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HomeMy WebLinkAbout01-0249Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 1/10/2005 COYNE LISA MARIE 3901 MARKET ST CAMP HILL, PA 17011 RE: Estate of PEALER JOHN D File Number: 2001-00249 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 2/27/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLENDA FARNER STRASBAUGH REGISTER OF WILLS CC: File Personal Representative(s) Judge STATUS REPORT UNDER RULE 6.12 Name of Decedent: JOHND. PEALER Date of Death: February 27, 2001 Will No. 2001-00249 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 X 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: MAY 2005 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 No_ d. Copies of receipts releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Dated: 2....-"'1-0$ c::::t .uSA o arket Street CampHilI,PA 17011-4227 (717) 737-0464 Counsel for Personal Representative C'".) vi Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 1/13/2006 COYNE LISA MARIE 3901 MARKET STREET CAMP HILL, PA 17011-4227 RE: Estate of PEALER JOHN D File Number: 2001-00249 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of wills a Status Report of completed or uncompleted administration. This filing is due by: 2/27/2006 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ,~~~ GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 2/03/2006 YONEKO E PEALER 212 BEAVER DRIVE MECHANICSBURG, PA 17055 RE: Estate of PEALER JOHN D File Number: 2001-00249 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 2/27/2006 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, '~U~4~ GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Counsel Judge ( 1-1-- COYNE & COYNE A PROFESSIONAL CORPORATION ATTORNEYS AT LAW Henry F. Coyne Lisa Marie Coyne 3901 Market Street Camp Hill, Pennsylvania 17011-4227 717-737-0464 Fax: 717-737-5161 March 24. 2006 Register of Wills Cumberland County Courthouse CarlIsle, PA 17013 Re: Estate of John D. Pealer, Deceased Dear Sir/Madam: We represent the Estate of the Late John D. Pealer. Pursuant to Orphans' Court rule No. 6.12 of the Pennsylvania Supreme Court Orphans' Court, enclosed is an original Status Report regarding this Estate. Please docket the original and return a "clocked-in" copy to this office with the enclosed envelope. Thank you for your assistance. If you have any questions, please contact me. Very truly yours, COYNE & COYNE, P.c. L~OynC LMC/amd Enclosure ST A TUS REPORT UNDER RULE 6.12 Name of Decedent: JOHN D. PEALER Date of Death: February 27,2001 Will No. 2001-00249 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion ofthe administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes No X_ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: FEBRUARY 2007 3. Ifthe 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 m mterest? Yes No d. Copies of receipts releases, joinders and approvals of formal or mformal accounts may be filed with the Clerk ofthe Orphans' Court and may be attached to this report. Dated: '3 jut fro / I .~,._.~- LISA M E COYNE, 3~Market Street Camp Hill, P A 17011-4227 (717) 737-0464 Counsel for Personal Representative \, " '\ \ j - _._---~ -~- ---~---_..- -~~----;;.......:. Q) Q) ~ 1: ~ Q)"C ~~ DO ~~ o ~ 3: o Q) ..a I "C -g ~ "~ Q) -0 "C "C ~- ~ S -g ~ i "~ ~ fff ~ -q- "C >- a:, .!a ~ ai ci r< J e ~' c Cl en ci. >< CD 0> S ~ g CD CD B- e. . e ,,"n; 5~CD5E o "en.r::. >- CD ~~~S:5 . <("~ ~"EO~ (")~en~~E "OCD~CDasCD c "~ "0 .r::. .0 Q. asQ)~-CDCD NO"OE-S~ ,...-i 53 ~ s g. 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Estate of PEALER JOHN D Late of HAMPDEN TOWNSHIP ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA Estate No.: 21-01-00249 Date: 3/14/2006 NO.: 21-01-00249 COYNE LISA MARIE 3901 MARKET STREET CAMP HILL PA 17011 4227 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6. 12 , SUPREME COURT ORPHANS I COURT RULE Personal Representative: YONEKO E PEALER Personal Representative Counsel: COYNE LISA MARIE Date of Decedent's Death: 2/27/2001 Date of Delinquency Notice: 2/27/2006 The undersigned, Glenda Farner Strasbaugh, Clerk of Orphans' Court, in accordance with rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor their counsel, have filed with the Register of Wills or Clerk of Orphans' Court, his/her Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule, and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Clerk of Orphans' Court on 1/17/2006 and that the ten (10) day notice to file the status report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or their counsel. cc: File Personal Representative Counsel Gl~r~~ Clerk of Orphans' Court A hearing is scheduled for May 01, 2006 at 11:00 AM in Courtroom No.2. If the Status Report is filed prior to the hearing date, the hearing will automatically be cancelled. Ed~2J~~ I. - __ , J :::. U Estate of PEALER ~)HN D Late of HAMPDEN TOWNSHIP ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA Estate No.: 21-01-00249 Date: 3/14/2006 NO.: 21-01-00249 YONEKO E PEALER 212 BEAVER DRIVE MECHANICSBURG PA 17055 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6. 12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: YONEKO E PEALER Personal Representative Counsel: COYNE LISA MARIE Date of Decedent's Death: 2/27/2001 Date of Delinquency Notice: 2/27/2006 The undersigned, Glenda Farner Strasbaugh, Clerk of Orphans' Court, in accordance with rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor their counsel, have filed with the Register of Wills or Clerk of Orphans' Court, his/her Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule, and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Clerk of Orphans' Court on 1/17/2006 and that the ten (10) day notice to file the status report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or their counsel. cc: File Personal Representative Counsel ~~~ Glenda Farner Strasbaugh Clerk of Orphans' Court A hearing is scheduled for May 01, 2006 Courtroom No.2. If the Status Report is file hearing date, the hearing will automatical Edgar ------------- --- . (J) co /^ '=' 0- a> :1 '-L '..'~ . "'.~)G ""0 a> o@Q~0 --- t.l ~ Cfl ~. ~ crq 0 a> ....... 0 ~ ...... Q -0 ..... ' (j'1 . po. ...c ::;1, ce-.()~~~ ~ 9 ~ ~ ~ y (' i-Q~g.o~ ~ 0 ';P-~()~~ C. -"\ ..-~~~~ '=' -.)(j'1~r;:.;rJJ t.l oo'i::)~~ 3 r-'(j)~~~ ~ ~~ ~ ~ & ~ ~p.()~ 0- o ,..... (fQ -"\ a> ~t:r Cfl ~ g> 0 ~ ~ 0 0- % ~ ""0 ~ + -'> rfl_ ".~ S' () g- o ~ ~ Ui' a ~ . c z ~ ~ <E ~ ~ ""0 o ~ ~ (J) ~ ~ o rn - - ~ - - - - -- -- - ~c--g~ 3~~%- ~ (f):i,. Q z ro~ 9 fP YJ, <? ~~ ~ ro-. o (ft-- "tl 0) 0:. -------------- $ ~';4J ~~ ~ ~ (j ,~ c ~.~ Q)'U1cI- CJ) Jf\~ '0 V' ~ ~ ,~ OJ] ~ 0 0 .~ oN' ~ ~ ~ ~ ~~ ~:8 .:J .g ~ - ~ ~ :g ~ as :0 ~ ~ ~ -5-8 -g ~ ~E Q) Q) ~cn Q) W 'U)- ~:= ci cD o CI> ~ 00. ~-c e :j 1a oeCl>oE o oen.r. >- CI> g.g~.s~ 0 <i: o~ ~ "E '0 gJ M~m~-5E -g o~ -0 ~ 11 8- aJ(j)i-CI>CI> C\ic'UE~~ r=-ia~.sg. B (/)OCl>~"C~ E oc E C ffi- C1>t)aJaJoc ~CI>co(/)e Se:5~:2'; ~:; g.1O~~ EEc~~6 o CI> oc 0 ~ .... o~a..cn<(o . . CI> ~ 'U Q) CJ) CJ) ~ 'U 'U <( Q) 13 ~ ~~ ~>O-l ~H ~~0 .~ p ~ ~il ~ ~~~ ~(() W>U ~H O~Z ~CU~ ~ :=c ZNU Orl~ ;>-IN~ ~ Q) CJ) :0 c as .c ~ Q) ~ ... .E a ~~ ~~ 8~ Q)' ci 1f d d ~ 000 ~ ~ o~ a.; o i u "t: 1 a: O(ij ._ Q)~~~ ~is'U (I) !E o~ ~ 02 i i ~ c=oa:- ~{] 0 0 M in IS) o r- rl rn ~ o ~ ~ If; ~ N o .b en II) N ~ ...D cO f'- .:r LrJ M ...D .:r '5. "CD o Q) a: c 5 Q) a: o ti (I) E o C ru C] C] C] CJ ru cO M LrJ CJ C] f'- "'-T o o C\I ~ as :J .c .~ Lf .8 E r" ~.ga; z~(4') ~ ~ E o c: .... ~ e. ~ en a.. ~ REV . 