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HomeMy WebLinkAbout02-0395 PETITION I"OR PRonATE and GRANT OF LETTERS 2./- 0.2. -3QS- Estate of LILLIE C HARRO also kilo IVII as Register of Wills for the Deceased. County of Cumberland in Social Security No. 204-01-0488 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents thai: Your pclitioncr(s), who is/are l8 years of age or older an the exccut rix in the last will or the above deeedelll, dated February 18, 1997 and codicil(s) dated No. To: the named ,19_ (~laIC relcvant cin:llImtunccs, e.g. renunciulioll, death of cxcCllLOr, CIC.) Deeclldellt was domiciled at death in Cumberland h P1'" last family or principal resiuence at.-C..amP Hi 11 C;:Jre Camp Hill (East Pennsboro Township), FA (lis! slree!, Ilumber antlllluIKip:tlity) County) Pennsylvania, with Center. 46 Erford Road, Deeendent, thell 92 years of age, died March 11 ,xl>\lZ002 a~ C~mp Hill r.~rp- c'pnrpr Except as follQws, decedent did not marry, was not divorced and did nO[ have a child born or adopted after execulion of'the will offered for probate; was notlhe victim of a killillg and was never adjudicated incompetent: Decedant was an unremarried widow Decelldellt at death owned property with estimated values as follows: (II' domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property ill Pennsylvania (I I' not domiciled in Pa.) Personal property in County Value or real ~slalc in Pennsylvania situated as I'ollows: $ 7.000.00 $ $ $ WHEREFORE, petitioller(s) respectrully requesl(s) the probatc or the last will and codicil(s) presented herc\vith and the grant of letters testamentary (1t:stotI1ICIII;lry; adtuinl"tratiol\ 'C.I.a.; administration d.b.n.c.l.a.) lh...:roll. , ~:r-~:h;;f'~~' da K d S?49 R~Rt Trinnle Road Mpr"h~ni("~hllrg, FA 170~O '0 " .~= 'J'- c.::;~ "'::1= ~..~ " Z~ ~.~ ;;1 :Ji OATH or PERSONAL REPRESENTATIVE COMMONWEALTH OF !)ENNSYLVANIA I.. j t;t; COUNTY OF CUMBERLAND The pctilioncr{s) <lbovc-llal11cd swcar(s) or affirm(s) that the statements in the foregoing petition are true anu correct to tbe best of the knowledge and belief of petitioncr(s) <lnd that as personal represen- tali\'c{s) of the above decedent pclitioner(s) will well and truly administer the est ale according to law. , ryfd;;,. /~N/ci (f,: ~ ~ , Register ~. affirmed 16th '" 00' " '" " ;;] :i2 Sworn to or before me 111 is I and MARY LEWIS 11-5"6- d-..., No. ,:)/- 0.:1. - 39.~ Estate of LILLIE C. HARRO , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW APRIL 17, 2002 IDlI2..0..0.2..-, 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 February 18. 1997 described therein be admitted to probate and filed of record as the last will of Lillie C. Harro and Letters Testamentarv arc hereby granted to Kathryne E. O'Hara ~(JJII#W=~KJ1 MARY LEWIS Register of wilis . FEES Probate, Letters, Etco 0 0 0 0 0 0 0 0 0 $ $ $ $ TOTAL _ $ 01 d 0 APRiL 17. 2002 Fl emaii 0 te; oex;;c": 00,,0 04-': 17:.002000000 , 40.00 12.00 William A. Yocum, 06263 ATTORNEY (Supo Cl. J.Do Noo) Short Certificates( ) 0 0 0 0 0 0 0 0 0 0 ~next.I;aopaqeso 0 0 0 JCP 1 00 !'i.OO 60.00 3001 Market Street ADDRESS Camp Hill. PA 17011 PHONE 717-761-5041 txun~) r '":,<.) 17::: Glli 9l IJdV ZOo '^"'l:J HIIl'i,HII'i REV 'll~(, This is [Q certify that the information here given 15 correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. Illlllll'lfIH"'"""" """I<.~\.\" OF PEi...., ,"~~'4'n'- \\,\~ .' ,'. " ~A~';. ~~_.~. . ~'- I.... _ .\~i ~Q, ",-;:: ~~I . '1.-,f(-.1' . ,I~~ t*'~' . e.~*l \*'- ,'-,- ,- A..~/ ~ -. ~,\ ~-~!.?LMENT ~(~;~\ll'\ "'HIHIIIIJIII /J -77<' "1." ~ /'<:., '/""-'''~ Local Registrar. .Fee for this certificate, $2.00 P 8031832 MAR 1 4 Z002 Date " i.ol3A.v,V87 COMMONWEALTH Of PENNSYLVANIA. OEPARTMENT OF HEALTH.. '111Al RECORDS CERTIFICATE OF DEATH N~ Of DeCEDENT jf"SI MrddiEl. LaII) 1. Lillie C. Harro '" J.Female 'SlAlIi:.'l-flruMllER SOCIAL SEC\JRITY "'Ur.l8ER ,. 204 01 - 0488 OATEOFDEATH,Mcnl/l,o.~.''IIar) March 11, 2002 ,b.Sw. PA =1y)0 ,. COUNTY OF DEATH 92 Vra UHDE'A I Ollii tioI.n t"'inuteto AG~\lasl~ \JHtlf1Rl~ AoIotIl"- o.ya O/orE OF Bl~TH ,,,,anlh,Day,',",1 alRTHPlACEICty;ol>d PlACEOFOERHiCt-(oc.""",,,,,.- __,,,.,,,~;I.o,,.cn<>l""'_) SLlt.",'c"'9"Countt\fl HOSPITAL ~ tIarrisburg,PA:-'oenIO ERI~"nlO tlOo'O FACIUT'I' "'AME It' no. ,n..'lU/Ion, o<VOI $I",,,, and n""'~J ... Cumberland OECEOENT'SUSUAl OCCUPAl'lON (~~.::.,'::::~~ 1a.ookkee er Sales lI~erber I s Fabric OECEOENT'S ...AllINGAOOAESS($l'..... C.tyI1'own. SWe.ZopCodel DECEOENT'S 5249 E. Trindle Road ~~~~E ...