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Home My WebLink About02-0353PETITION FOR PROBATE and GRANT OF LETTERS Estate of Mildred E. Smith No. also known as To: Deceased. Social Security No. 2 0 3 - 10 - 6 7 ~ 3 2.1.02-.R5 Register of Wills for the County of Cumberland Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(~), who is/Sa~ 18 years of age or older an the execut or in the last will of the above decedent, dated Apr i i 1 2, 2 0 0 1 and codicil(s) dated none in the named (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 1 Allian~ Drive, At~t. 106. /9 Carlisle, Cumberland County, Pennsylvania 17013' ~gtSd~ /=~P~ (list street, number and muncipality) Decendent, then 81 years of age, died Apr i 1 5, 2002 , loc at Harrisburq Hospital, Harrisburq, Dauphin County, Pennsylvan.'ia 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: none Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ 400,000 o 00 (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: none WHEREFORE, petitioner00 respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. El~ner H. Potteige~- Jr.'X' 1247 West Trindle Road Carlisle, PA 17013 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA '1 COUNTY OF __Cumberland ~ ss The petitioner(10 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- tativet%) of the above decedent petitioner(~ will well and truly administer the estate according to law. Sworn to or affir~ and subscribed { %~J~ ~ ~ before me this_ day of ~' APRIL 2002 ~ ~ qeLARY C IJECTIS --- ' l~egist~r ~ Estate of No. ~/- 0,Z-,563 Mildred E. Smith , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW APRIL 8 ~ 2002 I~ , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(x) dated Apr i 1 12, 2001 described therein be admitted to probate and filed of record as the last will of. M i 1 d r e d E. S m i th and Letters Testamentary are hereby granted to Elmer H. Potteiger, Jr. FEES Probate, Letters, Etc .......... $ 305.00 Short Certificates( ) .......... $ ]5.00 ~ extra .pages... $ 12,00 jcp $ 5.00 337.00 TOTAL __ $ riled ...AP.R..I.b..8.:..2.0.9.2 .................. call atty on 4-8-02 MA~Y C LEW'[S~egister of Wills David A. Baric, Esquire 0'Brien, Baric & Sch~r. _. , // ATTORNEY (Sup. Ct. I.D. No. 17 West South Street Carlisle ADDRESS PA 17013 (717) 249-6873 PHONE 7-.3 LAST WILL AND TESTAMENT Of MILDRED E. SMITH 2~- o~-,353 I, Mildred E. Smith, of Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST I direct the payment of my debts and the expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. If there be no cemetery lot available for my interment, owned by me at the time of my death, I authorize my personal representative to purchase such cemetery lot with a contract for perpetual care, using therefor funds from my estate, and I authorize my personal representative to cause title to or ownership of such lot so purchased to be vested in such person as my personal representative shall designate. Further, in this connection, I authorize my personal representative to expend funds from my estate, in such amount as my personal representative shall consider necessary and desirable, for the purchase, erection and inscription of a suitable marker for my grave. SECOND I give, devise and bequeath my estate of whatever nature and wherever situate as follows: a one-third (1/3) share to my brother, Elmer H. Potteiger, Jr., per capita; a one-third (1/3) share to my sister, Betty Louise Graham, per stirpes and a one-third (1/3) share to Deborah J. Bubb. In the event Deborah J. Bubb predeceases me or fails to survive me by thirty (30) days, then I give, devise and bequeath her one-third (1/3) share of my estate to her husband, William Bubb. In the event that I am predeceased by Deborah J. Bubb and William Bubb, that portion of my estate which would have passed to them shall pass to their issue in equal shares, per stirpes. In the event my brother, Elmer H. Potteiger, Jr. predeceases me, that portion of my estate which would have been passed to him shall be distributed to my sister, Betty Louise Graham and Deborah J. Bubb in accordance with the above provisions. THIRD I direct that no executor or other fiduciary named, nominated, or appointed by this my