1500 EX + {6..o0} w .... ~~(/) Oo::~ W"-O :xOO 00::-' ,,-Ill "- c( THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 3901 Market Street Camp Hill, PA 17011-4227 (1 ) 17,000.00 (2) None ",,~~,~'_.. q -e.~ (3) None I 0:> (4) None -0 (5) None :.;r - (6) ., None -.,-'-, ~ c,.) (7) None (8) 17,000.00 (9) 12,685.56 (10) 5,951.35 '. II! f / ....,.../<", Fe >< RE~~h:' <! 6 INHERITANCE TAX TU RESIDENT DECEDE OFF1Ci":',L USE C\iL V ~ 0249 NUMBER 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) z .045 (16) 0 16.Amount of Line 14 taxable at lineal rate x ;:: c( .... ::> (17) "- 17.Amount of Line 14 taxable at sibling rate x .12 ::;; 0 0 >< 18. Amount of Line 14 taxable at collateral rate ~ x .15 (18) 19. Tax Due (19) 18,636.91 11. Total Deductions (total Lines 9 & 10) (11 ) insolvent 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to lax has not heen (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Copyright 2000 form software only The Lackner Group. Inc. Form REV-1500 EX (Rev. 6-00) DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) COMMONWEALTH OF PENNSYLVAN1A DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 2001 YEAR S CIAL SECURITY NUMBER .... z w o w o w o : DECEDENT'S NAME (LAST. FIRST, AND MIDQLE INITIAL) PEALER, JOHN D. i 02/27/2001 01/10/1919 :(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) PEALER, YONEKO E. ~ 1. Original Return I 0 4. Limited Estate '~ o o 2. Supplemental Return o o o 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a living Trust (Atlach copy of Trust) 10. Spousal Poverty Credit (date of death between 1 - - '-1- 5 6. Decedent Died Testate (Attach copy of Will) 9. Litigation Proceeds Received .... z w o z o "- AME I Lisa Marie Coyne FIRM NAME (If applicable) i Coyne & Coyne, P.C. ~ELEPHONE NUMBER 717/737-0464 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) z o ;:: :5 ::> .... a: c( o W 0:: 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ,... ~ r- Decedent's Complete Address: STREET ADDRESS 212 Beaver Drive CITY Mechanicsburg I STATE PA I ZIP 170. j&-2)0 / Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) Total Credits (A + B + C) (2) 0.00 3. InteresVPenalty if applicable D. Interest E. Penalty B. Enter the total of Line 5 + 5A. This is theBALAfIICE DUE. (3) 0.00 (4) (5) 0.00 (5A) (5B) 0.00 TotallnteresVPenalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. 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 theTAX DUE. A. Enter the interest on the tax due. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;............................................................................. D 1:81 b. retain the right to designate who shall use the property transferred or its income;................................ D 1:81 c. retain a reversionary interest; or............................................................................................................ D 1:81 d. receive the promise for life of either payments, benefits or care?........................................................... D 1:81 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?................................................................................................................ D 1:81 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... D 1:81 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?......................................................................,........................................ D 1:81 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 retum, inciuding accompanying schedules and statements. and to the best of my knowledge and belief, it is true, correct and complete. Declaration preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Yoneko E. Pelaer DATE C) C-t, .'2 5- :-0-25'"0/ ,2,," 6- DATE SIGNATURE OF PERS SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE Lisa Marie Coyne ADDRESS DATE 3901 Market Street Camp Hill, PA 17011-4227 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)]. The statutedoes 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 P.S. 99116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116 ,~(72 P.S. 99116 (a) (1)]. '-~tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116 (a) (1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. *' SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT m_____~_____..~__ _________l~_____ ____ _~___ _________~_______ ESTATE 6F---------------~~---u-- - -----------lFiLE NUIVIBER-- ------------ PEALER, JOHN D. I 21 _ 2001 _ 0249 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be excnanged between a willing buyer and a willing seller, neither being compelled to buy or SEllI, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH . ------.-- --'" ~_._---_.._..- 17,000.00 . ------ -------._---, -...~~---- .---.-----...---. --------~~------. -- 1//4 Interest in Residual Lots of Oyster Mill Road, Enola, Cumberland County, P A (See Attached Settlement Sheet) ------.---------.-- "- ----.-,._---- '..------...--------...---- ---... ....---- TOTAL (Also enter on Line 1, Recapitulation) 17,000.00 -- A. B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1DFHA 2.DFmHA 3. DCONv. UNINS 4.DVA 5 DCONV INS 6. FILE NUMBER: 17. l.OAN NUMBER SETTLEMENT STATEMENT WINTERMYER 8. MORTGAGE INS CASE NUMBER: C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the setth~ment agent are shown. Items marked '1POC)" were paid outside the closing; they are shown here for informational purposes and f.lfe not included in the totals. 1.0 3/96 (WII\TERMYER.PFDlWINTERMYER/5) D. NAME AND ADDRESS OF BUYER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: LEON E. WINTERMYER WAYNE M. PEALER OYSTER MILL ROAD YONEKO PEALER. EXECUTRIX CAMP HILL, PA 17011 ESTATE OF J. DAVID PEALER BARBARA PARKINSON, EXECUTRIX ESTATE OF LEROY A. PEALER G. PROPERTY l.CCP,~ION: H. SETTLEMENT AGENT: 23-2114426 l. SETTLEMENT DATE: OYSTER MILL ROAD Midstate Abstract Company CAMP HILl., PA 17J11 March 14, 2001 CUMBERLAND County, Pennsylvania Pl.ACE OF SETTLEMENT 2331 Market Street Camp Hill, PA 17011 J SUMMARY OF BUYER'S TRANSACTION K SUMMARY OF SELl.ER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BUYER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contract Sales Price 68,000.00 401. Contract Sales Price r~ 102. Personal ProDerty 402. Personal Property 103 Settlement Charqes to Buyer (Line 1400) 1,498.75 403. 104. 404. 105 405 Ad"ustments For Items Paid Bv Seller in advance Ad'ustments For Items Paid By Seller in advance 106 CityfTown Taxes to 406. CityfTown Taxes to 107. County Taxes 03/14/01 to 01/01/02 139.48 407. County Taxes 03/14/01 to 01/01102 139.4: 108. School Taxes 03/14/01 to 07/01/01 117.21 408. School Taxes 03/14/01 to 07/01/01 1172 109. 409. 110 410. 111. 411. 112. 412 120. GROSS AMOUNT DUE FROM BUYER 69,755.44 420 GROSS AMOUNT DUE TO SELLER ~2.566 200. AMOUNTS PAID BY OR tN BEHALF OF BUYER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposit or earqest money 5,000.00 501. Excess DeDosit (See Instructions) ,- 202 Principal Amo~~.nt of New Loan(s) 502 Settlement Charges to Seller (Line 1400 5,915.2' 203 Existino 10an(;;)laken subiect to 503. ExislinQ loan s taken subject to 204 504. Payoff of first Mort9age 205. 505. Payoff of second Mortgage 206. 506. - 207. 507. (Deposit disb. as proceeds 208. 508. 209. 509. Adjustments For lIems UnDaid Bv Seller Adjustments For lIems UrlDaid Bv Seller 210. CityfTown Taxes to 510. CitvfTown Taxes to 211. County Taxes to 511. County Taxes to 212. School Taxes to 512. School Taxes to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218 518. -.