~- ,..Mechanicsburg,PA 17050 ",,<*>....0., FRliER'SNA"'E (Fi'iI. M><l<llft, ~a.) I'. Isaac Yost INFOAMANT'S NAME (T ypelPn/l1l ~athryne E. O'Hara I,IIfTHOOOFOISPOStTION 8\.lrieI~C.........O~,"""S1&1.0 QtheI(SpecIy' jj;ast Pennsboro T IClNOOF eUSlHESSlINOUST~V ~ Camp Hill Care Center RACE .A_&11lnl*an.IlIec:~. While. elC. ,-..., White ". ". Elemen~ry "'2 w.RIlA~STATUS.Manied N._......ie<l.Wido7wo&d. ilivorc-e<llSpecot'fl ,..widowed SVRVIVINO SPOUSE (11.._, 'l"'"'...-.......,.\ ~OE:CEOENTEVERIN us. AAMED FoACES? 'feeD Noli! ,~ "'" - _.. Cumberland 1Own8Ioip? nc.o:s....-.=-.:=oI MOTHER.S NAME (F.", ~_. M_ &.ornamlll ,.. Abi ail Davis 1NF000000T'S MAIUHoG ADDRESS ISI'...., CityIbwn. SlloI&. roll Code) .5249 E. Trindle Road, Mechanicsburg,PA PLACE OF OISPOSITIOH . Neme oj Ceme1ery. C,.....1Ofy lOCRlON . CityfTown, Slal..lip Code 0I~Aac:. l1c.Kl ".cl8cedenlliveodin P;:tc:t- P;::>nnc:hnrn ... ..-. 17050 ". 2T.I'IlRTI: Enl"ltItIdj.......inp.iea~compioo;.....",..whichc.lIls""lhed..l~ 00 l..OI'i{_c......OIIeacII_ 2002 ii,t. John's Cemetery 2~hiremanstown, FA 17011 M,o,yE ~AOORE$$Of fACIlIT'f 11 0 7 0 one&Murra FH408 3rd St New Cumberland, PA UCEl'lSENUMlIER DATESlG.NEO (MonltI.Oooy._t 23lt. nc. WIt.S CASE RE"ERREO TO MEOIC!<l EXAMiNERlCORONER? ".0 OFFU~?~SEe ."t"'f23ll-cOll/y_ce<1i1vinl;l .nal,,,.i/4lllealllln.Or_1O '*"'Y_oI.,..". DA1E PRONOUNCED OEAQ(Montl1. Da~. \'ea'f I" a .n1"lhe_old'y;ng.SUCII...ca'dtaC:",'.spo'al"rya"'lil.,ho<:~OI""'r1l.~u,. J-II-0 1.. a. ,.o.pp.o.''''''. '~--" :OIlMI_dQlII , i .,J1i\ PARTN: ~sOgni/lcanlCCllldilionl_ibulinglO...tf>.1>uI nal.......ing...IfIe~_Qiven...f'llRf1 A-t:vrt h> Y"CN'-{JIM- 1.J/9"'~7,.,.) 11t.U/e,...~ e?t Demp''',f DUE 1O(OR ASACOHSEOUENCE Of): &-INS Av~4, I: OUE1O(OA IlSA CONSHNEr<:E OF): DUE 1OCORAS ACONSEOUENCE OF): WERE AUTOPS"f l'INOlNGS MANNER OF DEATH I\\llIdt.,ABlEPRlOA10 COWPlETIOH Of' CAUSE [Y 0 OFOEAfH? -. Hom_ -..... 0 Pendjngtnve..oi\;llion 0 ~@" - 0 ~ iY" SuicidlO 0 COuldnolbl'deI,,"''''1Kl 0 DA1EOFfNJUAY (MonIll,Qay.\'eatl TIME OF INJURY IN.!UM AT1NClRJ(? DESCRIBE HOW~F1vOCCURREO _0 NoD-- a. M. PI..'CE OF INJURV . ;\l hom.. ,.."'. SU"I. rlClOfy, ol'liC:' b<IiIdlnQ.8IC,ISP8C~vl - .... lOCR~{$U:_.C~.Slal&\ He. 21b, ClRTIfIIEAlChed<(W\j"onef "CUITlI'VIHO PHYSICIAN (PII~."...nc""""""'ca....cJ_ ..h......n_ pI>~"","""".prOf>Ollf'lC8dd8..I~ aM <<>"'IlI8I8d 1\"", 23) lG..._<>t"".lIulow\edge.a_~\lnW___~Ml"'lsi'''''''''/I<I'''''l'I''', . "'. SIGNRURE AND TITLE OF CEFlTIfIE~ '''~OUNClNQANOCERTI''YINO PHYSICIAN fPtol""'""'Ool~. "-"""""""".l oe..tha(",':.olt~onQ rocau...<>l <lealh) TOlhe_ol...yknowr.dge."..IhOC:C\>F,....'_........d.te.ahd\lIK..__""_uuMlt.\&ndmfn...' .....'atH,.. o )U,. liCENSE NUMBEFI 311O,OSOoS"\?4....l,... 31<1. "2-.01.. NAME AND AOOAESS OF PERSON WHO C0t.4PlETEO CAUSE OF OEATH .... (llem27)TypeorP';nt c;..~. p.. cH....A-fL~~~ U'O. e.'i~ pa{lo..!rr- ~ ~ ...-:1-- (L "Mf.OICAL EllA.'NERICOfl;ONE~ Oft Ih. H'l. QI....mlll.lloll.nd/or In""UlI.llo/l, ill "'V opinidn. dulh occurr.d allhe 11m.. dal., alld p1ac., and dUll 10 th, <:a...~~..\ and I'IIUUUlfU"'loted......................... .,...... .............,......".. ..... ,.... ....,......,........,......... 31a. o U. DAtE FllEO(Monft>, O~~, .....al) \..?,/..l,r( I u. 7?/~ ry ",.., .L, -, 21-02-395 ";,LlIil~) : t ~ ~~) v~: Ol\, 9l Ndll ZOo LAST WILL OF LILLIE C. HARRO :2 1- 0,;).. - 3Q.s- I, LILLIE C.HARRO, of the Boro of New Cumberland, Cumberland County, pennsuylvania, declare this to be my Last Will and revoke any previously made by me. I direct that all of my estate of every nature whatsoever, together with insurances thereon go to my daughter, KATHRYNE E.O'HARA of Hampden Township, Cumberland County, Pennsylvania. In the event she predeceases me, my Grandson, TERRY L. O'HARA shall receive my estate. I further direct that they shall have the authority to distribute, at their disgression, assets to my Great Grand Children, DANIEL C. O'HARA, KATHLEEN L. O'HARA, PATRICK RICHARD O'HARA and my Great Great Granddaughter, ODESSA ALICE MAY O'HARA and any other Great Great Grandchildren who may be born after the date of this last will and who are living at the time of my death. These bequests will depend upon the assets available at that time. In the event distribution should pass to minor children, I appoint the parents of the minor children to oversee these assets and to responsibly administer them in the child's best interest. I direct that my body be buried in the