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Home My WebLink About02-0371 PETITION also known as Deceased. Social Security No. / ql-! ~.- ~ 3~ ~ / The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut in the last wilt of the above decedent, dated T~CL~ ~/ t .3 and codicil(s) dated [ FOR PROBATE and GRANT No. To: OF LETTERS 21-02-371 Register of Wills for the, County of (.JUD'I ~J~r-[/qA.4~ in the Commonwealth of Pennsylvania named ,19 q-~ (slate relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in 0k.k_nq ~ ~'/.._/:I-D D County, Pennsylvania, with h~'~ [astfa,milyorprin3:,ipalresidenceat Ot~rnt3~p._t~,.,tflD C~_t>~^gc~% l (list street, number and muncipality) Decendent, then ~ [- years of age,, died ~ ¢_~ 1 Q.~ ,.4~' ~ ~ ,[ 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 r,.r~34est.(s) the prpbate of the last will and codicil(s) presented herewith and the grant of letters r_~Jl~~~ (t~estamentary; administr~on c.t.a.; administration d.b.n.c.t.a.) theron. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA )~ COUNTY OF Q LkmqD~_/.~D._D _ ss The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of 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-- "'~F?-.-~x-~DJv~k'-J~,~~.h-A) before me this 10th day of ,-~ - . . ,. ~' [ ,,~ _APR/d~ 2002 , ! ~tP ~q, ~[ }/ L/.,._~(~ .~ x~l'lt~°.-lg'~fi'tx'rt~~~~' ~ MARY q] LEWIS v No.21-o2-371 Estate Of 'R.T,RANIOR ,7 IqR. T,SQN , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW APRIL 10, 2002 19 .... in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated 07-13-1995 described therein be admitted to probate and filed of record as the last will of ELEANOR J NELSON and Letters TESTAMENTARY ' are hereby granted to SUSAN A MTT,]',RR FEES Probate, Letters, Etc .......... $ 25.00 Short Certificates( ) .......... $ 9.00 ~ ext.r~a .pages... $ 15_ . jcp $ 5.00 54.00 TOTAL $. Filed . gPBI. L..1.0. ~. ¢.0.0.2. ................. calle executor on 4-10-02 [~RY 6~r LEW!l~¢gister of Wills AITORNEY (Sup. Ct. I.D. No.) ADDRESS - PHONE LAST WILL AND TESTAMENT OF ELEANOR J. NELSON I, ELEANOR J. NELSON, of the Borough of Wellsville, York County, Pennsylvania, do hereby make this my Last Will and Testament, revoking any former Wills and Codicils made by me. FIRST: I direct that all my legally enforceable debts, secured and unsecured, be paid as soon as practicable after my death. SECOND: I give my tangible personal property and all casualty insurance that I am carrying on said tangible personal property to my daughter, Susan A. Miller, or, if she does not survive me, I give said property to such of my grandchildren who are living at my death, to be divided equitably among or between them as they may determine, or, if they are unable to agree, as my Executor shall determine, after considering the wishes of such grandchildren. I have complete confidence that my daughter, my grandchildren or my Executor will honor any written instructions that I may leave with regard to said tangible personal property. Any such property not so distributed shall be sold, and the proceeds added to my residuary estate to pass as hereafter described. THIRD: I give, devise and bequeath all the rest, residue and remainder of my property of every kind and description (including lapsed legacies and devises) wherever situate and -1- whether acquired before or after the execution of this Will, absolutely in fee simple to my daughter and grandchildren, in the following proportions: two-thirds (2/3) to my daughter, Susan A. Miller, if she survives me; and one-third (1/3) to my grandchil- dren, Eric B. Nelson and Bradley D. Nelson, in equal shares, or to the survivor of them; provided, however, that if either of them predeceases me, his share shall be distributed to his then- living issue, per stirpes. If my daughter shall not survive me, then I give, devise and bequeath all of the property to my grandchildren who survive me, in equal shares, or to the survivor of them; provided, however, that if either of them predeceases me, his share shall be distributed to his then-living issue, per stirpes. FOURTH: If all the beneficiaries described in Article Third above are deceased and no other disposition of the residue of my estate is directed by this Will, then and in that event only, I give, devise and bequeath such rest, residue and remainder of my estate, real and personal, to those persons living at the date of my death who would be my heirs, their identities and respective shares to be determined in accordance with the law in effect in the Commonwealth of Pennsylvania at my death, as if I had died intestate. FIFTH: If any person under the age of twenty-one (21) years shall become entitled to any share hereunder, then such share shall immediately vest in such beneficiary, but notwithstanding -2- the provisions herein, my Executor may distribute such bene- ficiary's share to any adult person standing in loco parentis, or to a legal guardian of such beneficiary, or to a custodian (to be selected by my Executor) under the applicable Uniform Transfers to Minors Act, without requiring bond of such adult person, guardian or custodian. The receipt of such adult person, guard- ian or custodian shall constitute a full release of my Executor for any property so distributed. SIXTH: No person shall benefit hereunder unless such beneficiary shall survive me by thirty (30) days. SEVENTH: I name my daughter, Susan A. Miller, as my Execu- trix. I