-- 219 519. 220 TOTAL PAID BY/FOR BUYER 5,000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER I 5,9152 300. CASH AT SETTLEMENT FROM/TO BUYER: 600, CASH AT SETTLEMENT TO/mOM SELLER: 301. Gross Amount Due From Buver (Line 120) 69,755.44 601. Gross Amount Due To Seller (Line 420) H~6' 302. Less Amount Paid By/For Buyer (Line 220) I( 5,000.00) 602. l.ess Reductions Due Seller (Line 520) ( 5,915.2' 303. CASH ( X FROM) ( TO) BUYER 64,755.44 603. CASH ( X TO) ( FROM) SELLER I 62,341.4 OMS NO, 2502-0265 ~ p, L. SETTLEMENT CHARGES 700. TOTAL COMMISSION Based on Price $ 68,00000 @ 6.0000 % 4,080.00 PAID FROM PA\D FROM Division of Commission (line 700) as Follows: BUYER'S SELLER'S 701. $ 4,08000 to THE HOMESTEAD GROUP, INC. FUNDS AT FUNDS AT 702. $ to SETTLEMENT SETTLEMENT 703, Commission Paid at Settlement 4,080 704 to 800, ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Oriqination f7ee % to 802. Loan Discount % 10 803. Appraisal Fee to 804. Credil Report 10 805. Lender's Inspection Fee to 806. Mortoaae Ins. ADQ Fee to 807. Assumption Fee to 808. 809. 810 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901 Interest From to @ $ !day ( days %) ~ 1___ 902. MIP Totlns. for LifeOfLoan for months to 903. Hazard lnsural!ce Premium for 1.0 years to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance months @ $ per month 1002. Mortgage Insurance monlhs @ $ per month 1003. CitylTown Taxes months @ $ per month 1004. Countv Taxes months @ $ per month - 1005. School Taxes months @ $ per month 1006. months @ $ per month 1007. months @ $ per month 1008. months @ $ per month 1100, TITLE CHARGES 1101. Settlement or Closing Fee 10 1102. Abstract or Tille Search to 1103. Title Examina!ior. to 1104 Title Insurance Bjnder to 1105. Document Preparation to 1106. Closing Service Letter to 1107. Attorney's Fe€:s 10 REAGER & ADLER, PC 950.0C includes ~bo:;e item numbers. 1108 Title Jnsuranc{~ to MIDSTATE ABSTRACT 636.75 includes above item numbers.1102, 1103 & 1104 ) 1109 Lender's Cove:age $ 1110. Owner's Coverag~ $ 68,000.00 636.75 1111. Endorsement, 1eO, 300, 8.1 1112. Notary Fee to Cash 5.00 1113 Notary Fee 10 Cash 5.~0'c 1114. TRANSACTION "EE to THE HOMESTEAD GROUP, INC. 100.00 1115. CITY/COUNTY TAX/STAMPS to RECORDER OF DEEDS 60.00 1116. STATE TAX/STAMPS to RECORDER OF DEEDS 60.0C 1117. OVERNIGHT MAIL to Midstate Abstract Company 30.0C 1118 1200. GOVERNMEN.T RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 37.50; Mortgage $ Releases $ 37.50 1202. Citv/Cauntv TaXi~tamDs: Deed 620.00' Martoage - 620.00 1203. State TaxlStamps Revenue Slamps 62000; Mortoage 620.0C 1204. DEED 10 RECORDER OF DEEDS 39.50 1205 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survev . to 1302 Pesllnsaeclian to 1303 2001 COUNTYIfNP TAXES to JANE E. BIDDLE, TAX COLLECTOR 09-18-1308.024 170.2S 1304. 1305. 1400. TOTAL SETTLEMENT CHARGES (Enter an Lines 103, Section J and 502, Section K) 1,498.75 5,915.2~ B'j signing page "\ of this statement. the signatories acknowledge receipt of a compleled copy of page 2 of this two page statement Midstale Abstract Company Settlement Agent Certified to be a true copy. ( WINTERMYER I WJNTERMyER 16 ) I ACKNOWLEDGMENT OF RECEIPT OF SETTLEMENT STATEMENT I Buyer: LEON E. WINTERMYER Seller: WAYNE M. PEALER YONEKO PEALER, EXECUTRIX ESTATE OF J. DAVID PEALER BARBARA PARKINSON, EXECUTRIX ESTATE OF LEROY A PEALER DONALD W. HOFFMAN, EXECUTOR ESTATE OF HELEN PEALER HOFFMAN Settlement Agent: Midstate Abstract Company (717)763-1383 Place of Settlement: 2331 Market Street Camp Hill, PA 17011 Settlement Date: March 14,2001 Property Location: OYSTER MILL ROAD CAMP HILL, PA 17011 CUMBERLAND County, Pennsylvania I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement. WAYNE M. PEALER LEON E. WiNTERMYER YONEKO PEALER, EXECUTRIX BARBARA PARKINSON, EXECUTRIX DONALD W. HOFFMAN, EXECUTOR . SCHEDULE H FUNERAL EXPENSES & ADlVUNISTRATlVE COSTS 1_ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT , -------_._"'-----'---~----,._----'--~_._- .-..--- -- ~._._---_..._-----,.._------ -..._----.. ~--~------...-_.- ---- FILE NUMBER 21 - 2001 - 0249 ESTATE OF PEALER, JOHN D. Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION l AMOUNT -----~-_.~_.~---_._.- -- FUNERAL EXPENSES: Reception 1. 2. Honorarium B. ADMINISTRATIVE COSTS: 1. I Personal Representative's Commissions Y oneko E. Pelaer Social Security Number(s) I EIN Number of Personal Representative(s): Street Address 212 Beaver Drive City Year(s) Commission paid State Zip 2006 2. Attorney's Fees COYNE & COYNE, P.C. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant YONEKO E. PEALER Street Address 212 Beaver Drive Ci~ 11echanicsburg State P A Spouse 17055 Zip Relationship of Claimant to Decedent 4. Probate Fees Cumberland County Register of Wills 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs Cumberland County Law Journa1-- Legal Advertisement 2 Postage Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 500.00 100.00 2,000.00 3,500.00 3,500.00 145.00 75.00 34.00 2,831.56 12,685.56 *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Schedule H Funeral Expenses & Mninistrative Cas1s~~_~ ESTATE OF PEALER, JOHN D. 3 Patriot News-- Legal Advertisment 4 1/4 Closing Costs-- Oyster Mill Lots 5 Reserves 6 Filing Fee-- Inheritance Tax Return 7 Duty's Lock & Key 8 McKonly & Asbury, CPAs I FILE NUMBER------ _.~-_200~- 0249____ 110.00 Page 2 of Schedule H 1,478.82 500.00 15.00 157.74 570.00 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE __c_~__~IA~_I~ITIES'n_& L1EN~__~u_____ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT OECEDENT ESTATE OF PEALER, JOHN D. ---.-..---------- ------- --- ._-----~..~-- -----...,-----_.-------- . -~-T FIU~ NUMBER------- 21 - 2001 - 0249 ---------_._----------,------_.~_.._---------~._--- _._.._---~_.- Include unreimbursed medical expenses. ITEM NUMBER 1 DESCRIPTION .-------------.. -~---_._-----------._'--_._------- AMOUNT 2,739.85 820.00 2,368.00 23.50 5,951.35 Holy Spirit Hospital 2 McKonly & Asbury, CPAs 3 Pac Dept. of Revenue-- 2000 State Taxes 4 Boscov's TOTAL (Also enter on Line 10, Recapitulation) REV-1513 EX+ (9-00) *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ~ ~_______ _____L-__ ~__~__~____________ ---------- !FILENUMBER-------- i 21 - 2001 - 0249 NA~E AND~DDRE~~ OF P~RSON(S) RE~EIVIN:PR;~:RTY ----1 R:o~~~~~Et~~-T--~~og~I~:~~~~RE~ TAXABLE DISTRIBUTIONS (include outright spousal distributions) ! Y oneko Pealer ESTATE OF PEALER, JOHN D. NUMBER I. Wife 100% of Estate I Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate. on Rev 1500 cover she t II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS , TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE~ 1 WHEREAS, on the 7th dated May 25th 1999 was admitted to probate as the last will of PEALER JOHN D (LA~T, YIH~T, MIUUL~) late of HAMPDEN TOWNSHIP Register of Wills of CUMBERLAND County, Penns Certificate of Grant of Letters No. 2001-00249 PA No. 21-01-0249 ESTATE OF PEALER JOHN D (LA~T, tlH~T, MIUUL~) Late of HAMPDEN TOWNSHIP CUMH~HLANU CUUNTY, Deceased Social Security No. 180-26-6905 day of March 2001 an ins. , CUMBERLAND County, who died on th2 27th day of February 2001 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS , Register of Wills in and fa the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to YONEKO E PEALER who has duly qualified as Executor(rix) and has agreed to administer the estate according to law, all of which