St. John's Cemetery, Trindle Road, Hampden Township, Cumberland County, Pennsylvania, in the lot I own there, beside my husband, DANIEL CHARLES HARRO. I direct that all my just debts and funeral expenses be paid as soon as practical after my demise. I direct that all taxes that may be assessed in consequence of my death, of whatever nature by whatever jurisdiction imposed. shall be paid from my resisduary estate. I appoint my daughter, KATHRYNE E. O'HARA, of5249 E. Trindle Road, Mechanicsburg, Pennsylvania as the executor of this my Last Will. In the event she predeceases me or is unable to perform these duties, I appoint my GrandSon, TERRY L. O'HARA as Alternate Executor. I direct that my personal representative or their successors, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN ~OF, I have hereunto set my hand this ,1997. / g day of . The preceding instrument consisting of this and one (1) other typewritten page, each identified by the signature of the Testatricx, LILLIE C. HARRO, was on the day and date thereof signed, published and declared by LILLIE C. HARRO, the Textatrix, therein named, as and for her Last Will, in the presence of each other, have subscribed our names as witnesses hereto. Shelb~ f<, 1\.10":11 residing at MCc.h"'-n'c.~bcl'j !-A J<CH 1-\':j.1'" L.-\<)~Q.' residing at -1-\0., r,s,6u>,O P A . We, LILLIE C. HARRO, ~ ~.~"' C ~ fL.. n f)/1 and Co'\. c 01'\ " the Testatrix and the witnesses respectively, whose names are si ed to the ttached 0 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, and that she executed it as her free and voluntary act for the purpose therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of his or her knowledge, the Testatrix was at the time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. ~';; . /f;4 (, . ~t;" '-.-. ,. O/7/2~ LILLIE C. HARRO .i./'dk~ / Witness #. '-?no..-z._..&-.R..~ '11ir1J/s 9~ ~;jVL- Subscribed, sworn and acknowledged before me vlAfJl'N';q [/;; t: 1:.-"1 FR.L( bX LILLIE C. HARRO: the Testatrix, and subscribed and sworn to before me by ..:::shell)!I!?' /J).1/rt II and t;Afh y ::;;; L 1./1'19 c: I! the witnesses, this If! dayo~, ~p,h.L-' AH.-LJ--' 1997 /.~:ft~l(A Jt?/ ~2f~ Notary Pu c ~E t-;;:~'I;~'-~ -1 ,......', L ,- .,..e"J",t-:'... ....', ~,.f\:::l.. ,;~."-' ,', .. '.-~' , ': ,Iv.; L:......H.;\'t,c Ii" , WI r':,.-rC:T! , ;:;-, ..__.~ l .Maja8;'Y~;~"\';";';; " [,';l",'>; E -- CEI\'l'lFICA'1'10N Of NO'l'lCI:: UNOI::" "UJJE S. G (a) ,Name 01 Decedent: LILLIE C. HARRO Date of Death: March 11. 2002 l\dmin. No. Will No. 21-02-0395 " '1'0 the Registerl '1 certify thu t 110 tice 0 ( bene (ic ial i1lter85 t required by Rule 5. G (a) 0 ( the OJ:phons' (au!:t :l\uies wus served Oil 'or malled to ,the (ollowlng beneEicia1:,ies u( the above-cuptlu1Ied estate Oil /lltl/ lr . 2Q02 : Name J\ddress KATHRYNE E. 0' HARA 5259 East Trindle Rd.. Mechanicsbur~. PA 17050 Notice hus now been given to ull persons entitled thereto under Hule 5.G(a) el\cept NO EXCEPTIONS Date: /1)11-11 :zY . 2002 ">~d/r rf {9~~ S g1lutu~ ' N Nallle Kathryne E. O'Hara In N Address 5249 East Trindle Road ,..,'- r:= <: Mechanicsburg, PA 17050 N P , ~ , '1'elephone (717) 7'66-6918 , - ~ -.. r ". -~ Cupacity: x 1'e1:501lal Hepresentatlve Counsel (or personal representat'lve REV-l5OQEX {&-OOI COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 I- Z W C W U W C w ..., ~~tI) u"'''' w"u ,,00 u"'~ ..", .. " INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) HARRO LILLIE C. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) March 11, 2002 Jul 8, 1909 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) og 1. Original Return o 4. Limited Estale o 6. Decedent Died Testate {Attach oopyofWiIIl o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date oldealh after 12-12-82) o 7. Decedent Maintained a. Living Trust \""\lath copy oj Trust) D 10. Spousal Poverty Credit (daleof~athbelween 12-31.91 and H9S) OFFICIAL USE ONLY (J/ I7-Sf- eX FILE NUMBER .-l. L - JL.2... JL -1- .JL 5.. _ COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 204 - 01 0488 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Return (date of death prior to 12-13.82) D 5. Federal Estate Tax Return Required a. Total Number of Safe Deposll Boxes D 11. Election 10 tax under Sec:. 