Last Will and Testament shall be required to post any bond or give any security of any type for any purpose whatsoever, any law or rule of the court of the commonwealth of Pennsylvania or any other jurisdiction to the contrary notwithstanding. I direct that the law of the Commonwealth of Pennsylvania shall apply to any interpretation or application of the validity of this instrument. FOURTH My executor shall have the following powers in addition to those vested in them by law and by other provisions of this will, applicable to all property, real, personal or mixed and wheresoever situate, including property held for minors, whether principal or income, exercisable without court approval, and effective, with respect to each item of said property until actual distribution thereof. A) To retain, as investments of my estate or trust, any or all assets of my estate, real, personal, or mixed, without regard to any principal of diversification, and to purchase and acquire real or personal property and to hold any or all of such real and personal property retained or acquired without making the same productive of income. B) To permit the children, or any of them, to occupy any real estate retained or acquired upon such terms and conditions as my executrix or trustee shall deem proper. C) To pay all taxes, charges and expenses of maintenance, upkeep, improvements, development, protection, preservation and investment of any retained or acquired real or personal property, such payments to be made from either principal or income as my executrix or trustee shall determine. D) To retain or invest any and all funds, whether principal or income, in any real or personal property without restriction to legal investments; to purchase investments at premiums; to exercise all rights of a security holder or share holder in any corporation; and to lease, mortgage, pledge, give options upon or sell at public or private sale and without approval of any court, any real or personal property, or portion or portions thereof, irrespective of the manner or the which the means by same was ~.cquired by my said executrix or trustee. E) To make payment or distribution herein provided for in cash, kind or partly in cash and partly in kind, at valuations fixed by my executrix or trustee at the time of distribution. FIFTH Any and all payment or payments of any sum or sums, whether in cash or in kind and whether for principal or income, payable to an heir, or any of them, shall be made upon the sole receipt of the respective individual to whom the payment is made, and free from anticipation, alienation, assignment, attachment, and pledge, and free from control by the creditors of any such beneficiary. SIXTH I appoint my brother, Elmer H. Potteiger, Jr., Executor of this my Last Will and Testament. Should my said Executor fail to survive me or for any reason fail to qualify as Executor, then I appoint Deborah J. Bubb, Executrix of this my Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of four (4) typewritten pages, the first three (3) of which bear my signature in the margin for the purpose of identification, this of April, 2001. Mildred E. Smith J~ day (SEAL) Signed, sealed, published and declared by the above named testatrix, Mildred E. Smith, as and for her Last Will and Testament, in the presence of us, who, at her request, in her sight and presence, and in the sight and presence of each other, have hereunto subscribed our n,a~es as witnesses. ADDRESS~''~'~ ~ ADDRESS~I'~/k),/,,0¢..,/n. zz~ <,Cf-, /~(_, H~(I? ~.?5. p,lr OMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND We, Mildred E. Smith, SS. the testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument of her Last Will and Testament, and that she signed willingly and that she executed as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as witnesses, and that to the best of their knowledge, the testatrix was at the time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. subscribed before me this I~ day of April, 2001. Sworn to and I Jennifer S. t.lndsay I Cadisle Boro, Cumberl~ndOou~ty J,~y Com~ssion Expires Nov. 29 2003 i ~b~, Penn~ania Ass~iation ot Notanes CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Mildred E. Smith Date of Death: April 5, 2002 To the Register: I certify that notice of beneficial interest required by Rule 5.6 (a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on April 12, 2002. Name Address Elmer H. Potteiger, Jr. 1247 West Trindle Road, Mechanicsburg, PA 17055 Betty Louise Graham Wildra Lake Lodge # 134 6053 Wilora Lake Road Charlotte, North Carolina 28212-2801 Deborah J. Bubb 762 East Louther Street, Carlisle, PA 17013 Notice has now been given to all pe¥~,ons entitled th,.