fulll' appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, of my Office the 7th day I have hereunto set my hand and affixed the, seal of March 2001. [7~//1 cZ~~;ti~~m~~j f'/1?A7//~Y , eg l ...er 0 ~ s **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) ~ ~ ~ ~ ~ LAST WILL AND TESTAMENT OF JOHN D. PEALER I, JOHN D. PEALER, of the TO\V11ship of Hampden, Cumberland County, Pennsylvania, declare this to be my Last Will and revoke any Will previously made by me. ITEM 1: I direct that upon my death no funeral or memorial services be conducted. I further direct that my remains be cremated and that the services in that regard be arranged through the Myers Funeral Home of Mechanics burg, Cumberland County, Pennsylvania. ITEM 2: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my Estate. ITEM 3: For aU purposes of distribution under this Will, my natural son, DONALD D. PEALER, and my adopted son, CRAIG LEE PEALER, shall be treated as though each were children of the marriage of my beloved wife, YONEKO E. PEALER, and me, and their issue shall be treated as though they were issue of the marriage of my wife and me; and, as used herein, the term "my sons" shall include both children, as though they were siblings born of our marriage, and the term "my issue" shall include both sons and their issue, as though all such issue were issue of the marriage of my wife and me. 1 cPr1 .~ .~ ~ ~ ITEM 4: I give and bequeath all of my household furniture and furnishings, motor vehicles, books, pictures, jewelry, china, crystal, appliances, silverware, wearing apparel, recreational equipment, articles of household or personal use or adornment, together with all policies of insurance thereon, to My Spouse, if My Spouse survives me. If My Spouse does not survive me, I give such articles to my children living at my death, in as nearly equal shares as they shall select under the supervision of my Executor, it being my desire that my children be guided by any memorandum which I may leave with my Will. Any cost of packing and shipping said personalty to the beneficiaries, including insurance, shall be paid by my Executor as a general administration cost. If any such articles cannot be fairly divided or distributed in kind in the opinion of my Executor, such articles shall be sold and the proceeds thereof shall pass as a part of my residuary estate. ITEM 5: If My Spouse survives me, I give, devise and bequeath to my Trustee hereinafter named, IN TRUST NEVERTHELESS, to be held, administered and disposed of in accordance with this ITEM for the benefit of My Spouse and my issue (herein referred to as the "Unified Credit Trust") an amount equal to the sum of the balance of the dollar amount not taxed in my estate due to the application to my estate of (i) the applicable credit amount against federal estate tax under Section 2010 of the Internal Revenue Code of 1986, as amended, or any subsequent successor or parallel provision thereto (the "Applicable Credit"), after deducting therefrom the value, for federal estate tax purposes, of (A) assets included in my federal gross estate which pass or have passed other than under the terms of this \Vill and which \vill utilize a portion of the Applicable Credit, (B) any bequests under 2 ~ -l: X this \Vill and which will utilize a portion of the Applicable Credit, (B) any bequests under the preceding ITEM of this Will which will utilize a portion of the Applicable Credit and (C) adjusted taxable gifts not included in my federal gross estate but included in the computation of the tentative federal estate tax in my estate; and (ii) the state death tax credit allowed for federal estate tax purposes (but only to the extent its use will not increase any Death Taxes, other than Pennsylvania Inheritance Tax or Pennsylvania Estate Tax, owing by my estate). My Trustee shall have, hold, manage, invest and reinvest the assets of the Unified Credit Trust, collect the income and in addition, my Trustee shall pay to My Spouse such amounts of the principal of such trust as, in the sole discretion of my Trustee, shall be necessary for the maintenance, support and medical and nursing care of My Spouse, taking into consideration any other source of income for My Spouse. (a) Beginning at my death, my Trustee shall pay over the net income of the Unified Credit Trust to My Spouse during My Spouse's lifetime, in installments not less frequently than quarterly. In addition, my Trustee shall pay to My Spouse such amounts of the principal of such trust as, in the sole discretion of my Trustee, shall be necessary for the: maintenance, support and medical and nursing care of My Spouse, taking into consideration any other means readily available for such purposes. My Spouse shall have the exclusive and unrestricted right during My Spouse's lifetime to occupy or otherwise use any residence held wholly or partially in this Trust and the Trustee shall, at the request of My Spouse, sell any interest in any residence held in this Trust and may use the proceeds for the purchase of 3 (b) Upon the death of My Spouse, my Trustee shall distribute the principal and any undistributed income of the Unified Credit Trust to my issue then living, per stirpes; provided,. however, that should any such issue be the issue of a deceased child of mine and shall not then have attained the age of thirty years, each such issue's share shall be retained by my Trustee, IN TRUST NEVERTIffiLESS, each to be held, administered and disposed of as a separate trust estate in accordance with ITEM 7 for the benefit of each such issue (the "Grandchild's Trust"). ITEM 6: If my Spouse survives me~ I give, devise and bequeath all of the rest, residue and remainder of my property, real, personal and mixed, not disposed of in the preceding portions of this Will, to My Spouse. If My Spouse does not survive me, I give and bequeath said residue to my issue living at my death, per stirpes; provided, however, that ~ ~ ~ ;:::,)ID accordance with ITEM 7 for the benefit of each such issue (the "Gr.mdchild's ~ ITEM 7: My Trustee shall have, hold, manage, invest and reinvest the assets of ~ each Grandchild's Trust, collectthe income and ., , . (a) Untll the beneficlary of the GrandchIld s Trust (the 'Grandchild') shall have should any such issue be the issue of a deceased child of mine and shall not then have attained the age of thirty years, each such issue's share shall be distributed to my Trustee, IN TRUST NEVERTIffiLESS, each to be held, administered and disposed of as a separate trust attained the age of thirty (30) years, my Trustee shall from time to time pay to or for the benefit of the Grandchild such amounts of the net income and principal of the Grandchild's 4 (a) Until the beneficiary of the Grandchild's Trust (the "Grandchild") shall have attained the age of thirty (30) years, my Trustee shall from time to time pay to or for the benefit of the Grandchild such amounts of the net income and principal of the Grandchild's Trust as, in the sole discretion of my Trustee, shall be necessary for the Grandchild's maintenance, support, medical and nursing care and education, including college and graduate education, taking into consideration any other means readily available for such purposes. At the end of each year any unexpended income shall be added to the principal of the Grandchild's Trust. (b) After the Grandchild shall have attained the age of thirty years, my Trustee shall thereafter pay to the Grandchild the net income