9113(Al (AtlachSch0) ,TIlIl! l!EC,TI()f11 USrill;C()MPCETEQIALL'C()RRESP()NDENCEAND;,CONFIDENTIAL\T,o,x NFoRMA,'tIClN'l!I'l' NAME COMPLETE MAILING ADDRESS William A. Yocum FIRM NAME III . ) 3001 Market Street ~E Camp Hill, PA 17011 TELEPHONE NUMBER 717-761-5041 ..., z w o z o .. '" w '" '" o u 1. Real Eslale (Schedule A) 2. Stocks and Bonds (Schedule B) (1) 00.00 (2) (3) (4) (5) 7,576.50 (6) 4,825.56 (7) 5.014.27 , ' EJ)IRJ;:CrED TO: OFFICIAL USE ONLY ~- ;-" :-." d N z o ~ :J l- ii: c:( u w 0:: 3. Closely Held Cmporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Sc~edule 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. Debls of Decedent, Mortgage Liabi\\t\es, & liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) (9) (10) 7,683.80 6,268.96 ~ =< ~ --.J ::;:.:'? I..() iJi (6) 17,416.33 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made {Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ f-' :J l1. ::E o U >< ~ 15. Amount of Line 14 taxable at the spousal lax rale, or transfers under Sec. 9116 (a)(1.2) x.O_ (15) x ,0 '!2.. (16) x .12 (17) x .15 (18) (19) (11) (12) (13) 13.952.76 1,ldi1 'lq 16. Amount of Line 14 taxable at lineal rate 3,463.59 (14) 3.463.57 17. Amount of Line 14taxabte at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 155.86 155.86 20,0 "i ''::.'"'' "",' ',,' :'i"t;' '>' ,,' BE SURE TO ANSWER ALl.: QUESTIONS ON REVERSE SIDE AND RECHECK MATH~'~"" ," ";'~ ~.j/.;j\:;' . . ;. ~ Decedent's Complete Address: STREET ADDRESS C Hill Care Center, 46 Erford Rd., . . . amp Camp Hill, (East Pennsboro Township), PA 17011 CITY , I STATE PA I ZIP 17nll Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 155.86 7.80 Total Credits (A + B + C ) (2) 7.79 3. InteresUPenalty if applicable D.lnterest E. Penally TotallnteresUPenally ( 0 + E ) (3) 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) 00.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 148.07 A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (5B) 148.07 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 a. retain the use or income of the property transferred;.......................................................................................... 0 b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 ~. retain a reversionary interest; or.................................................................."......................................,............... 0 d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 2. If death occurred a~er December 12, 1982, did decedentlransfer property within one year of death without receiving adequate consideration? ....................................................".....,.................................................. IXJ 3. Did decedent own an "in trust for" or payable upon dealh bank account or security at his or her dealh? .............. 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................,....."........".................................. ........................... ................. 0 No [X] [X] [X] Q9 o Q9 [X] 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 thai I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and beliel, it is true, correct and complete. Declaration of pre parer other than the personal representaijve is based on all information of which preparer has any knowledge. SIGNATURE.oF PERSON RESPONSIBL tOR FILING RET~RN ,/ .' .. {r.' " ADDR S 5249 East Trindle Road, Mechanicsburg, PA 17050 SIGN~~~AR~?~~RESENTATIVE ADDRESS ( . 3001 Market St. Camp Hill, PA 17011 - .. . __._M'"_,,=~.,.__ s~_._....~~,.,.wM""<"U",'~"_...,_....",___" _. ."""'.,"'__ For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rale 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) (ill. 2.. DATE ~'-J/rd;Z 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 Ihe surviving spouse is 0% [72 P.S, 99116 (al (1.1) (iill The statute does not exemot 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 rale imposed on the net value of transfers from a deceased child lwenty-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)J. 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(1.2) [72 P.S. 99116(a)(II1. The tax rate imposed on the net value of Iransfers 10 or for the use of the decedent's siblings is 12% [72 P.S. 99116(a)(1.3)1. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV.1508E)(+l~71 SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY , COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER LILLIE C. HARRO 21-02-0395 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorshIp must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Burial Certificate-PNC Bank-(Burial Reserve Account) paid to Stone & Murray Funeral Home - dated March 18,2002. See attached exhibits - Bank check and funeral bills. Note- this amount includes refund of $924.05 for insurance in excess of funeral bilL............................................... VALUE AT DATE OF DEATH 6,964.05 2. Blue Cross-Blue Shield refund (4-12-02)........................ 