direct that my Executrix, herein referred to as my Executor regardless of number or gender, serve without bond in any jurisdiction in which called upon to act. My Executor shall receive reasonable compensation for services rendered. EIGHTH: (1) I give to any Executor named in this Will or any Codicil hereto or to any successor or substitute Executor all of the powers enumerated in this Will and all of the powers applicable by law to fiduciaries in the Commonwealth of Pennsyl- vania and in particular through the Pennsylvania Probate, Estates and Fiduciaries Code, as effective and as in effect on the date of my death, during the administration and until the completion of the distribution of my estate. I direct that all such powers -3- shall be construed in the broadest possible manner and shall be exercisable without court authorization. (2) My Executor is authorized and empowered to sell at public or private sale, or exchange, and to encumber or lease, for any period of time, any real or personal property and to give options to buy or lease any such property. Additionally, my Executor is authorized and empowered to compromise claims, to borrow from anyone (including a fiduciary hereunder) and to pledge property as security therefor, to make loans to and to buy property from anyone (including a fiduciary or beneficiary hereunder); provided that any such loans shall be adequately secured and at a fair interest rate. (3) All estate, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property comprising my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid out of the residue of my estate, as if such taxes were expenses of administration, without apportionment or right of reimbursement. I authorize my Executor to pay all such taxes at such time or times as deemed advisable. -4- IN WITNESS WHEREOF, I have set my hand and seal on this my Last Will and Testament this I'~'~''' day of ~\~ , 1995. ELEANOR J.- N~LS~N (SEAL) SIGNED, SEALED, PUBLISHED, and DECLARED by ELEANOR J. NELSON, as and for her Last Will and Testament, on the day and year last above written, in the presence of us, who, at her request, in her presence, and in the presence of each other, all being present at the same time, have hereunto subscribed our names as witnesses: -5- SELF-PROVING AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF ~0(~ : WE, ELEANOR J. NELSON and /~49/~;M ~. /~/d~--/ J~. , , and ~ ~C~% ~Q~ ~ ~ , 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 as her Last Will and that she had signed willingly (willingly directed another to sign for her), and that she executed it 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 witness and to the best of his or her knowledge the Testatrix was at that time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. ELEANOR J. NELSON, Testatrix Witness~~~ ~ Witness ~j v . - Witness Subscribed, sworn to, and acknowledged before me by ELEANOR J. NELSON, the Testatrix, and subscribed and sworn to before me by , , and , witnesses, this /3¥Q day P'J 0 ~,'A ~-~; A t._ SEAl_ PATHIC, IA J I'tOK~", t,O~A~¥ I~UDLIC REV-1500 EX (6~0) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER o03qi COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURIIY NUMBER ~ Eleanor J. Nelson 191-18-3751 t'tlLI DATE OF DEATH (MM-DO-YEAR) DATE OF BIRTH (MM-DO-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ILl 10-14-2001 06-15-1920 REGISTER OF WILLS LLI (IF APPLICABLE)SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER L~ Z n~ 0 Z ~ 1. Odginal Return ~ 2. Supplemental Return E~] 4. Limited Estate ~--] 4a. Future Interest Compromise (date of death after 12-12-82) E~6. Decedent Died Testate (Attach copy of Will) [--] 7. Decedent Maintained a Living Trust (Attach copy of Trust) E~9. Litigation Proceeds Received NAME Susan Stott FIRM NAME (If Appliceble) Stott & Stott TELEPHONE NUMBER 717-243-8077 ~ 3. Remainder Return (date of death pdor to 12-13-82) ~----] 5. Federal Estate Tax Return Required 0 8. Total Number of Safe Deposit Boxes II 10. Spousal Poverty Credit date of death between 12-31-91 and 1-1-95) ~ 1 1. Election to tax under Sec. 9113(A) (Attach Sch O) COMPLETE MAILING ADDRESS 157 South Hanover Street Carlisle, PA 17013 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 (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) [-q Separete 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) 1 1. Total Deductions (total Lines 9 & 10) 1 2. 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) 3,477.85 8,878.27 OFF~iAL USE ONLY (8) 12,356.12 817 5,826.83 (11) 6,643.83 5,712.29 5,712.29 (12) (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 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) 1 6. Amount of Line 14 taxable at lineal rate 1 7. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. 5,712.29 x.0 x.o 45 x .12 x .15 __ (15) (16) (17) (18) (19) 257.05 257.05 1W4645 1.000 l~ecedent's Complete Address: lSTREETADDRESS One L____on__gsdorf Way c~lY Carlisle STATE ZIP PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) (1) 257.05 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) .00 257.05 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 257.05 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; ....................... E~ r~ 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? ............................ [] F~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? E~] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate properly which contains a beneficiary designation? ................................ E~ [~ 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 of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGt'CATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS 1349 Zimmerman Road, Carlisle, PA SIGNATURE O~~ATIVE DATE 17013 DATE ADDRESS 157 South Hanover 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.§ 9916 (a) (1.1) (i)]. For dates of death on or after Jan uary 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. § 91 t 6 (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 retum 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 im posed 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 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. 1w4646 1.000 REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONALPROPERTY ESTATE OF FILE NUMBER Eleanor J. Nelson Include the proceeds of litigation and the date the proceeds were received by the estate. Ail property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH Bank Of Hanover Checking Acct. %916951 Prudential Insurance Demutualization Payment Pennsylvania Individual Income Tax Refund 2,741.29 682.56 54.00 TOTAL (Also enter on line 5, Recapitulation) $ 3, 4 7 7.8 5 (if more space is needed, insert additional sheets of the same size) lW46AD 1.000 REV-1510 EX+ (1-97) 'COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Eleanor J. Nelson 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 PROPERTY % OF ITEM INCLUOE ME NAME OF THE TRANSFEREE, THEIR RE~TIONSHIP TO DECEDENT AND THEDATE OF DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER TRANSFE~ A~H A ~PY OF THE DEED FOR RE~ ESTATE. VALUE OF ASSET INTEREST (IF ~PUCABLE) 1. $25 Series E U.S. Savings Bond, issued 8/62 202.53 50% 101.27 Q6419324755E, interest $183.78 Susan A. Miller, Daughter Date of Transfer 03/27/2000 2. $25 Series E U.S. Savings Bond, issued 5/62 204.09 50% 102.05 Q6419324753E, interest $185.34 Susan A. Miller, Daughter Date of Transfer 03/27/2000 3. $25 Series E U.S. Savings Bond, issued 8/63 203.17 50% 101.59 Q6419324748E, interest $184.42 Susan A. Miller, Daughter Date of Transfer 03/27/2000 4. $25 Series E U.S. Savings Bond, issued 6/63 205.22 50% 102.61 Q6419324748E, interest $186.47 Susan A. Miller, Daughter Date of Transfer 03/27/2000 5. $25 Series E U.S. Savings Bond, issued 9/63 204.14 50% 102.07 Q6419324746E, interest $185.39 Susan A. Miller, Daughter Date of Transfer 03/27/2000 6. $25 Series E U.S. Savings Bond, issued 12/63 205.41 50% 102.71 Q6419324743E, interest $186.66 Susan A. Miller, Daughter Date of Transfer 03/27/2000 7. $25 Series E U.S. Savings Bond, issued 10/63 204.14 50% 102.07 Q6419324744E, interest $185.39 Susan A. Miller, Daughter Date of Transfer 03/27/2000 8. $25 Series E U.S. Savings Bond, issued 11/63 204.14 50% 102.07 Q6419324745E, interest $185.39 Susan A. Miller, Daughter Date of Transfer 03/27/2000 9. $25 Series E U.S. Savings Bond, issued 8/63 203.17 50% 101.59 Q6419324749E, interest $184.42 Susan A. Miller, Daughter Date of Transfer 03/27/2000 10. $25 Series E U.S. Savings Bond, issued 5/63 203.67 50% 101.84 Q6419324750E, interest $184.92 Susan A. Miller, Daughter Date of Transfer 03/27/2000 11. $25 Series E U.S. Savings Bond, issued 7/63 205.22 50% 102.61 Q6419314751E, interest $186.47 Susan A. Miller, Daughter Date of Transfer 03/27/2000 TOTAL FROM ADDITIONAL ATTACHED PAGES 7,755.79 TOTAL(Alsoenteronline7, Re~pitul~ion} $ 8,878.27 (If more space is needed, inset[ additional sheets of same size.) 1W46AF 1.000 Attachment to Schedule G, Inter-Vivos Transfers & Misc. Non-Probate Property Elear!.or J. Nelson Page 1 Of 5 % of Item Description of Property Date of Death Decd's Number Value of Asset Interest Taxable Value 12. $25 Series E U.S. Savings Bond, issued 3/63 $203.70 50% Q6419324754E, interest $184.95 Susan A. Miller, Daughter Date of Transfer 03/27/2000 13. $25 Series E U.S. Savings Bond, issued 4/63 $203.67 50% Q6419324752E, interest $184.92 Susan A. Miller, Daughter Date of Transfer 03/27/2000 14. $25 Series E U.S. Savings Bond, issued 1/64 $205.41 50% Q6419324742E, interest $186.66 Susan A. Miller, Daughter Date of Transfer 03/27/2000 15. $25 Series E u.S. Savings Bond, issued 2/64 $201.34 50% Q6419324741E, interest $182.59 Susan A. Miller, Daughter Date of Transfer 03/27/2000 16. $25 Series E U.S. Savings Bond, issued 8/64 $199.63 50% Q6419324740E, interest $180.88 Susan A. Miller, Daughter Date of Transfer 03/27/2000 17. $25 Series E U.S. Savings Bond, issued 8/64 $199.63 50% Q6419324739E, interest $180.88 Susan A. Miller, Daughter Date of Transfer 03/27/2000 18. $25 Series E U.S. Savings Bond, issued 9/64 $200.56 50% Q6419324738E, interest $181.81 Susan A. Miller, Daughter Date of Transfer 03/27/2000 19. $25 Series E U.S. Savings Bond, issued 10/64 $200.56 50% Q6419324737E, interest $181.81 Susan A. Miller, Daughter Date of Transfer 03/27/2000 20. $25 Series E U.S. Savings Bond, issued 11/64 $200.56 50% Q6419324736E, interest $181.81 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 7/64 Q6419324735E, interest $184.88 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 6/64 Q6419324734E, interest $184.88 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 5/64 Q6419324733E, interest $183.53 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 4/64 Q6419324732E, interest $183.53 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 