derived from the Grandchild's Trust in installments not less frequently than quarterly and such amounts of the principal as, in the ~ EL ~ have then attained the age of thirty years or if the Grandchild shall thereafter attain that age, ~ my Trustee shall distribute outright to the Grandchild the then remaining principal of the ~ ~ Grandchild's Trust. (d) If a Grandchild shall die before final distribution of the assets of the sole discretion of my Trustee, shall be necessary for the Grandchild's maintenance, support, medical and nursing care and education, including college and graduate education, taking into consideration any other means readily available for such purposes. (c) If at the time of the creation of the Grandchild's Trust the Grandchild shall Grandchild's Trust is made, the then remaining principal and any undistributed income of the Grandchild's Trust shall be distributed to the Grandchild's issue then living, per stirpes; 5 ~ ~ ~ ~ or if the Grandchild shall have no issue then living, to the issue then living of u1e parent of the Grandchild who was a child of mine, per stirpes, or, if such parent shall have no issue then living, to my issue then living, per stirpes; provided, however, in any event, if any such beneficiary is then a beneficiary of a Grandchild's Trust hereunder, the share of such beneficiary shall be added to the principal of such Grandchild's Trust, as if an integral part thereof, to be held, administered and disposed of in accordance with the terms thereof. ITEM 8: Nothing herein is intended to, nor shall it be construed to, postpone the vesting of any part of the assets of any separate trust estate hereunder for more:hatl twenty- one years after the death of the survivor of me, My Spouse and my issue living ?ot the time of my death. At the expiration of such period the assets of all the separate :rust estates hereunder shall immediately vest in fee simple absolute in and be distributed o'"tright to the person or persons then entitled to receive the income therefrom, whether in my Trustee's discretion or otherwise. ITEM 9: No interest in mcome or principal of my estate or any trust created hereunder shall be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary of my estate or of any trust created hereunder prior to the beneficiary's actual receipt thereof. My Executor or Trustee shall pay over the net income and the principal to the beneficiaries herein designated, as their interests may appear, without regard to any attempted anticipation (except as may be specifically provided herein),pledging or assignment by any beneficiary of my estate or of any trust 6 ~ ~~ created hereunder and without regard to any claim thereto or attempted levy, att..achment, seizure or other process against said beneficiary. ITEM 10: Any person who shall have died at the same time as I or under such circumstances that it is difficult or impossible to determine who shall have died first, shall be deemed to have predeceased me. Any person other than me who shall have died at the same time as any then beneficiary of income of my estate or a trust created hereunder or under such circumstances that it is difficult or impossible to determine who shall have died first, shall be deemed to have predecease~d such berieticiari ITEM 11: In the settlement of my estate and during the continuance of any trust created hereunder, my Executor and my Trustee shall possess, among others, the following powers, exercisable ",ithout prior court approval, but in all cases to be exercised for the best interests of the beneficiaries: (a) To retain any investments I may have at my death so long as my E""\ecutor or Trustee may deem it advisable to my estate or trust so to do, including securities owned, issued or underwritten by any corporate Executor or Trustee or any of their affiliates. (b) To vary investments, when deemed desirable by my Executor or Trustee, and to invest in such bonds, stocks, notes, real estate mortgages or other securities or in such other real or personal property, including securities owned, issued or underwritten by any corporate Executor or Trustee or any of their affiliates, or as to which my corporate Executor or Trustee or any of their affiliates are investment advisors, as my Executor or Trustee shall deem wise, without being restricted to so called "legal investments". 7 ( ~ (c) In order to effect a division of the principal of my estate or trust or for any other purpose, including any fmal distribution of my estate or trust, my Executor or Trustee is authorized to make said divisions or distributions of the personalty and realty partly or wholly in kind. If such division or distribution is made in kind, said assets shall be divided or distributed at their respective values on the date or dates of their division or distribution. In making any division or distribution in kind, my Executor or Trustee shall divide or distribute said assets in a manner which will fairly allocate any unrealized :qpreciation among the beneficiaries. (d) To sell either at public or private sale and upon such terms and conditions as my Executor or Trustee may deem advantageous to my estate or trust, any or all real or personal estate or interest therein owned by my estate or trust severally or in conjunction with other persons or acquired after my death by my Executor or TIUS7ee, and to consummate said sale or sales by sufficient deeds or other instruments to the purchaser or purchasers, conveying a fee simple title, free and clear of all trust and without ooligation or liability or the purchaser or purchasers to see to the application of the purchase money or to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge and delivery any and all deeds, assignments, options or other writings which may be necessary or desirable in carrying out any of the powers conferred upon my Executor or TrLlStee in this paragraph or elsewhere in this Will. (e) To mortgage real estate and to make leases of real estate for any term. 8 ~ (f) To borrow money from any party, including my Executor or Trustee, to pay indebtedness of mine or of my estate or trust, expenses of administration, Death Taxes or other taxes. (g) To pay all costs, expenses, legally enforceable debts, funeral expenses and charges in connection with the administration of my estate or trust. (h) To vote any shares of stock which form a part of my estate or trust and to otherwise exercise all the powers incident to the ownership of such stock and to actively manage and operate any incorporated or unincorporated business, including any joint ventures and partnerships, and to incorporate any such unincorporated business, ",ith all the rights and powers of any owner thereof. (i) To hold investments in the name of a nominee. (j) To compromise controversies. (k) To disclaim, in whole or in part, any and all interests in property owned by me at the time of my death, including those passing tome by Will, intestacy, contract, joint ownership, operation oflaw or otherwise. (1) To employ and compensate from income or principal, inthe discretion of my Executor or Trustee, investment and legal counsel, accountants, brokers and other specialists, and, whenever there shall be no corporate Executor or Trustee in office, a corporate custodian, and to delegate to investment counsel discretion with respect to the investment and reinvestment of any or all of the assets held hereunder. 