112.45 3. Rent Rebate applied for from the State of PA on 2-12-02........ 500.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 7,576.50 """""".;'",'. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTL Y.OWNED PROPERTY ESTATE OF LILLIE O. HARRO FILE NUMBER 21-02-0395 If an asset was made joint within one year of the decedent', date of death, It must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELA TtONSHIP TO DECEDENT A. Kathryne E. O'Hara 5249 E. Trindle Rd., Mechanicsburg, PA 17050 Daughter B. Kathryne E. O'Hara 5249 E. Trindle Rd., Mechanicsburg, PA 17050 Daughter C. JOINTLY -OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %QF DATE OF DEATH ITEM FOR JOlNT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECO'S VAlUE OF NUMBER TENANT JOINT deed forjointiy-held real estale. VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A. 7/31/9 Susquehanna Valley Federal Credit Union Share Account (Savings Account) 1/77 88-00. . . 7,565.61 50% $ 3,782.81 2. B. /4/98 Susqtlehanna Valley Federal Credit Union Draft Account (Checking Account)#7788-40. 2,085.49 50% 1,042.75 TOTAL (Also enter on line 6, Recapltulalion) $ 4,825.56 - (If more space is needed, Insert additional sheets of the same size) ~~'M""l':" '*' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON.PROBA TE PROPERTY LILLIE C. HARRa FILE NUMBER 21-02-0395 ESTATE OF This schedule ml.lst be complete<:! and filed if the anS'Ner to any of queslions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER 1. DESCRIPTION OF PROPERTY INCLUDE TI-1E NMlE OF THE TRANSFEREE. TI-lEIR RELATIONSHIP TO DECEDENT AND THE DATEOfTRAASFER ATTil.CH A COPY OF THE DEEDFORREALESrATE. (J/oOF DECO'S INTEREST DATE OF DEATH VALUE OF ASSET 297 Shares of PNC FINL SVCS Group, Inc. valued at 54.74 for $16,028.53. Stock owned jointly by Lillie C. Harro, the decedent, and Kathryne E. O'Hara, her daughter. Date of death was March 11, 2002 and date of sale was February 28, 2002. All proceeds of sale were placed in account of daughter, Kathryne E. O'Hara within one year of date of death...................... SEE PNC Statement for Account Number 43533531 attached hereto 16,028.53 5010 TOTAL (Also enteron line 7, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) EXCLUSION If Af'P\JC/IaL\':\ 3,000.00 TAXABLE VALUE 5,014.27 5,014.27 ~"11EX.t'~" '*' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RE1URN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS LILLIE C. HARRO FILE NUMBER 21-02-0395 ESTATE OF Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRiPTION AMOUNT A. FUNERAL EXPENSES: 1. Stone &YMurray Funeral Home..................................... . $ 6,040.00 2. Reception following funeral. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250.00 3. Monument Lettering - Gingrich................................... . 80.00 B, ADMINISTRATIVE COSTS: 1. Personal Representative's Commissior.s Name of Personal Representative (s) Kathryne E. O'Hara 00.00 Social Secunty Numberls) I EIN Number of Personal Representative(s) Street Address 5249 E. Trindle Road City Meuhanicsburg State PA Zip 17050 Year(s) Commission Paid: Waived by Executrix 2. Attorney Fees William A. yocum................................... . 500.00 3. Family Exemption: (If decedent's address is not the same as claimant's. attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees ........................................................ 60.00 5. Accountant's Fees - Not incurred to date.............................. . 00.00 6. Tax Return Preparer's Fees - Not incurred to date.......................... . 00.00 7. Pharmerica - Medication..........;....... . "0"............. ... ... . 62.65 8. Legal Advertising - Patriot-News. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91.15 9. Legal Advertising - Cumberalnd Law Journal. . . . . . . . . . . . . . . . . . . . . 75.00 10. Reserve for filing fees, taxes & Contingencies................. 500.00 11. Filing fees for Inheritance Tax and County Inventory........... 25.1D0 TOTAL (Also enter on line 9, Recapitulation) $ 7,683.80 (If more space is needed, insert additional sheets of the same size) ,<v.""ex.:,.",. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RES'DENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF LILLIE C. HARRO FILE NUMBER 21-02-0395 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 218.85 1. Pearl Vision - glasses........................1-21-02........... 2. Country Meadows - residential care.............1-13-02........... 2,550.09 3. Loan to Decedent from daughter to supplement decedent's checking account for payment of a bill .................2-20-02........... 500.00 4. Beverly Health Care- residential care..........3-8-02............ 3,000.00 5. Beverly Health Care - Final payment for residential care to date of death...................................... .3-27-02........... 284.62 NOTE - None of the above enumerated expenses were or will be paid or reimbursed by medical insurance. TOTAL (AlsD enter Dn line 10, Recapitulation) $ 6,268.96 (If more space is needed, insert additional sheets 01 the same size) ,"",""',1',971. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECE ENT SCHEDULE J BENEFICIARIES RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY 00 Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS (include outrighl spousal distributions) 1. Kathryne E. O'Hara Daughter Entire Estate 5249 E. Trindle Road Mechanicsburg, PA 17050 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1- TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ LILLIE C. HARRO FILE NUMBER 21-02-0395 ESTATE OF (If more space is needed, insert additional sheets of the same size) " SUSQUEHANNA ~ ~ \fALLEY FEDERAL CREDIT UNION April 16, 2002 Kathryne E. O'Hara 5249 East Trindle Road Mechanicsburg, PA 17055 Re: Lillie C. Harro, Deceased SSN: 204-01-0488 Dear Kathryne: Following is the date of death, March 11,2002, information you will need for the above referenced decedent: 1. Share Account 7788-00. The balance was $7,552.31 plus accrued interest of $13.30 for a total value of $7565.61. The account has been titled in the names of Lillie C. Harro and Kathryne E. O'Hara since July 31,1991:' 2. Draft Account 7788-40. The balance was $2085.49 with no accrued interest. The account has been titled in the names of Lillie C. Harro and Kathryne E. O'Hara since June 4, 1998. If we can be of any further assistance, feel free to call. Sincerely, ~/ ;?~ Larry L. Stoner President/CEO ~ 3850 I-lARTZDALE DRIVE. CAMP HILL, l'A 17011-7809 LOCAL: (717) 737-4152 TOLL FREE: (800) 948-1454 FAX: (717) 737-0589 ~ G PNCBROKERAGECORP 1hTough the courtesy 01 J.J.B. Hilliard W.l. Lyons, Inc. A PNC Bank Company C/O Hilliard Lyons P.O. Box 32760 Louisville, KY 40232 . . May Lose Value '". . No Bank Guaranl&liI :B16S4 C 3 0045 ~ Ol2OQOO- 0008 004Z2 A 512:3..... 1",111",111""1,1,11"",11,,1,1,,1,1,,,1,1,1,.11,1,.1,1,,1 LILLIE C HARRO AND KATHRVNE E D'HARA JT TEN 5249 E TRINDLE RD MECHANICS BURG PA 17050-3552 Portfolio Value Summary February 28, 2002 Cash & Money Market Funds $16,028.53 TOTAL PORTFOLIO VALUE $16,028.53 Prior Statement $0.00 $0.00 Income Summary February 28. 2002 Year to Date TOTAL INCOME so.oo $0.00 Cash Flow Summary OPENING BALANCE Securities Sold/Deposits CLOSING BALANCE February 26. 2002 SO.OO 16,028.53 $16,028.53 Accounf carried with J.J.8. Hilliard, W.L. Lyons, Inc. Member New York, American, Chicago and 80ston Stock Exchanges; CeDE; NASD; end SIPC. -' ( Account Statement Financial Consultant: J236 CHARLES LITTLE PNC BROKERAGE 2 WEST PINE STREET MOUNT HOLLY SPRINGS. fA 17065 ASST. JOETTE ALBERT Statement Period: February 1, 2002 . February 28, 2002 Account Number: 43533531 Customer Service: 1-800.762-6111 Web Site: WWWPNCBANK.COM &q/ -~ (yd Portfolio Distribution The pie chart below illustrates your positive security holdings, excluding outside assets. a Cash & Money Market Funds 100% ~ DO YOU WANT TO TAKE A BITE OUT OF TAXES? TALK TO YOUR PNC BROKERAGE CORP INVESTMENT CONSULTANT ABOUT INVESTMENTS THAT PROVIDE TAX-EXEMPT INCOME OR TAX-DEFERRED GROWTH OPPORTUNITIES. Page 1 of 2 February 2002 00ClQCl848 281654 c , 0Cl<e 05 OIZOUoo. 0008 00422 A = - - ~ ~ = """ == - := """ = 9" A PNC Bank Comp~ny ~ . May Lose Value ~ -. No Bank Guarantee Statement eno February 1, - February LIlliE C HARRO AND KA THRYNE E O'HARA JT TEN Account Number: 43533531 lnvestment Consuttant: CHARLES UTTLE e PNCBRQKERAGECO?P Portfolio Value ICASH & MONEY MARKET FUNDS 100% $16,028,53 $16,028,53 100% Estimated Current Annual = Yield Income """ - ..... $0.00 - = = Total - = Estimated Annual Income $0,00 Acct Type Quantity Description CASH BALANCE Sub Total Symbol Unit Price Percent of Market Value Portfolio ITOTAL PORTFOLIO VALUE Total Market Value TOTAL PORTFOLIO VALUE $16,028,53 Activity Details !PURCHASES AND SALES Date Acet Type Description 02/28/2002 P N C FINL SVCS GRP INC TOTAL Activity Quantity Price Amount . 