12/64 Q6419324731 E, interest $183.11 Susan A. Miller, Daughter Date of Transfer 03/27/2000 21. $203.63 50% 22. $203.63 50% 23. $202.28 50% 24. $202.28 50% 25. $201.86 50% $101.85 $101.84 $102.71 $100.67 $ 99.82 $ 99.82 $100.28 $100.28 $100.28 $101.82 $101.82 $101.14 $101.14 $100.93 Attachment to Schedule G, Inter-Vivos Transfers & Misc. Non-Probate Property Eleanor J. Nelson Page 2 Of 5 % of Item Description of Property Date of Death Decd's Number Value of Asset Interest Taxable Value 26. $25 Series E U.S. Savings Bond, issued 3/64 $202.30 50% Q6419324730E, interest $183.55 Susan A. Miller, Daughter Date of Transfer 03/27/2000 27. $25 Series E U.S. Savings Bond, issued 1/73 $121.28 50% Q6419324773E, interest $102.53 Susan A. Miller, Daughter Date of Transfer 03/27/2000 28. $25 Series E U.S. Savings Bond, issued 2/73 $121.59 50% Q6419324772E, interest $102.84 Susan A. Miller, Daughter Date of Transfer 03/27/2000 29. $25 Series E U.S. Savings Bond, issued 3/73 $121.59 50% Q6419324771E, interest $102.84 Susan A. Miller, Daughter Date of Transfer 03/27/2000 30. $25 Series E U.S. Savings Bond, issued 3/73 $121.59 50% Q6419324770E, interest $102.84 Susan A. Miller, Daughter Date of Transfer 03/27/2000 31. $25 Series E U.S. Savings Bond, issued 4/73 $121.59 50% Q6419324769E, interest $102.84 Susan A. Miller, Daughter Date of Transfer 03/27/2000 32. $25 Series E U.S. Savings Bond, issued 5/73 $121.59 50% Q6419324768E, interest $102.84 Susan A. Miller, Daughter Date of Transfer 03/27/2000 33. $25 Series E U.S. Savings Bond, issued 6/73 $121.88 50% Q6419324767E, interest $103.13 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 7/72 Q6419324780E, interest $103.25 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 6/72 Q6419324779E, interest $104.49 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 5/72 Q6419324778E, interest $104.15 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 8/72 Q6419324781E, interest $103.52 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 9/72 Q6419324782E, interest $103.52 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 10/72 Q6419324783E, interest $103.52 Susan A. Miller, Daughter Date of Transfer 03/27/2000 34. $122.00 50% 35. $123.24 50% 36. $122.90 50% 37. $122.27 50% 38. $122.27 50% 39. $122.27 50% $101.15 $ 60.64 $ 60.80 $ 60.80 $ 60.80 $ 60.80 $ 60.80 $ 60.94 $ 61.00 $ 61.62 $ 61.45 $ 61.14 $ 61.14 $ 61.14 Attachment to Schedule G, Inter-Vivos Transfers & Misc. Non-Probate Property Eleanor J. Nelson Page 3 Of 5 % of Item Description of Property Number Date of Death Decd's Value of Asset Interest Taxable Value 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. $25 Series E U.S. Savings Bond, issued 11/72 Q6419324775E, interest $103.52 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 12/72 Q6419324774E, interest $103.79 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 3/72 Q6419324794E, interest $104.15 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 2/72 Q6419324793E, interest $104.14 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 1/72 Q6419324792E, interest $103.85 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 12/71 Q6419324791E, interest $106.56 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 9/71 Q6419324790E, interest $107.61 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 7/71 Q6419312789E, interest $107.31 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 6/71 Q6419324788E, interest $108.20 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 5/71 Q6419324787E, interest $107.85 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 8/71 Q6419324786E, interest $107.61 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 10/71 Q6419324785E, interest $107.61 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 11/71 Q6419324784E, interest $106.27 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 4/71 Q6419324729E, interest $107.85 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $122.27 50% $122.54 50% $122.90 50% $122.89 50% $122.60 50% $125.31 50% $ 61.14 $ 61.27 $ 61.45 $ 61.45 $ 61.30 $ 62.66 $126.36 50% $ 63.18 $126.06 50% $126.95 50% $126.60 50% $126.36 50% $126.36 50% $125.02 50% $126.60 50% $ 63.03 $ 63.48 $ 63.30 $ 63.18 $ 63.18 $ 62.51 $ 63.30 Attachment to Schedule G, Inter-Vivos Transfers & Misc. Non-Probate Property Eleanor J. Nelson Page 4 Of 5 % of Item Description of Property Date of Death Decd's Number Value of Asset Interest Taxable Value 54. $25 Series E U.S. Savings Bond, issued 5/71 ~ $126.60 50% Q6419324728E, interest $107.85 Susan A. Miller, Daughter Date of Transfer 03/27/2000 55. $25 Series E U.S. Savings Bond, issued 3/71 $126.60 50% Q6419324727E, interest $107.85 Susan A. Miller, Daughter Date of Transfer 03/27/2000 56. $25 Series E U.S. Savings Bond, issued 2/71 $126.60 50% Q6419324726E, interest $107.85 Susan A. Miller, Daughter Date of Transfer 03/27/2000 57. $25 Series E U.S. Savings Bond, issued 1/71 $126.30 50% Q6419324725E, interest $107.55 Susan A. Miller, Daughter Date of Transfer 03/27/2000 58. $25 Series E U.S. Savings Bond, issued 11/70 $139.69 50% Q6419324723E, interest $120.94 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 12/70 Q6419324724E, interest $121.26 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 10/70 Q6419324722E, interest $120.94 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 9/70 Q6419324721 E, interest $120.94 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 