9 ~ ~ (m) To divide any trust hereunder into two or more separate, but identical, trusts. To divide any trust hereunder which would have a generation skipping transfer ta.."< inclusion ratio other than one (1) or zero (0), into two (2) separate trusts which are fractional shares, known as the "exempt trust" and the "nonexempt trust". The exempt trust is that fractional share of the total trust fund that has a generation skipping transfer tax inclusion ratio of zero (0), and the nonexempt trust is the remaining fractional share of the trust, with a generation skipping transfer tax inclusion ratio of one (1). The terms and conditions oftl:e nonexempt trust and the exempt trust will be identical. Any reference to a trust created ur:der this Will, without a further specification or limitation, shall be nonexempt trust, in ?roportionate amounts, where relevant. The assets of each separate exempt and nonexempT :rust shall be held, administered and invested as separate trusts, and my Trustee shall mair.'2i.n adequate accounting and records for both such trusts. My Executor shall indicate on the federal estate tax return filed for my estate that separate trusts will be created (or funded) and clearly set forth the manner in which the trust is to be severed and the separate trusts funded.. (n) To designate one or more persons or a corporation to act as ancillary fiduciary in any jurisdiction in which ancillary administration may be necessary, such ancillary fiduciary to serve without bond or security and to have all powers, authorities and discretion conferred hereunder. 10 ~ ~ ITEM 12: In the settlement of my estate: (a) My Executor shall not be personally liable for any loss to my estate or to any beneficiary of my estate resulting from an election made in good faith to claim a deduction as an income tax deduction or as an estate tax deduction. (b) In valuing property in my gross estate for the purposes of any Death Tax, my Executor shall not be personally liable for any loss to my estate or to any beneficiary of my estate resulting from my Executor's decision made in good faith to use a particular valuation date. ITEM 13: All inheritance, estate and similar taxes becoming due by reason of my death, except any taxes relating to generation skipping transfers imposed under Chapter 13 of Subtitle B of the Internal Revenue Code, as amended ("Death Taxes"), whether such Death Taxes shall be payable by my estate or by any recipient of any property, shall be paid by my Executor out of the property passing under ITEM 5 of this Will or if such assets passing under ITEM 5 are not sufficient, then out of the property passing under ITEM 6, as an expense and cost of administration of my estate; provided, however, that if any property held in any testamentary or inter vivos trust created by My Spouse is includable in my estate for purposes of any Death Tax, then any Death Tax attributable to their inclusion of any such property in my estate for the purposes of that Death Tax shall be paid out of such property or by the recipients of such property; and, if such Death Taxes are nevertheless paid by my Executor, I direct my Executor to obtain reimbursement or contribution for any such taxes paid by my Executor. Except to the extent above provided, my Executor shall have no duty 11 ~ --0 ~ ~ or obligation to obtain reimbursement for any Death Taxes paid by my Executor, even though paid with respect to proceeds of insurance or other property not passing under this Will. ITEM 14: No prov1slOn m this Will IS intended to exerCIse any power of appointment which I may possess. ITEM 15: If at any tin1e any individual under the age of thirty (30) years shall be entitled to receive any assets free of trust by reason of my death, whether payable hereunder, by operation of law, contract or otherwise, I appoint my Trustee hereinafter named as Custodian for such indiyidual under the Pennsylvania Uniform Transfers to Minors Act. ITEM 16: If there should be established by My Spouse, either by Last Will and Testament or by inter vivos Deed or Agreement, trusts similar to the trusts herein established for the benefit of my issue, my Trustee herein shall have the right and power to merge trusts herein established with similar trusts for the same beneficiaries established by My Spouse and to operate each of the merged trusts as a single trust. If, in the sole discretion of my Trustee, at any time any trust hereunder is or becomes too small to justify its maintenance as a separate trust, my Trustee, without any liability to any person or remainderman whose interest may be affected thereby and without the necessity of court approval, shall terminate such trust by distributing all the income and principal of the trust to the then income beneficiary or beneficiaries of said trust. If any additions to any such trust are received after its termination under this ITEM, such trust shall be revived and this provision shall continue to apply to it. The Trustee discretion herein granted shall in no event be construed as giving 12 ~ iD ~ .~ any potential distributee of a trust the right to compel a termination in whole or in part of such trust. ITEM 17: I appoint my wife, YONEKO E. PEALER of the To""nship of Hampden, Cumberland County, Pennsylvania, Executrix of this my Last WilL Should my wife, YONEKO E. PEALER fail to qualify or cease to act as my Executrix, I appoint DONALD D. PEALER Executor of this my Last Wil1. ITEM 18: I hereby appoint My Spouse, YONEKO E. PEALER and CL\RENCE E. ASBURY as Co-Trustees of any trust created hereunder. If for any reason there is ever only one Trustee, such Trustee shall designate a person or bank to serve as Co-Trustee with him or her, such designation to be in writing and effective without court approval. So long as a Trustee or the issue of such Trustee is a beneficiary of any trust hereunder, such Trustee shall not (i) participate in any discretionary determination of the Trustee to distribute principal or income of such trust to or for the benefit of such beneficiary or to his or her issue; or (ii) participate in any discretionary determination of the Trustee to terminate said trust under the ITEM 16. An individual Trustee shall be deemed to have failed to serve as . - Trustee hereunder if, among other reasons, the treating physician of said individual Trustel~ shall certify in writing that such Trustee possesses permanent mental or physical incapacity which preclude such Trustee from discharging his or her duties as Trustee hereunder. Any Trustee serving herellllder shall have the right to resign from such office at any time, with or without cause and without Court approval. No successor Trustee shall be liable for the actions of a resigning or removed Trustee occurring prior to such successor Trustee taking 13 office. All references in this Will to my "Trustee" shall refer to my originally named Co- Trustees or to my successor Trustee(s), as the case may be. ITEM 19: My Custodian, Executor and Trustee shaH qualify and serve without the duty or obligation of filing any bond or other security. Any corporate fiduciary shall be entitled to compensation in accordance with its standard schedule of fees in effect from time to time. IN WITNESS W1IEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding pages, this tL day of 1999. }r1 A 'V} '/ We, the undersigned, hereby certify th the foregoing Will was signed, sealed, published and declared by the above-named Testator as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence and in the presence of each other, have hereunto set our hands and seals the day and year above written, and we certify that at the time of the execution thereof, the said Testator was of sound and disposing mind and memory. r~ 'Yl q _ residing at ~, Yf full",~reSidingat f,b I 'g> OJ. L I s1v~... /2J.. ~ic.S~. IJ;1-170!.