~,reto un~ule 5.6(a) except: none Date: April 12, 2002 David A. Baric, Esquire O'Brien, Baric & Scherer 17 West South Street Carlisle, Pennsylvania 17013 (717) 249-6873 Capacity: __ Personal Representative x Counsel for Personal Representative Robert L. O'Brien David A. Baric Michael A. Scherer Law Offices O'BRIEN, BARIC & $CHERER 17 West South Street Carlisle, Pennsylvania 17013 June 24, 2002 (717) 249-6873 Fax (717) 249-5755 E-mail: obs~obslaw, corn direct: dbaric~obslaw, corn Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, Pennsylvania 17013 Estate of Mildred E. Smith S.S. # 203-10-6783 File # 21-02-0353 Dear Sir or Madam: Enclosed please find a check in the amount of $70,500.00 representing the estimated tax payment in the above-captioned estate matter. Very truly yours, DAB/jl Enc. cc: File dab.dir/estates/smith/registerofwills.ltr David A. Baric, Esquire COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF ~NDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 001328 BARIC DAVID A ESQ 17 WEST SOUTH ST CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 203-10-6783 FILE NUMBER: 2102-0353 DECEDENT NAME: SMITH MILDRED E DATE OF PAYMENT: 06/24/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 04/05/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $70,500.00 REMARKS: TOTAL AMOUNT PAID: DAVID A BARIC ESQUIRE $70,500.00 SEAL CHECK# 11 INITIALS: AC RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS 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 001707 BARIC DAVID A ESQ 17 WEST SOUTH ST CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 203-10-6783 FILE NUMBER: 2102-0353 DECEDENT NAME: SMITH MILDRED E DATE OF PAYMENT: 10/09/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 04/05/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 9325.61 TOTAL AMOUNT PAID: 9325.61 REMARKS' DAVID A BARIC ESQUIRE SEAL CHECK# 13 INITIALS: AC RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21 02 035 Z UJ UJ ~oo I.- Z Z o o UJ n, DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Smit,h, Mildred E. DATE OF DEATH (MM-OD-YEAR) I DATE OF BIRTH (MM-DO-YEAR) April 5, 2002 I January 16, (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) 1920 SOC~RRYNUMB~ 203 _ 10 -- 6723 THIS RETURN MUST BE FILED IN DUPUCATE W1TH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ['-~-'] 1. Original Return '--14. Limited Estate -'"'] 6. Decedent Died Testate (,~,ach copy of wit/ -'-I 9. Litigation Proceeds Received l-'--I 2. Supplemental Return I---I 4a. Future Interest Compromise (da~e of deam afte~ 12-12-82) · I----17. Decedent Maintained a Living Trust (Attac~ cow o~ ~ I--I 10. Spousal Poverty Credit (date ofdeam between 12-31-91 and 1-1-95) David A. Baric, Esquire FIRM NAME (If Applicable) O'Brien, Baric & Scherer TELEPHONE NUMBER (71.7) 249-6873 I'--13. Remainder Return (d~ta o~ p~x~ 12-13..~2) I--"15. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 1'~111. Election to tax under Sec. 9113(A) (X~ach So~ O) COMPLETE MAILING ADDRESS 17 Nest, South St,feet, Carlisle, Pennsylvania 170].3 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) --]Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 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) 0.OO O.OO 0.00 0.00 349,034.55 0.00 234,252.86 (8) 47,398.44 O.OO (11) (12) (13) (14) OFFICIAL USE ONLY 583,287.41 47,398.44 O.OO 535,888.97 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 201,O90.74 17. Amount of Line 14 taxable at sibling rate 334,798.23 18. Amount of Line 14 taxable at collateral rate 19. Tax Due x .0_ (15) x .0_ (16) 24,130 . 