8/70 Q6419324720E, interest $120.94 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 7/70 Q6419324719E, interest $120.61 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 6/70 Q6419324718E, interest $119.25 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 5/70 Q6419324717E, interest $118.61 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 5/70 Q6419324716E, interest $118.61 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 4/72 Q6419324776E, interest $104.15 Susan A. Miller, Daughter Date of Transfer 03/27/2000 59. $140.01 50% 60. $139.69 50% 61. $139.69 50% 62. $139.69 50% 63. $139.36 50% 64. $138.00 50% 65. $137.36 50% 66. $137.36 50% 67. $122.90 50% $ 63.30 $ 63.30 $ 63.30 $ 63.15 $ 69.85 $ 70.01 $ 69.85 $ 69.85 $ 69.85 $ 69.68 $ 69.00 $ 68.68 $ 68.68 $ 61.45 Attachment to Schedule G, Inter-Vivos Transfers & Misc. Non-Probate Property Eleanor J. Nelson Page 5 Of 5 % of Item Description of Property Date of Death Decd's Number Value of Asset Interest Taxable Value 68. $25 Series E U.S. Savings Bond, issued 4/72 _ $122.90 50% Q6419324777E, interest $104.15 Susan A. Miller, Daughter Date of Transfer 03/27/2000 69. $25 Series E U.S. Savings Bond, issued 4/61 $201.36 50% Q6419324766E, interest $182.61 Susan A. Miller, Daughter Date of Transfer 03/27/2000 70. $25 Series E U.S. Savings Bond, issued 5/61 $201.36 50% Q6419324765E, interest $182.61 Susan A. Miller, Daughter Date of Transfer 03/27/2000 71. $25 Series E U.S. Savings Bond, issued 6/61 $201.95 50% Q6419324764E, interest $183.20 Susan A. Miller, Daughter Date of Transfer 03/27/2000 72. $25 Series E U.S. Savings Bond, issued 7/61 $201.95 50% Q6419324763E, interest $183.20 Susan A. Miller, Daughter Date of Transfer 03/27/2000 73. $25 Series E U.S. Savings Bond, issued 8/61 $203.88 50% Q6419324762E, interest $185.13 Susan A. Miller, Daughter Date of Transfer 03/27/2000 74. $25 Series E U.S. Savings Bond, issued 9/61 $206.17 50% Q6419324761E, interest $187.42 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 10/61 Q6419324760E, interest $187.40 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 2/61 Q6419324759E, interest $180.32 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 3/61 Q6419324758E, interest $182.62 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. savings Bond, issued 1/61 Q6419324757E, interest $178.43 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $25 Series E U.S. Savings Bond, issued 9/61 Q6419324756E, interest $187.42 Susan A. Miller, Daughter Date of Transfer 03/27/2000 $1000 Series E U.S. savings Bond, issued 4/72 M213418799E, interest $4166.00 Susan A. Miller, Daughter Date of Transfer 03/27/2000 75. $206.15 50% 76. $199.07 50% 77. $201.37 50% 78. $197.18 50% 79. $206.17 50% 80. $4916.00 50% $ 61.45 $100.68 $100.68 $100.98 $100.98 $101.94 $103.09 $103.08 $ 99.54 $100.69 $ 98.59 $103.09 $2458.00 TOTAL $7755.79 REV-I~I 1 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Eleanor J. Nelson Debts of decedent must be reported on Schedule I. ITEM NUMBER 5. 6. 7. DESCRIPTION FUNERAL EXPENSES: ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Susan A. [Vjiller Social Security Number(s) / EIN Number of Personal Representative(s) Street Address 1349 Zimmerman Road City Carlisle State PA Zip 17013 Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent Probate Fees Register of Wills Accountant's Fees Stott & Stott Tax Return Preparer's Fees State__ Zip TOTAL (Also enter on line 9, Recapitulation) $ AMOUNT 300.00 42.00 475.00 817.00 (If more space is needed, insert additional sheets of same size) 1W46AG 1.000 REV-1512 EX+ (1-9;') OMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGELIABILITIES,& LIENS ESTATE OF FILE NUMBER Eleanor J. Nelson Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. 5,826.83 Cumberland Crossings Retirement Community 1 Longsdorf Way, Carlisle, PA 17013 TOTAL(Also enter on line 10, Recapitulation) $ 5, 826. 83 (If more space is needed, insert additional sheets of the same size) 1W46AH 1.000 REV-1'513 EX + (9-00) C{~MMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Eleanor J. Nelson RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 3 o TAXABLE DISTRIBUTIONS[includeoutrightspousaldistributions, andtrans~rs underSec. 9116(a)(1.2)] Susan A. Miller 1349 Zimmerman Road, Carlisle, PA 17013 Bradley Nelson c/o Joyce Bisalli 263 Barrens Church Road, Dillsburg, PA 17019 Eric Nelson 5920 Catherine Street, Harrisburg, PA 17112 Daughter Grandson Grandson 67% of rest, remainder and residue 16.50% of rest,remainder and residue 16.50% of rest,remainder and residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, 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 II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ lW46AI 1.000 (If more space is needed, insert additional sheets of the same size) Register of Wills of CUMBERLAND County, Pennsylvania Certificate of Grant of Letters No. 2002-00371 PA No. 21-02-0371 ESTATE OF NELSON ELEANOR J (LAS'±', WHEREAS, on the 10th dated July 13th 1995 Late of Deceased Social Security No. 191-18-3751 day of April SOUTH MIDDLETON TOWNSHIP 2002 an instrument was admitted to probate as the last will of NELSON ELEANOR J (.bAS'r, ~'±~S'Z', ~±~L~) late of SOUTH MIDDLETON TOWNSHIP , CUMBERLAND County, who died on the !4th day of October 2001 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS , Register of Wills in and for the County of CUMBERLAND in the Commonwealth