>-S- fr.. 5~ r<-?t"J {;-anI e.rt b Irv0 Xf/5/e /A- /70/3 I 14 CONfMONWEALTH OF PENNSYLVANIA ) ) ss: COUNTY OF CUMBERLA1'ill ) We, JOHN D. PEALER, Li 5/1 /?1 A--1'C I E CC;yN C, and ~ f. !i!uJ1J~ . the Testator 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 Testator signed and executed the instrument as his Last Will and that he h~d signed willingly, and that he executed it as his free and voluntary act for the purpose therein expressed, and that each of the \\itnesses, in the presence and hearing of the Testator, signed the will as witness and that to the best of his or her lmowledge, the Testator was at the time eighteen (18) years of older, of sound mind and under no constraint or undue influence. Subscribed, sworn and acknowledged before me ~ '("1 F- JO:HN" D. PEALER, the Testator, and sub~ribed and swo to L t <; It /y/A-7'ZU? &yA/C and C, L ~. dt. witnesses, this Z- ~!2: dayafm / 9. by by the: NOTAAlAl Sa!. ?1€NRY F. COYNE. I'lotcry ~~r!: r Hompd.,~ i~~.. <:,u/n.b&rlc;'\d C:~~/;', "AI' M,: ~~t:.s.lon ~pK'"JL':-::..t ~71 Z~J .....,..,.---~ -' 15 .,". IJZ '.JkI"'.,:, \, it. ~ ~.;" '; I';!j 1J1". , .-"""~ 'r"" ",,' ".', ~'i, ' , a 8' , ~ , -~ " ;!'" ',,r , . ,'j } .-." Ii , , " .,' /; , 'A" /.'"j " . . I1h tJ'" ~ i . .' '\". ~,>,")I ... -,' ,'" "',"';'h!/ ,'\\?~- ,,>, .. · d", ',e" :->,'::-\, , '", J} . ,"\1 r..:.., " ("') .:::r ... "':_i~. C- g;) C; u-Q,'~', o c.., ~_ ~ ~n.. ~\/;'" ~.;..._, .. ....:cL '-' 0.., .. ~~ o - -:.C 0- cP \ ~ ;;t:. ,J::J 'is ,~ \ L -'fW\r, t' , . 4-'~O r r,,::,:: ~, r- . C'J q W~ ~~uJ;" UJ...JO:C; Z I-: ti r- ~ <{ ..- o (/)w'CE o >-uJ':L. - O:...J _>tZ<{...J ~ 0: - UJ 0 ~::r: Z \=; ..- ll- ~ <{~~ o 0 o <1) <fJ ;:l o ;::. ~ ;:l <1) 8~ >--- 6- r'l ~(j)'O <fJ ;:l <1) r- ,-. 0 <fJ,....... -U;:l .... 0 -< ~-g'Bp.. <0 ro ;:l oS ~O_ ~<1)U<fJ ......P ...... <fJd<1)~ .t:h ~ ~ ro V"';:loU ~U ~ " r Decedent's Complete Address: STREET ADDRESS 212 Beaver Drive CITY Mechanicsburg I STATE PA I ZIP 170. ';-&-2)0/ Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) Total Credits (A + B + C) (2) 0.00 3. InteresVPenalty if applicable D. Interest E. Penalty TotallnteresVPenalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. 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 theTAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is theBALAfIICE DUE. (3) 0.00 (4) (5) 0.00 (5A) (5B) 0.00 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;............................m.............................................. D 1:81 b. retain the right to designate who shall use the property transferred or its income;................................ D 1:81 c. retain a reversionary interest; or..............................__...........................m............................_................. D 1:81 d. receive the promise for life of either payments, benefits or care?.......................................................... D 1:81 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?................................................................................................................ D 1:81 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........ D 1:81 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?......................................................................,........................................ D 1:81 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 retum, inciuding accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Yoneko E. Pelaer DATE C) Cj- , _'2 5- .2 tJ (} 6- DATE SIGNATURE OF PERS SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE Lisa Marie Coyne ADDRESS DATE 3901 Market Street Camp Hill, PA 17011-4227 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)]. The statutedoes not exemota 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. 99116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116 .~[72 P.S. 99116 (a) (1)]. ~tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116 (a) (1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Cumberland County - Register Of wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 2/07/2007 COYNE LISA MARIE 3901 MARKET STREET CAMP HILL, PA 17011-4227 RE: Estate of PEALER JOHN D File Number: 2001-00249 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of wills a Status Report of completed or uncompleted administration. This filing is due by: 2/27/2007 please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner StrasbauJ~ Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 2/07/2007 YONEKO E PEALER 212 BEAVER DRIVE MECHANICSBURG, PA 17055 RE: Estate of PEALER JOHN D File Number: 2001-00249 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 2/27/2007 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel STATUS REPORT UNDER RULE 6.12 Name of Decedent: JOHN D. PEALER Date of Death: February 27,2001 Will No. 2001-00249 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 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 with the Clerk of the Orphans' Court and may be attached to this report. Dated: 1--/ <8 f 07 I LISA COYNE, ESQ IRE 39011 rket Street Camp Hill, P A 17011-4227 (717) 737-0464 Counsel for Personal Representative 00 w 11 J _ ;''\'.....; Z \ 81. \ iff COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX BUREAU OF INDIVIDUAL TAXE~i-",(\r;",'-r\ (~n!~R.,\I.ISEMENT, ALLOWANCE OR DISALLOWANCE INHERITANCE TAX DIVISION "t',I/,-, -~!.-' '_,'r1t/IDF.,bEDUCTIONS AND ASSESSMENT OF TAX PO BOX 280601 HARRISBURG PA 17128-0601 '* REV-1547 EX AFP (06-05) DATE 01-02-2007 ESTATE OF PEALER JOHN D DATE OF DEATH 02-27-2001 FILE NUMBER 21 01- 0249 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 03-03-2007 ( See reverse side under Objections) Amount Remittedl I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE .... RETAIN LOWER PORTION FOR YOUR RECORDS +- ------------------------------------------------------------------------------------------- REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF PEALER JOHN D FILE NO. 21 01-0249 ACN 101 DATE 01-02-2007 2il07 JAN -8 Pt1 2: 51 CI EPl< nF" IL_; 11'\ I......... LISA MARIE COyNjRPHi\\!'S CCIJRT COYNE & COYNEcu'r-' 3901 MARKET ST CAMP HILL PA 17011 T AX RETURN WAS: (X) ACCEPTED AS F I LED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN Transfers (Schedule G) (1) (2) (3) (4) (5) (6) (7) 17,000.00 .00 .00 .00 .00 .00 .00 (8) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 1. Real Estate (Schedule A) 2. 3. 4. 5. 6. 7. 8. Stocks and Bonds (Schedule B) Closely Held Stock/Partnership Interest (Schedule C) Mortgages/Notes Receivable (Schedule D) Cash/Bank Deposits/Misc. Personal Property (Schedule E) Jointly Owned Property (Schedule F) Total Assets 17,000.00 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. II. 12. 13. 14. Debts/Mortgage Liabilities/Liens (Schedule I) Total Deductions Net Value of Tax Return (9) (10) 12,685.56 Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) Net Value of Estate Subject to Tax 5,951.35 (11) (12) (13) (14) 18.636.91 1,636.91- .00 1,636.91- NOTE: If an assess.ent was issued previouslY, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ~ returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due ED S: P YM N RECE T DISCOUNT +) DATE NUMBER INTEREST/PEN PAID (-) (15) .00 X 00 .00 (16) .00 X 045 = .00 (17) .00 X 12 = .00 (18) .00 X 15 = .00 (19)= .00 AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 .00 .00 .