88 x .12 (17) 50,219.73 x .15 (18) (19) 74,350.61 Decedent's Complete Address: STREET ADDRESS One Alliance Drive CITY Carlisle ISTATE Pa I ZIP 17013 Tax Payments and Credits: 1. Tax Oue (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount InterestJPenalty if applicable D. Interest E. Penalty 70,500.00 3,525.00 Total Credits (A + B + C ) (2) Total Interest/Penalty ( D + E ) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (1) 74,350.61 74,025.00 (3) (4) 325.61 (5) (5A) (5B) 3 2 5.6 1 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 h'ansferred 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 "in trust for' or payable upon death bank account or secudty at his or her death? .............. [] [] 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 dedare that I have examined this return, including accomFanying schedules and statemenls, and to the best of my knowled~;e and belief, it is ~e, correct and complete. Declaration olr preparer other than the personaJ represenlative is based on all ini%rmaSon of which preparer has any knowledge. SIGNATURE OF PERSON I~F.S.PONSIBLE FOR FILING A D D R'"I~--'~S 1_~47 West Tri~ndl/~Road, Mechanicsbur§, S IG NATU RE {~)J~E PARER O,~l~flr~Al"~ E'~a~;;~[ S E N TAT IV E PA 17055 ADDRESS 17 West South Street, Carlisle, PA 17013 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §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 exempl a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §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 RS. §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. COMMONWEALTH OF PENNSYLYANL~ INHE~TANCE TAX RETURN RESIDENT DECEDENT ESTATE OF H i i d r e d g SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY Smi th FILE NUMBER 21-02-0353 Include the proceeds of litkja~n and the date the proceeds were received by the estate. All property jointly-owned with the fight of sun~ivorship must be disclosed on Schedule ITEM NUMBER 2. 3. 4. 5. 6. 7. 8. DESCRIPTION PNC Bank Interest Checking Acct. No. 51-4024-2012 PNC Bank Performance Money Acct. No. 50-0062-7578 PNC Bank Performance Money Acct. No. 50-0350-3546 Allfirst Bank Money Fund Acct. No. 0950021788 Market Market Alternative Refund From Chapel Pointe Retirement Center Federal Income Tax Refund (2001) Pennsylvania Income Tax Refund (2001) Personalty TOTAL (Also enter on line 5, Recapitulation) VALUE AT DATE OF DEATH $ 5,162.35 $89,860.06 $33,496.42 .184,091.72 $33,000.00 $ 1,126.00 $ 171.00 $ 2,127.00 349,034.55 $ (If more s~ace is needed, insert additional sheets of the same size) COMMONWEALTH O~ PENNSYLVANIA INH£RITANCE TAX RETUI~I RESIDENT DECEDENT ESTATE OF Mildred E. Smith SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21-02-0353 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPER~ % OF ITEM i,~UOE THE WE ~ ME TRANS,CE~E^W~ ^ C~'"~ ~no.~P~E ~EO F~TO~OC'CE~'m'EST^~E.~D ME m~ ~ 'r,~ DATE OF DEATH DECD'S EXCLUSION TAXABLE VALL NUMBER VALUE OF ASSET INTEREST ~,,wu~E) 1. Transferee: Deborah J. Bubb 202,022.76 100 n/a 202,022. Niece Transfer: April 5, 2002 Monumental Life Insurance Co. Policy No. FI001789001-06N0001529 (Annuity) 2. Transferee: Deborah J. Bubb 32,230.10 100 n/a 32,230. Niece Transfer: April 5, 2002 Transamerica Life And Annuity Contract No. 26149911 234,252.86 TOTAL(Alsoenteronline7, Re~pitulation) $ 76 10 (If more space is needed, insert additional sheets of the same size) C.,O~TH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF Mildred E. Smith SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-02-0353 Oebl~ of decedent must be reported on Schedule L ITEM NUMBER DESCRIPTION 8. 9. FUNERAL EXPENSES: Ewing Brothers Gingrich Memorials ADMINISTRATIVE COSTS: Personal Representative's Commissions Name0fPe~onalRep~senta~ve(s) Elmer Potteiger, Jr. / Social Secu~y Number(s) / EIN Number of Personal Representative(s) - S~eetAddmss 1247 West Trindle Road C~y Carlisle smto PA Y~s) CommL~bn Pa~: 2002 A~omeyF~ O'Brien, Baric & Scherer Family ExemplJon: (If decedents address is not b~e same as daimanfs, attach explanation) Claimant Zip 17013 Street Address City State ~ Zip Rela~nship of Claimant to Decedent Probate Fees Accountant's Fees Tax Retum Preparer's Fees Sprint MCI Chapel Pointe Capitol Tax Bureau DeHart's Auction (commission) The Sentinel (legal advertisement) Cumberland Law Journal (legal advertisement) TOTAL (Also enter on line 9, Recapitulation) AMOUNT 7,519.80 95.00 16,932.41 21,165.75 352.00 28.96 9.93 448.50 10.00 638.10 122.99 75.00 $ 47,398.44 (If more space is needed, insert additional sheets of the same size) REV4513 EX - (1-97') ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RE$1OENT OECEDENT ESTATE OF Mildred E. Smith SCHEDULE J BENEFICIARIES FILE NUMBER 21-02-0353 NUMBER H. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) Elmer H. Potteiger, Jr. 1247 West Trindle Road Mechanicsburg, PA 17055 Betty Louise Graham Wildra Lake Lodge $ 134 6053 Wildra Lake Road Charlotte, NC 28212-2801 Deborah J. Bubb 762 East Louther Street Carlisle, PA 17013 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) brother sister niece AMOUNT OR SHARE OF ESTATE 1/3 of rest, residue and remainder 1/3 of rest, residue and remainder 1/3 of rest, residue and remainder ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 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 ]'[- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT OF MILDRED E. SMITH I, Mildred E. Smith, of Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST I direct the payment of my debts and the expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. If there be no cemetery lot available for my interment, owned by me at the time of my death, I authorize my personal representative to purchase such cemetery lot with a contract for perpetual care, using therefor funds from my estate, and I authorize my personal representative to cause title to or ownership of such lot so purchased to be vested in such person as my personal representative shall designate. Further, in this connection, I authorize my personal representative to expend funds from my estate, in such amount as my personal representative shall consider necessary and desirable, for the purchase, erection and inscription of a suitable marker for my grave. SECOND I give, devise and bequeath my estate of whatever nature and wherever situate as follows: a one-third (1/3) share to my brother, Elmer H. Potteiger, Jr., per capita; a one-third (1/3) share to my sister, Betty Louise Graham, per stirpes and a one-third (1/3) share to Deborah J. Bubb. In the event Debo~'al~ ,J. BUi:)b P~'~c~-a~ ~e- or fails to survive me by thirty (30) days, then I give, devise and bequeath her one-third (1/3) share of my estate to her husband, VVilliam Bubb. In the event that I am predeceased bY Deborah J. Bubb and William Bubb, that portion of my estate which would have passed to them shall pass to their issue in equal shares, per stirpes. In the event my brother, Elmer H. Potteiger, Jr. predeceases me, that portion of my estate which would have been passed to him shall be distributed to my sister, Betty Louise Graham and Deborah J. Bubb in accordance with the above provisions. THIRD I direct that no executor or other fiduciary named, nominated, or appointed by this my Last Will and Testament shall be required to post any bond or give any security of any type for any purpose whatsoever, any law or rule of the court of the Commonwealth of Pennsylvania or any other jurisdiction to the contrary notwithstanding. I direct that the law of the Commonwealth of Pennsylvania shall apply to any interpretation or application of the validity of this instrument. FOURTH My executor shall have the following powers in addition to those vested in them by law and by other provisions of this will, applicable to all property, real, personal or mixed and wheresoever situate, including property held for minors, whether principal or income, exercisable without court approval, and effective, with respect to each item of said property until actual distribution thereof. A) To retain, as investments of my estate or trust, any or all assets of my estate, real, personal, or mixed, without regard to any principal of diversification, and to purchase and ac~q~'i~ re~I or personal property' and"to hO-J(~--~ ~)-~ of such real a~d personal property retained or acquired without making the same productive of income. B) To permit the children, or any of them, to occupy any real estate retained or acquired upon such terms and conditions as my executrix or trustee shall deem proper. C) To