of PennSylvania, hereby' certify that I have this day granted Letters TESTAMENTARY to MILLER SUSAN A who has duly qualified as Executor(rix) and has agreed to administer the estate according to law, all of which fully appears ef record in .my Office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, i have hereunto set my hand and affixed the seal of my Office the 10th day of April 2002 . ' HeglsEer Or ~111~. **NOTE** i~LL N~R~t~S ~kBOVE i~_PP~JtR (I_~LST, FIRST, MIDDLE) LAST WILL AND TESTAMENT OF ELEANOR J. NELSON I, ELEANOR J. NELSON, of the Borough of Wellsville, York County, Pennsylvania, do hereby make this my Last Will and Testament, revoking any former Wills and Codicils-made by me. FIRST: I direct that all my legally enforceable debts, secured and unsecured, be paid as soon as practicable after my death. SECOND: I give my tangible personal property and all casualty insurance that I am carrying on said tangible personal property to my daughter, Susan A. Miller, or, if she does not survive me, I give said property to such of my grandchildren who are living at my death, to-be divided equitably among or betWeen them as they may determine, or, if they are unable to agree, as my Executor shall determine, after considering the wishes of such grandchildren. I have complete confidence that my daughter, my grandchildren or my Executor will honor any written instructions that I may leave with regard to said tangible personal property. Any such property not so distributed shall be sold, and the proceeds added to my residuary estate to pass as hereafter described. THIRD: I give, devise and bequeath all the rest, residue and remainder of my property of every kind and description (including. lapsed legacies and devises) wherever situate and -1- whether acquired before or after the execution of this Will, absolutely in fee simple to my daughter and grandchildren, in the following proportions: two-thirds (2/3) to my daughter, Susan A. Miller, if she survives me; and one-third (1/3) to my grandchil- dren, Eric B. Nelson and Bradley D. Nelson, in equal shares, or to the survivor of them; provided, however, that if either of them predeceases me, his share shall be distributed to his then- living issue, per stirpes. If my daughter shall not survive me, then I give, devise and bequeath all of the property to my grandchildren who survive me, in equal shares, or to the survivor of them~ provided, however, that if either of them predeceases me, his share shall be distributed to his then-living issue, per stirpes. FOURTH: If all the beneficiaries described in Article Third above are deceased and no other disposition of the residue of my estate is directed by this Will, then and in that event only, I give, devise and bequeath such rest, residue and remainder of my estate, real and personal, to those persons living at the date of my death who would be my heirs, their identities and respective shares to be determined in accordance with the law in effect in the Commonwealth of Pennsylvania at my death, as if I had died intestate. FIFTH: If any person under the age of twenty-one (21) years shall become entitled to any share hereunder, then such share shall immediately vest in such beneficiary, but notwithstanding -2- the provisions herein, my Executor may distribute such bene- ficiary's share to any adult person standing in loco parentis, or to a legal guardian of such beneficiary, or to a custodian (to be selected by my Executor) under the applicable Uniform Transfers to Minors Act, without requiring bond of such adult person, guardian or custodian. The receipt of such adult person, guard- ian or custodian shall constitute a full release.of my Executor for any property so distributed. SIXTH: No person shall benefit hereunder unless such beneficiary shall survive me by thirty (30) days. SEVENTH: I name my daughter, Susan A. Miller, as my Execu- trix. I direct that my Executrix, herein referred to as my Executor regardless of number o'r gender, serve without bond in any jurisdiction in which called upon to act. My Executor shall receive reasonable compensation for services rendered. EIGHTH: (1) I give to any Executor named in this Will or any Codicil hereto or to any successor or substitute Executor all of the powers enumerated in this Will and all of the powers applicable by law to fiduciaries in the Commonwealth of Pennsyl- vania and in particular through the Pennsylvania Probate, Estates and Fiduciaries Code, as effective and as in effect on the date of my death, during the administration and until the completion of the distribution of my estate. I direct that all such powers -3- shall be construed in the broadest possible manner and shall be exercisable without court authorization. (2) My Executor is authorized and empowered to sell at public or private sale, or exchange, and to encumber or lease, for any period of time, any real or personal property and to give options to buy or lease any such property. Additionally, my EXecutOr is authorized and empOwered~to compromise claims, to borrow from anyone (including a fiduciary hereunder) and to pledge property as security therefor, to make loans to and to buy property from anyone (including a fiduciary or beneficiary hereunder); provided that any such loans shall be adequately secured and at a fair interest rate. (3) All estate, inheritance, succession and other~ death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property