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) PETITION FOR PROBATE and GRANT OF LETTERS Estate of ~A~ D e~/~ No. ~ l-Ol- 02..4 cl also known aV To: Register of Wi1!or the h-..d . County of "'t ~ In the Commonwealth of Pennsylvania . Deceased. Social Security No. I a-O - 2h - 0 1/ os The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the executr~" in the last will of the above decedent, dated ~ ~ m ~ and codicil(s) dated named ,1~ (state relevant circnmstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in (! C/Htlu.v~ Coun&~~n~sYlvania, with h ls last family or principal residence at ;2/ d A -RA"Ir4v- R./.) ~~/~ -Yhz...16o(.j h t LJ ( (list street, number and muncipality) Decendent, then 2> 2- at IVtr~~rc.. Shv~ Except as follows, de ent 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 incom peten t: years of age, died t?h 27 , ~ 2t:J() / , 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 Fa.) Personal property in County Value of real estate in Pennsylvania situated as follows: s~, (!)i!:'O. - $ $ $ $ WHEREFORE, petitioner(s) respectfullY...2qu st(s) the probate of the last will and codicil(s) presented herewith and the grant of letters -, PS (testamentary, dministration c.t.a.; administration d.b.n.c.t.a.) theron. VJ V u c ~ :"9~ VJ -' ~ .... o:::~ C -00 c.;:: 0::1'';:: ~~ ~o... ~ '- ~ 0 ~ C ell Vi OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I s'" COUNTY OF CUMBERLAND J ~ The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the be~t 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 591 estate according to law. s,wo,rn to or affirmed and,', SUbscribed, { ~~ Y.~ ~ before me this 6th day of ~ MARCH ~2001 . ~ ,7??/ // r (l.J~ / .(U~{'tf /Xlf 4. ""u~-r !:i / ; y .- ~ , 'R~~~ ~ IlP-115-~ No. 21-01-249 Estate of JOHN D PEALER , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW MARCH 7 ~~ 2001, 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 MAY 25, 1999 described therein be admitted to probate and filed of record as the last will of JOHN D PEALER TESTAMENTARY YONEKO E PEALER and Letters are hereby granted to ~ ..~ ~ /2 }A~ '/ / / / / (/"f -j /L/..e./ /B / / / (j -<1f2L~1~/ R4ister of Wills f FEES Probate, Letters, Etc. ......... Short Certificates( ).......... 1f&YiB~ilition ................ JCP $ $ $ --$ TOTAL _ $ 80.00 15.00 42.00 5.00 142.00 t/sA mr1~/~ GYN6 ATTORNEY (Sup. Ct. 1.0. No.) S3 7 a Y ADDRESS / ~ 11'// ~t4 I 7d~ 5/ftJj tU~k I- 5--1. 71 7- 75' 7 -iR:1I"h ~ PHONE Filed I'his is to certify that the information here given is correcd)' copied from an original certificate of death dt;ly filed with me as Local R~gistrar. The original certificate will be Forwarded to the State Vital Records Office tor permanent filing, WARNING: It is illegal to duplicate this copy by photostat or photograph. rtftli,j/iiiiffl;;;~ 1",,'II~~\I~-M!El-~ l~/ ~~~~ '!~_. .1li1Ioa... \~\ (i~~' ~ ,--~ '~i'" \' ~ ~ C)! - :;f :'~~ ~ <-'.,. ~ i . r:' ~ \\ * 'g- ._~,,;; * I ~~,,' /~/ \~ ~ '-, /~~ ,I' ---:.-~~,~1MEN1- ~{~ ","" ""/;//'HIIII/fJfJJJIV ~ tJ4-(~~ I('nJu ~ Local Registrar (j Fee for this certificate, $2.nO No. ?11 t-lftctl ~ )0 i? ( Date P 7234104 21-01-249 H105i4JAev 2187 COMMONWEALTH OF PENNSVLVANIA . OEPARTMENT OF HEALTH · VITAL RECOROS CERTIFICATE OF DEATH 7YPEiPRINT IN PERMANENT BLACK INK ~ 8 ~ a ~ ~ z J661 NAIoIE Of OECEDENT If"" M'dd'.. laslj AGE (l3s18irltlaay} UNDER I YEAR Montn. Oar- 81RTHPLACf :C.('14l'.a 3taltJ OIl fCf~9" Couotry) y,~ 5 COUNTY Of DERH Ill, White SURVIVING SPOuSE lit ."., .:)I'd! ma.aen naJl\tU . 11.. DECEDENT'S MAILING Y oneko Eto Iwp Coly!tloro II. INfORloIANT'S HAIoIE [T ypelPrll1l) 2Oa. IoIETHOO OF DISPOSITION O IlunaI 0 Cr.""'11On 0 00Nl.1On au... (~"" . 21., SlGNAJURE Of fUNERAL S Schaefferstown, Pa. 17088 . ~rb..~~ t~l~n._I;l~__-_______ ~ro~ONsEouENCE Of): ~~'M~,",h'lni,","'hllr9 Pa DATE SIGNED (Mon/II, Day, ......, 23b 23c. ~ CASE REfE'RREO TO :~Iit ;~Mf.j~f\lCORONER? No 0 21. , ApproJllm.at. : inlarv" be.....n : onset And death I / / ----. ._~---~ ---.......--.....f I : . -~---.---- .--l TIME Of INJURY PART/I; Other signkanl con<htionli oonrrlbu(ing to c:Je.i.lh. but ftOe, resull"'9 in the unOerty'Ing cauM ON.n '" PARl ~ b . _'___n __ . I OUE ro(OR ASA CONSEOUENCE at) C ~ rotOR AS A CoNsEQUENCT&1---------- d _._ WERE AUlOPSY FINOINGS MANNER Of OEATH AI/A,U,BLE PRIOR ro COMPLETION OF CAUSE Of DEATH? H..uraf q [] o DATE OF INJURY {Monltl. DaY', Yea'l INJURY AT WORK? OESCRIBE HOW INJURY OCCURRED Accldttnl Pending InvesliyallOl1 rJ [] [] ;~CE of-INJuRY - AI hOme. far~~~e.t. factory, ortlC. bu4ding, .,,; l$pocll"} 300, _ 0 NoD Hom'cad. Y.. D NoD M.3Oc. SulCldB Could 001 be dtHermmed 1... 21b. CERTIFIER tC"eck Clflly onel .CER1'fY'NG PHYSICIAN jPhl'st(~nc~r"f....l{lg CdUse cJ !.k>.uh ""t'er> ..jpothu ph"S'L,an h..l:> f)I0I10WllNlh-:.tlf\ "UIU Cl)lnlJll:l~ lIem2Jl To the beat o. m., know&edg., de.th occurred due to th. caus4!(s) and m.oner.. st.led .. 2', 'MEDICAL EXAMINER/COAONER On the ba.i. of ..aminaUon and/or investigation, in my opinion, death occurred ilt 'he lime, date, and place, and due IQ the cause(..) and manner .s stated _. ....... .. . .. .......... ,. . . . . . . . _ . . . . . .. . _ .. ... , . . . . . . . . . . . . .. ............... 31. R~~=~=MBER ~_ iOdJ"iJ ~l~i~ ~~~F---~-- -- _ -------- 31b, ~ lii~ [] ~: Me. L __J:E :~i't 0/_ r_~~~ NAME AND "OORE SOf PERSONWHOCOMPlETEOCAUSE Of EATH (lIem 27) Type 01 P"')Io'I:: D V >AA'" \.,Jo&W\n . ~'fhl'j J F'tv I-J 32 7.D1 f11,~t m;n "Pp. ~ :';~~~ 7; Z' A:::+ J .PRONOUNCING AND CERTifYING PHYSICIAN IPtlV~lJn t'lOI': .lfOllUU.!C,{llJ UCJlh d..ld ,-.e'IIIYln4 to<-,;lli~ at \lc~Ir,\ To 'he be... 01 my knowle6gfl, de.lh occurred.l 1M Um.. dale. ~od place. and due 10 Ih. cause(a} and manne,.. sl.led I cv oK-, STATUS REPORT UNDER RULE 6.12 Name of Decedent: :];/,;r J) ~~/~ J-:'J 7~Oj Date of Death: wi 11 No. ::z.. 001_ 00 Z'/9 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 X 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: -:L---.fL, 200.3 (/ 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 No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: 1- rl ....(:.'5 ~~U . i at-ure ( !-I<. A M ~JL:.? Name (Please type c3rrJ/ ~. Address ~~::::::J.lVB or Ipr int) ~ / &y; /-Af-t ;;4- / 701/ ('7/7) 7 57- () L/ h Lj Te 1. No. Capacity: Personal Representative ~ Counsel for personal representative (MAH:rmf/AM3) '- Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 1/06/2003 YONEKO E PEALER 212 BEAVER DRIVE MECHANICSBURG, PA 17055 RE: Estate of PEALER JOHN D File Number: 2001-00249 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 2/27/2003 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, DONNA M. OTTO DEPUTY REGISTER OF WILLS cc: ,J File Counsel Judge E - CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: JOHN D. PEALER Date of Death: 2-27-2001 Will No.: 21-01-0249 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 May 23,2001: Name: Address: Y oneko E. Pealer Donald Pealer Craig L. Pealer 212 Beaver Dr., Mechanicsburg, PA 17055 14721 Whitcap Blvd., Apt. 343, Corpus Christi, TX 78418 CMR 454, Box 1719, APO AE 09250 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None COYNE & COYNE, P.C. Date: 73 /W~/ .t?J)' ,'~ 7c;~r Li Marie Coyne, 901 Market Street Camp Hill, P A 17011-4227 (717) 737-0464 Pa. Supreme Ct. No. 53788 Counsel for Personal Representative