether there is medical coverage for my children in case of illness and should the Trustee ascertain that there is not such provision from any other source to make payment out of the funds in trust to provide for the equivalent of Blue Cross and Blue Shield medical care coverage; C. To invade and use the principal, as well as the income to provide for the purpose of this Trust and to provide for higher education for such of my children as may desire it; D. To hold the assets of the Trust in the name of a nominee; E. Upon any child no longer living with or under the supervision of the guardian of the person hereinafter named, to pay the income of the Trust attributable to the share of such child to such child until he becomes Twenty-five (25) years of age. The Trust shall terminate as to the interest of each child in the Trust upon that child attaining the age of Twenty-five (25); F. The Trustee should retain the dwelling house if at all practicable as long as both of our children desire to live there. - 2 - 4. Should my husband, WILLIAM J. O'BRIEN, fail to survive me and my oldest child have attained the age of Twenty-five (25) years, then I direct that there be no trust and I give my entire estate of whatsoever nature and kind and wheresoever situate at the time of my death to my children in equal shares, KEVIN MICHAEL O'BRIEN and TIMOTHY JAMES O' BRIEN. 5. Should neither my husband nor any of my children survive me, then I give my entire estate to SUSAN REYNOLDS of 288 Devon Street, Kearny, New Jersey. 6. I nominate, constitute and appoint my husband, WILLIAM J. O'BRIEN, to be the Executor of this, my Last Will and Testament but should he fail to survive me I nominate, constitute and appoint SUSA/~ REYNOLDS as Executrix to act in his place and stead IN WITNESS WHEREOF, I have hereunto set my hand and seal this 20th day of June , 1983.  Jnet O' Brien (SEAA) Signed, sealed, published and declared by JANET O'BRIEN, the above named Testatrix, as and for her Last Will and Testament, in the presence of us, who, in her presence, at her request and in the presence of each other have hereunto subscribed our names as witnesses. - 3 - COMMONWEALTH OF PENNSYLVANIA ) : COUNTY OF CUMBERLAND ) SS.: I, JANET O'BRIEN, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me, by JANET O'BRIEN, the Testatrix, this 20th day of June 1983. COM~ONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND Notary Puget. lc--" ¢ NOTARY PUBLIC Carlisle, Cumbel~l~J ~nl¥ : SS.: ) We, JAMES D. FLOWER and JAMES D. FLOWER, JR. the witnesses whose names are signed to the attached or oregolng f · , instrument, being duly qualified according to law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will; that JANET O'BRIEN signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by JAMES. D. FLOWER and JAMES D. FLOWER, JR. , witnesses, this 20th day of June , 1983. Notary Public NOTARY PUBL;C ,-: C~rl~ste, Cu mbel'JallllJ - 4 - ay C0mmi~sioa ~xp~ee M~,~ 2~ ~.~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 001 731 THOMAS E FLOWER ESQUIRE 2109 MARKET STREET CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 147-30-9255 FILE NUMBER: 2102-0326 DECEDENT NAME: O'BRIEN JANET DATE OF PAYMENT: 10/16/2002 POSTMARK DATE: 10/14/2002 COUNTY: CUMBERLAND DATE OF DEATH: 02/09/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $4O3.6O TOTAL AMOUNT PAID' $403.60 REMARKS: THOMAS E FLOWER ESQUIRE SEAL CHECK# 1029 INITIALS: JA RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES TNH£RZTANCE TAX DZVTSTON DEPT. 280601 HARRISBURG, PA 17128-0601 THOMAS E FLOWER ESQ SAIDIS ETAL 2109 MARKET ST CAMP HILL PA 17011 COMMONWEALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DZSALLOHANCE 'OF DEDUCTIONS AND ASSESSHENT OF TAX DATE ESTATE OF DATE OF DEATH ..FXLE;NUNBER COUNTY ACN 12-02-2002 OBRIEN 02-09-2002 21 02-0326 CUMBERLAND 101 Amoun~ Remi~ed JANET L MAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LZNE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF OBRIEN JANET L FILE NO. 2! 02-0326 ACN 101 DATE 12-02-2002 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a*e (Schedule A) (1) 2. S~ocks end Bonds (Schedule B) (2) $. Closely Held S~ock/Par~nership In~eres~ (Schedule C) ($) ~. Nor~gages/No~es Receivable (Schedule D) (~} 5. Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E) 6. Jointly Owned Proper~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To'al Asse~s APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Cos~s/Hisc. Expenses (Schedule H) (9) 10. Deb~s/Hor~gage Liabilities/Liens (Schedule I) (10) 11. To*al Deductions 12. Ne~ Value of Tax Re~urn .O0 2z358.66 .00 .00 15z840.31 .00 .00 (8) 3,884.43 3,345.87 (11) (12) 15. 1~. NOTE: ASSESSHENT OF TAX: 15. Amoun* of Line 1~ at Spousal rale 16. Amount of Line lfi taxable at Lineal/Class A rate 17. Amount of Line 1~ ai Sibling rate lB. Amoun~ of Line lq ~axable at Collateral/Class B ra*e 19. Principal Tax Due TAX CREDITS: PAYflENT RECEIPT DISCOUNT (+) DATE NUHBER INTEREST/PEN PAID (-) 10-14-Z002 CD001751 .00 Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (13) Ne~ Value of Es~a~e Subjec~ ~o Tax (lq) If an assessment was issued previously, 1ine$ 14, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. NOTE: To insure proper credit ~o your account, submi~ ~he upper portion of ~his form wi~h your ~ax payment. 16,198.97 7.230.30 8,968.67 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 8,968.67 18 and 19 wi11 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS REQUIRED. IF TOTAL DUE 1S REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) TOTAL TAX CREDIT [ BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 403.60 AHOUNT PAID 405.60 .00 .00 .00 (lS) .00 X O0 = .00 (16) 8,968.67 X 045 = 403.60 (17) . O0 x 12 = . O0 (18) .00 x 15 = .00 (19)= 403.60 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STATUS REPORT UNDER RULE 6.12 Name of Decedent: Janet O'Brien Date of Death: 02-09-02 No. 2002-00326 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 X.; No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: No X ao Did the personal representative file a final account with the Court? Yes_; account is: b. The separate Orphans' Court No. (if any) for the personal representative's c. Did the personal representative state an account informally to the parties in interest? Yes X; No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: t'7_ to~, ~ -~_ _ ,__... _ Signature Name: Thomas E. Flower, Esquire I.D. No. 83993 ...... SAIDIS, SHUFF, FLOWER & LINDSAY 2109 Market Street Camp Hill, PA 17011 .i::~: (717) 737-3405 Capacity: __ Personal Representative X Counsel for Personal Representative IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STATUS REPORT UNDER RULE 6.12 Name of Decedent: Janet O'Brien Date of Death: 02-09-02 No. 2002-00326 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 X; No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: ao Did the personal representative file a final account with the Court? Yes_; No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes X; No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Signature Name: Thomas E. Flower, Esquire I.D. No. 83993 SAIDIS, SHUFF, FLOWER & LINDSAY 2109 Market Street Camp Hill, PA 17011 (717) 737-3405 Capacity: Personal Representative X Counsel for Personal Representative