comprisinq my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid out of the residue of my estate, as if such taxes were expenses of administration, without apportionment or right of reimbursement. I authorize my Executor to pay all such taxes at such time or times as deemed advisable. IN WITNESS WHEREOF, I have set my hand and seal on this my Last Will and Testament this I~ day of ~~\~ , 1995. ELEANOR J. "N~LSON (SEAL) SIGNED, SEALED, PUBLISHED, and DECLARED by ELEANOR J. NELSON, as and for her Last Will and Testament, :on the day and year last above written, in the presence of us, who, at her request, in her presence, and in the presence of each other, all being present at the same time, have hereunto subscribed our names as witnesses: -5- SELF-PROVING AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF ~0(~ : 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 as her Last Will and that she had signed willingly (willingly directed another to sign for her), and that she executed it 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 witness and to the best of his or her knowledge the Testatrix was at that time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. ELEANOR J. NELSON, Testatrix Witness Witness Witness Subscribed, sworn to, and acknowledged before me by ELEANOR J. NELSON, the Testatrix, and subscribed and sworn to before me by ~ ~ ' i~ ' , and ~ ~iQ , witnesses, this /3~L~ day of 1 , 1995. 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 00135O MILLER SUSAN A 1349 ZIMMERMAN RD CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 191-18-3751 FILE NUMBER: 2102-0371 DECEDENT NAME: NELSON ELEANOR J DATE OF PAYMENT: 06/28/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 10/14/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $257.05 REMARKS: SUSAN A MILLER TOTAL AMOUNT PAID: $257.05 SEAL CHECK# 245 INITIALS: VZ RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS 36 SOUTH PITT STREET CARLiSLe, PA 17013 (717) :245-8508 ATTORNEY AT LAW WWW. ADAMSLA~ ESQADAMS~AOI fAX: (7 I 7) 24! IN RE: ESTATE OF ELEANOR J. NELSON · REGISTER OF WILLS OF · CUMBERLAND COUNTY, PENNSYLVANIA · NO. 371 of 2002. CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Will No. TO THE REGISTER: Eleanor J. Nelson October 14, 2001. 371 of 2002. 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: marfle Eric Nelson Bradley Nelson Susan Miller Address 5920 Catherine Street, Harrisburg, Pa. 17112 263 Barren's Church Road, Dillsburg, Pa. 17019 1349 Zimmerman Road, Carlisle, Pa. 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a). Date: 7"- ~x~ -- ~ ~,, t,t~5]Adams, Esquire ~ No. 79465 36 South Pitt St. Carlisle, Pa. 17013 ~ :1.3 (717) 245-8508 ~ Counsel for Personal Representative. Register of Wills RE: File # 2102-0371 Dear Sir or Madame, Estate of Eleanor J. Nelson C/O Stott & Stott 157 S. Hanover St. Carlisle, PA 17013 (717) 243-8077 Fax - (717) 243-1748 Please apply this payment of $ 215.78 to the above reference estate for the payment of inheritance tax. Sincerely, Susan E. Stott 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 001647 SUSAN E STOTT 157 S HANOVER STREET CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 191-18-3751 FILE NUMBER: 2102-0371 DECEDENT NAME: NELSON ELEANOR J DATE OF PAYMENT: 09/24/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 0/14/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $215.78 TOTAL AMOUNT PAID: $215.78 REMARKS' SUSAN E STOTT SEAL CHECK# 248 INITIALS: JA RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG,. PA 17128-0601 COHHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX RE¥-1547 SUSAN STOTT STOTT & STOTT 157 S HANOVER ST CARLISLE PA 17~0 ~15 CUT ALONG THIS LINE ~ DATE ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN 10-07-2002 NELSON 10-14-2001 21 02-0571 CUMBERLAND 101 Amoun~3,~R~'lli~ed HAKE CHECK PAYABLE AND REMIT PAYNI REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 RETAIN LONER PORTION FOR YOUR RECORDS *~M 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 7O8 MILLER SUSAN A 1349 ZIMMERMAN RD CARLISLE, PA 17013 fold ESTATE INFORMATION: SSN: 191-18-3751 FILE NUMBER: 2102- 0371 DECEDENT NAME: NELSON ELEANOR J DATE OF PAYMENT: 10/09/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 10/14/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $3.54 TOTAL AMOUNT PAID: $3.54 REMARKS: SUSAN A MILLER (CASH PAYMENT FOR INH TAX) SEAL INITIALS' SK RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS BURE'~U OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 YHARRISBURG, PA 17128-060! SUSAN STOTT STOTT & STOTT 157 S HANOVER ST ~ CARLISLE PA 1701~ COHHONgEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUHBER i:COUNTY ACN 10-07-2002 NELSON 10-14-2001 21 02-0571 CUHBERLAND 101 Amount Rami'l:'l:ad ELEANOR J HAKE CHECK PAYABLE AND RENZT PAYNENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-Z547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLOWANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF NELSON ELEANOR d FILE NO. 21 02-0371 ACN 101 DATE 10-07-2002 TAX RETURN NAS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel Es~eta (Schedule A) (1) 2. Stocks end Bonds (Schedule B) (2) :5. Closely Held S/cock/Par/cnership Interest (Schedule C) (:5) 4. Not,gages~No,es Receivable (Schedule D) (4) 5. Cash/Bank Dapos/~cs/Hisc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Assets APPROVED DEDUCTZONS AND EXEHPTZONS: 9. Funeral Expansas/Adm. Costs/N/sc. Expenses (Schedule H) (9) 10. Dabts/Hortgage L/ab/li~c/as/Lians (Schedule I) (10) 11. Total Deductions 12. Ne~ Value of Tax Return 5~477.85 8z878.27 .00 .00 NOTE: To insure proper .00 credit ~o your account, .00 subm/~ ~ha upper por~/on .00 of ~h/s form with your ~ax payment. (8} 817.00 1:5. 