pay all taxes, charges and expenses of maintenance, upkeep, improvements, development, protection, preservation and investment of any retained or acquired real or personal property, such payments to be made from either principal or income as my executrix or trustee shall determine. D) To retain or invest any and all funds, whether principal or income, in any real or personal property without restriction to legal investments; to purchase investments at premiums; to exercise all rights of a security holder or share holder in any corporation; and to lease, mortgage, pledge, give options upon or sell at public or private sale and without approval of any court, any real or personal property, or portion or portions thereof, irrespective of the manner or the means by which the same was ,~acquired by my said executrix or trustee. E) To make payment or distribution herein provided for in cash, kind or partly in cash and partly in kind, at valuations fixed by my executrix or trustee at the time of distribution. FIFTH Any and all payment or payments of any sum or sums, whether in cash or in kind and whether for principal or income, payable to an heir, or any of them, shall be made upon the sole receipt of the respective individual to whom the payment is made, and free from ant~clpabon, alienation, assignment, attachment, and pledge, and free from control by the creditors of any such beneficiary. SIXTH I appoint my brother, Elmer H. Potteiger, Jr., Executor of this my Last Will and Testament. Should my said Executor fail to survive me or for any reason fail to qualify as Executor, then I appoint Deborah J. Bubb, Executrix of this my Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of four (4) typewritten pages, the first three (3) of which bear my signature in the margin for the purpose of identification, this j~t~ day of April, 2001. (SEAL) Signed, sealed, published and declared by the above named testatrix, Mildred E. Smith, as and for her Last Will and Testament, in the presence of us, who, at her request, in her sight and presence, and in the sight and presence of each other, have hereunto subscribed our n. aones as witnesses. ADDRESS~ , ~ ADDRESS6/'~ lk),bOCt,(fl,u~ ~f-, /~t, H~tly ~?,¢5. t:)/r · OMMONVVEALTR OF PENNSYLVANIA : .......... ~ · SS. COUNTY OF CUMBERLAND We, Mildred E. Smith, and ~q/~&r~,. L.... A her', the testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument of her Last Will and Testament, and that she Signed willingly and that she executed as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as witnesses, and that to the best of their knowledge, the testatrix was at the time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. Sworn to and subscribed before me this I~ day of April, 2001. Jennifer S. Ltndsay. N~.aq,, Pubi;c ~ Cadisle Boro, Cumberland Coumv My Com~ss on Expires Nov. 29, 2~03 ~ ~b~,Penn~zan~a~at~cn ~t Non, nas BUREAU OF ZNDZVZDUAL TAXES TNHERTTANCE TAX DTVZSTON DEPT. 280601 HARRISBURG, PA 17128-0601 DAVID A BARIC ESQ OBRIEN ETAL 17 W SOUTH ST CARLISLE CONNONNEALTH OF PENNSYLVANZA DEPARTNENT OF REVENUE PA 17015 NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTZONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH ,F/LE NUNDER COuNyy ACN REV-liq? EX AFP CD1-D2) 11-19-2002 SHZTH HILDRED E 0q-05-2002 21 02-0555 CUNBERLAND 101 Aaount ReaAttad HAKE CHECK PAYABLE AND RENZT PAYHENT TO: REGISTER OF NILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THZS LTNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-OE) NOT]:CE OF ZNHERZTANCE TAX APPRAZSENENT, ALLONANCE OR DZSALLONANCE OF DEDUCTTONS AND ASSESSNENT OF TAX ESTATE OF SHITH HILDRED E FZLE NO. 21 02-0:555 ACN 101 DATE 11-19-2002 TAX RETURN HAS: [ X) ACCEPTED AS F/LED ( ) CHANGED RESERVAT]:ON CONCERN/NE FUTURE ZNTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN I Real Estate (Schedule A) 2 Stocks and 8onds (Schedule B) 3 Closely Held Stock~Partnership [ntarest (Schedule C) q Mortgages/Notes Receivable (Schedule D) 5 Cash/Dank Daposlts/Hisc. Personal Property (Schedule E) 6 Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTZONS AND EXEHPTZONS: 9. Funeral Expenses/Ada. Costs/Misc. Expanses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule 1) 11. Total Deductions 12. Net Value of Tax Return (1) .00 (2) .00 ($) .00 .00 ($) $q9/05~.55 (6) .00 NOTE: To insure proper credit to your account, submit the upper portion of this fora with your tax payaen~. (9) q7,398.qq (2o) .00 (11) 67.