0 ~ SALE 297.000 54.7400 $16,028.53 '" $16,028,53 0 . Cash Flow Analysis [CHRONOLOGICAL TRANSACTION SUMMARY Date Acct Type Activity Description Quantity Amount Balance BEGINNING BALANCE $0.00 P N C FINL SVCS GRP INC 297.000 P N C FINL SVCS GRP INC (297.000) 16,028.53 ENDING BALANCE $16,02B,53 $16,028,53 02126/2002 02/28/2002 RECEIVED SALE Page 2 of 2 February 2002 Account carried with J,J,B, Hilliard, W.L. Lyons, Inc, Membe! New Ycnk, f1.me!ical'l, Chice.'i)o tond Boslon S~oc\~ Extnange!>: CaOE; NASD; iBnd S\PC, ~ Z816~ C 3 0045 03 OU04200.0008 0Q0(12 A. '" A. CHARGE FOR SERVICES SELECTED Traditional Funeral Package. . . . . . . . . . . . . . . . . Basic Services of Funeral Director & Staff . . . . . . .. y; '?:2 () . Embalming. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other Preparation of Body . . . . . . . . . . . . . . . . . . . . Use of Facilities & Staff for Viewing / Visitation. . . . Use of Facilities & Staff for Funeral Ceremony. . . . Use of Facilities & Staff for Memorial Service . . . . . Use of Equipment & Staff for Graveside Service . . . Use of Equipment & Staff for Church Service . . . . . Transfer of Remains to Funeral Home .......... Hearse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . """""-................................. -~~;:::I $aJtM1&.~. 91f:........ ......... ---=-- I Service/Utility Vehicle...................... TOTAL OF SERVICES SELECTED (A).............$ I "i7"'Y.s:-~ B. CHARGE FOR MERCHANDISE SELECTED Casket(orolherreceplacJe) .R~.... /~- -::1-064 (~f'7'7?CS $M/Ych ~ Outer Burial Container gP.. <:2,~ '7~. d" Acknowledgement Cards. . . . . . . . . . . . . . . . . . . . . . . . . ::~~~ :~~:;s'; ~;~~~r' ~~;~~ If/i~~)flb ," Cremation Urn " . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Clothing .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . /t<---r t! cC""" "( TOTAL ?F MERCHANDISE SELECTED (B) . . . . . . . . .$ Stone & Murray Funeral Home JAMES E. MURRAY. JR. F.O. 408 THiRD STREET NEW CUMBERLAND. PENNSYLVANiA 17070 (71 7) 774-2750 DECEASED ?./CL/d= C. ~~ DATE OF DEATH /11.4I'?c.!-/ /C;: ::;?~=...:? NO. DATE OF STATEMENT /"?"~f'" /~ ;;;?..e Z,. STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED Charges are only for those items that you selected or that are required. If we are required by law or by a cemetery or crematory to use any items, we will explain reasons in writing below. C. SPECIAL CHARGES Forwarding remains to Receiving remains from Immediate burial. . . . . . . . . . . . . . . . . ... Direct cremation................. .., TOTAL OF SPECIAL CHARGES (C). . . .' ... $ D. CASH ADVANCES ce/f~ COPies~e~ertificate O?C:::>.. 6 _ @ $' each. . . . . . . Clergy~O_~~ /=.=0 Mu).!cian /C=5~1?..62". c..~.s.c=::> /~=G Newspaper Notices --=-~ - ~ t;"-~OO/........,.c;. -., Cemetery r~ C> -:)'OO.OD TOTAL OF CASH ADVANCES (D). . . . ... ... $79 ? DC> We charge you far our services in obtaining (specify cash advance jtems:) . SUMMARY Total Funeral Home Charges (A+S+C) $ '5'R7"5: Sales Tax, if applicable. . . . . . . . . . . . $ Total Cash Advances (D)...........: 7i:;'5": cC> COMPLETETOTAL..... ............ _00 0.99 P~~;AOM ~?~t ~ BALANCE DUE. .' ... . . .. . ." . .. . . $ _ ~.--:. DISCLOSURES If you selected II f/Jrngral that may require embalming, $i.JCh liS a funeral with viewing, you may have to pay for embalming. You do not have /0 pay lOT embalming you did not approve if you selected arrangements such liS II direct cremation or immediate burial. If we charged tor emtJa/ming, we will explain why below. Reason for embalming: j=>UjLJLJ:'C c:.-r-6:..._::V~~ If any law, cemetery or Cr9mstory requirements have required the pur- Chase of any items fisted the w requirement is lained belOw. ..... ,..- Full paymenl IS due no Jaler than If any payment is not paid when . a~nticipa~ 01 % per month (ANNUAL PERCENTAGE RA _"1..) on the unpaid balance will be due. I agree to pay the Balance Due listed on this $talement, plus any late Ctlarge. In the e....ent I delaull in payment to this funeral establishment, I agree to pay reasonable attorney's fees and court costs in addition to any Late Charge applicable. I understand and agree that I am assuming personal liability for the charges set. forth in this Statement and that this is in addition to the liability imposed by law upon the estate of the deceased. By my signature below, I hereby agree to all of the above and acknowledge receipt of a copy of this Statement r ~Ah'r"'P' c9' Q;linuv ~ / ~~ Sodal SeaIrity NIIlTIbet r 8y D,,,od CE Thi, Ivn.,.1 ~( "":~m:"" all ,"Ni .S. andca~ lndj~~/~nl. Cashier's Check 0. PNCBAN< I'NC Bank, National Association Southcenlral PA No. 1126876 60.1273/313 AM10375S-0300 Date Morch 18. 