14. NOTE: ASSESSMENT OF TAX: 1S. Amount of Line 14 et Spousal rata 16. Amount of Line 14 taxable a~ L/naal/Class A rata 17. Amount of L/ne 14 at S/bl/ng rate 18. Amount of L/ne 14 taxable a~ Collateral/Class B rata 19. Pr/ncipal Tax Due TAX CREDITS: PAYHENT RI~C[I*p1' DTSCOUNT DATE NUHBER INTEREST/PEN PAID (-) 06-28-2002 CD001~50 .00 12,556.12 1~051.69 (Il) 1.8~8.69 (Z2) 10,507.45 Char/~abla/Govarnmantal Bequests; Non-elected 911:5 Trusts (Schedule J) (13) Nat Value of Estate Subjec~ to Tax (14) Zf an assessment ~as issued previously, llnes 1~, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. .00 10,507.45 INTEREST IS CHARGED THROUGH IO-ZZ-ZOOZ AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 18 and 19 will 257.05 215 78 5.54 219.52 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE S/DE OF THIS FORH FOR INSTRUCTIONS.) TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 257.05 AHOUNT PAID (~) .00 x O0 = .00 (16) 10,507.45 x 045= 472.85 (~7) .00 x 12 = .00 (18) .00 x 15 = .00 (~9)= 472.83 REV-1470 EX (6-8~) INHERITANCE TAX EXPLANATION COMMONVVEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG~ PA 17128-0601 DECEDENT'S NAME FILE NUMBER Eleanor J. Nelson 2102-0371 REVlEVVED BY ACN John Kuchinski 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES G The bonds on this schedule have been moved and correctly reported on Schedule F, as jointly held assets between the decedent and daughter. I I The value of this debt has been reduced from $5,826.83 to $1,031.69 per corrected information submitted to the Department. Row Page 1 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z8060! HARRXSBURG., PA 171Z8-0601 CONNONNEALTH OF PENNSYLVANTA DEPARTHENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF ACCOUNT R£V-2~O7 EX AFP C01-OZ) SUSAN STOTT STOTT & STOTT 157 S HANOVER ST~ CARLISLE PA!'iT01$ DATE 10-28-2002 ESTATE OF NELSON DATE OF DEATH 10-14-2001 FZLE NUNBER 21 0Z-0571 COUNTY CUHBERLAND ACN 101 Amount: Remi~ed ELEANOR J HAKE CHECK PAYABLE AND REHZT PAYNENT TO: REGISTER OF WILLS CUH]iERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper cred/~ ~o your account, submit: ~:he upper portion of :khis form wi~:h your ~ax payment. CUT ALONG THZS L/NE ~ RETA'rN LONER PORT/ON FOR YOUR RECORDS ~ ESTATE OF NELSON ELEANOR J F'rLE NO. 21 02-0571 ACN 101 DATE 10-28-2002 THTS STATENENT TS PROVTDED TO ADV'rSE OF THE CURRENT STATUS OF THE STATED ACN TN THE NANED ESTATE. SHO#N BELOtf TS A SUHNARY OF THE pRTNC/PAL TAX DUE., APPLZCAT/ON OF ALL PAYHENTS, THE CURRENT BALANCE., AND., IF APPLZCABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 10-07-200Z PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYHENTS (TAX CREDITS): 472.85 PAYHENT RECEIPT DISCOUNT (+) DATE NUNBER INTEREST/PEN PAID (-) AHOUNT PAID 06-28-2002 09-24-2002 IO-09-ZOOZ CD001550 CD001647 CD001708 .00 .00 2.55- 257.05 215.78 ZF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATZON OF ADDITIONAL ZNTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), TOTAL TAX CREDIT 475.82 BALANCE OF TAX DUE .99CR ZNTEREST AND PEN. .00 TOTAL DUE .99CR YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) 38 SOUTH PITT STREET CarliSle, PA 17013 (717) 245-8508 IN RE: ESTATE OF ELEANOR J. NELSON JAN AOAMS ATTORNEY AT LAW · REGISTER OF WILLS OF · CUMBERLAND COUNTY, PENNSYLVANIA · NO. 371 of 2002 WWW.ADAMSI ESQADAMS~A FAX: (7|7) 2 RELEASE I, the undersigned, being a beneficiary of the above-captioned estate, do hereby hereby release, forever discharge, save, hold harmless and indemnify Susan Miller Executrix of the estate, of and from ali actions, suits, payments, accounts, reckonings, claims, and demands, whatsoever for or by reason thereof. IN WITNESS WHEREOF, and intending to be legally bound hereby, the undersigned has caused this instrument to by duly executed, this ~'7'-rp day of ~'~A3 ,2003. WITNESS: Witr{es~ - v Bradley D. Nelson, 43eneficlary 36 SOUTH PITT STREET Carlisle, PA 17013 (717) 245-8508 AOA S ATTORNEY AT LAW WWW.ADAMSLAV eSQAdAMS~AO1 FAX: (717) 24E IN RE: ESTATE OF ELEANOR J. NELSON · REGISTER OF WILLS OF · CUMBERLAND COUNTY, PENNSYLVANIA · NO. 371 of 2002 RELEASE I, the undersigned, being a beneficiary of the above-captioned estate, do hereby hereby release, forever discharge, save, hold harmless and indemnify Susan Miller Executrix of the estate, of and from all actions, sUits, payments, accounts, reckonings, claims, and demands, whatsoever for or by reason thereof. IN WITNESS WHEREOF, and intending to be letg4ally bound hereby, the undersigned has caused this instrument to by duly executed, this ,~ ~/'r t day of .CC ~ ,2003. WITNESS: E ri'~B .'~-~elsonfBeneficiary Name of Decedent: STATUS REPORT UNDER RULE 6.12 Date of Death: j ~5- i t-i - "~,CD~ ! Will No.: OQoOr~ _ ~-~[ Admin. No.' 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 [] 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 ~] 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 [] No r-] Co Date: Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. ./Si~na'h~re Address ~I'elephone No. 17oI_~ Capacity: [-] Personal Representative ~] Counsel for personal representative