~gS.qq (12) 555,888.97 15. NOTE ASSESSNENT OF TAX: 15. Aaount of Line lq at Spousal rata 16. Aaount of Line lq taxable at Lineal~Class A ra~a 17. Aaount of Line lq at Sibling rata 18. Aaount of Line lq taxable at Collateral/Class B rata 19. Pr~nc~paZ Tax Due TAX CREDZTS: PAYMENT RECEIPI DZSCOUNT (+J DATE NUMBER ZNTEREST/PEN PAID (-) 06-2~-2002 CD001528 $,710.5~ 10-09-2002 CD001707 .00 (15) .00 x O0 : .00 (16) .00 x Oq5: .00 (17) 201,090.7q x 12 = 2q,150.88 (18) $$q,798.25 x 15 : 50,219.75 (19)= 7q,$50.61 AHOUNT PAZD Charitabla/Govarnaental Bequests; Non-elected 9113 Trusts (Schedule J) (15) . O0 Nat Value of Estate Subject to Tax (lq) 5:35,888.97 Tf an assessment was issued prevLously, 11nee 14, 15 and/or 16, 17, 18 and 19 w111 reflect flgures that include the total of ALL returns assessed to date. 70,500.00 325.61 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATZON OF ADDZTZONAL /NTEREST. TOTAL TAX CREDZT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 7q,556.1q 185.53CR .00 185.53CR ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE 1S REFLECTED AS A 'CREDZT' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE S/DE OF THZS FORM FOR ~NSTRUCTZONS.) (7) 23q/151.86 (8) 585,287.ql BUREAU OF ZNDTVZDUAL TAXES INHERITANCE TAX DIVTS/ON DEPT. Z80601 HARRISBURG,, PA 17128-0601 COMMONWEALTH OF PENNSYLVAN'rA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-i;O7 EX AFP (01-02) DAVID A BARIC ESQ OBRIEN ETAL 17 W SOUTH ST CARLISLE PA 17~)~15 DATE 12-16-2002 ESTATE OF SMITH DATE OF DEATH 0q-05-2002 FILE NUMBER 21 02-0555 COUNTY CUMBERLAND ACN 101 I Amoun~ Remi~ed MILDRED E HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credi~ ~o your account:, submi~ ~:he upper por~:ion of ~his for. wi~h your ~ex payment. CUT ALONG THIS LINE ~ RETA'rN LOWER PORTION FOR YOUR RECORDS *~ REV-1607 EX AFP (01-02) x~ INHERITANCE TAX STATEHENT OF ACCOUNT ESTATE OF SMITH MILDRED E F'rLE NO. 21 02-0555 ACN 101 DATE 12-16-2002 THIS STATEMENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAMED ESTATE. SHO#N BELO# ZSA SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND., ZF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-19-2002 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): PAYMENT DATE 06-2q-200Z 10-09-2002 11-26-2002 RECEIPT NUMBER CDOO1528 CD001707 REFUND 7q,350.61 ZF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' ¢CR), DISCOUNT (+) INTEREST/PEN PAID (-) 5,710.55 .00 .00 AMOUNT PAID 70,500.00 325.61 185.53- TOTAL TAX CREDIT 7q,550.61 BALANCE OF TAX DUE .00 ZNTEREST AND PEN. .00 TOTAL DUE .00 YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR ZNSTRUCTTONS. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Mildred E. Smith Date of Death: April 5, 2002 Will No. Admin. No. 2002-00353 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: 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: a. Did the personal representative file a final account with the Court? Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes x No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed/~th the Cerk of the Orphans' Court and may b~ attached to t~Fis/report. Date:July 3, 2003 Signature (MAH:rmf/AM3) David A. Baric, Esquire Name (Please type or print) 17 West South Street Address Carlisle, PA 17013 (717) 249-6873 Tel. No. Capacity: X __Personal Representative __Counsel for personal representative STATUS REPORT UNDER RULE 6.12 Name of Decedent: Mildred E. Smith Date of Death: April 5, 2002 Will No. Admin. No. 2002-00353 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: 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: a. 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 w~ the Cerk of the Orphans' Court and may ~attached to this/~port. Date: September 3, 2003 Signature ~.-~.- David A. Baric, Esquire ' Name (Please type or print) ~n 17 West South Street ~._ Address Carlisle, PA 17013 (717) 249-6873 ? Tel. No. Capacity: Personal Representative (MAH:rmf/AM3) x Counsel for personal representative