7.002 Pey to the Order of Stono , Murray funeral 110mB ~~ti1~d{ .:((;; f)::(jF{.J .,.~ r:6-::: :~5~"-~-"] >.. :::-~~:~.r~{imt:.u--.. _"'"'F"'~'_"~'" .__'.~w Dollars Lilli.. C. 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CRO!ROf--<:Z>'" .....+- ;[/.,..-Mi ;;n"'~ ..11,._;"" J'/.,,,j $ 43,,1/__ ..__ : '- ~~'-" ~~M.J. ~J r1+''(., ~ ~OOLl.AFlS61 5 ~"'der ....U'aI CredIt UIIfoa r::.v~PA.l'lllI!, ~ ~ .I :_~fJ--::::':'~' ~~~ :iUS i!5&~: OOOO~OEl~O i!~ UOR ...oooeDas..".., J , ~] ] ] J . ~ ';';"J . <;..... ~ J . I , ] ,., ~ ~ ... , v = , r ~ ..~~ .... .' - . . .. ", ~ t . .. ~ . .. = ~ .' , , "'" , '"' SI , Jo:~:no"o~-4 .. r.... E:) OOgf.!fflt F!l .. AL'h'-'''' ...111 "'1_ ,,:...._~~_.(k Ire. ...~.. - -... ... --.----- ....u..".:... - "'~;'-':""" :::uti~=i i ~~~~ ~- , ,'., , ~~r-.... T'::-' 1""'"- ~ . "l>""-' > "''''~;;..c :tl" (: . ..~r--~rn~;:! .....;.;;...t < .'~ ~;gg~:r:g~ m ~,-:IHht!.!=t"O 2l;l~!iEiQ~~ S!1la:r:f:' :xl ~11l""'< 0 m0 -, . :D'2 o ~ ~ Capital lllueCross '. :..' ~~t~~:"~~~(I:~~~~:~~~l:lA~~I.~ HARRISBURG, PA. 17177 CHECl<. NUMBER 265151 THE ESTATE OF LILLIE C HARRO 5249 EAST TRINDLE ROAD MECHANICSBURG PA 17055-3552 AGREEMENT NUMBER 204010488 ......................... EXPLANATION OF REFUND ......................... PERIOD OF REFUND FROM: 03/15/2002 TO: 04/15/2002 REFUND REASON: CANCELLED DECEASED TYPE OF COVERAGE: REFUND AMOUNT: SECUR!TY 65 $112.45 TOTAL REFUND AMOUNT: $112.45 .~ ,Q.vf; ,16 . ;3.r! p, 1- cb~~~ ' James Gingrich Memorials . 'Invoice . ~ >,- ',' {':;:;:,i,:'j,:,<;:!rmJi~iim'~!~,:::) '): ',l 'ii. . - 125006 5243 SIMPSON FERRY ROAD MECHANICSBURG PA 17050 5/1/2002 KATHERINE O'HARA 5249 E. TRINDLE ROAD MECHANICSBURG PA. 17050 Item Description ITEM SUMMARY Qty. Price Each Total Inscription work for: HARRO, LILLIE 80.00 80.00 l- I- I- Total 80.00 . cut along dotted line H,.".,",." 80.00. : Lettering was done on: 5/1/2002 .n ___ Please call us with any questions at(111) 166-5622 do,_,.,'.., - ><'i0lDi); Please Send Payment to: James Gingrich Memorials 125006 Family Name: HARRO, LILLIE KATHERINE O'HARA 5243 SIMPSON FERRY ROAD MECHANICSBURG PA 17050 Balance Due 80.00 Amount Enclosed COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND t, J ss: KATHRYNE E. O'HARA according to law, deposes and says that she is the Exe.C'utr-tx of the Estate of LULIE C. HARRO late of --East..--I'ennsoor.o--Townsh-ip- Cumberland County, Pa.. deceased and that the within is an inventory made by KATHRYNE E. O'HARA ._ _. ., the said Executrix of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. being duly Sworn Sworn ~ ~ 2002 ~ ~-r;? ^' 'l-v,,- rf. iS~ il ~ IT A / Eucu-tor . Administrator and subscribed before me, Kathryne E. O'Hara NOTARIAL EAL WILLIAM A. YOCUM, Notary Pub~c Camp Hill Baro, CumLierland County My Commission [)':P!i~:5 J~!f:e ,2.7,2004 j 5249 E. Trindle Road Address Mechanicsburg, PA 17050 Date of Death 11th Day March Month 2002 Y..r INSTRUCTIONS I. An inventory must be filed within three months aHer appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. '" '" ~ ~ H " >- " I- W 0 w ~ '" I- .. W -< 0 .. 0.. I- u 0 V> 0 .Q .. " 0 w '" '" 0 '" >- '" w ~I g .. " l- I 0.. 0.. c I- ..J U. .. ~ Z -< 0 " 0.. 0 U. ..J P< :l: W 0 -< w ,,;. -< > Z '" ~I ... - Z 0 '" c 0 '" " 0 V> Z '" 0 '" H, U Z w -< gl .... 0.. " C .. , - -.: 0 .. A " .... .. E 0 - ..! .. " 0 ..J U u:: co & Inventory of the real and personal estate of LILLIE C. HARRO deceased 1. Savings Account - Susquehanna Valley Federal Credit Union Account #7788-00-0ne-Half interest in joint Savings Account......... $ 3,782 81 2. Checking Account - Susquehanna Valley Federal Union Account #7788-40-0ne-Half interest in joint checking account........ 1,042 75 3. 297 Shares of PNC FINL SVCS Group Inc. owned jointly with her daughter -One-Half interest (less $3,000.00 exclusion)............. 5,014 27 4. Blue Cross-Blue Shield refund...................................... 112 45 5. Rent Rebate applied for............................................ 500 00 6. Refund of excess Burial Certificate payment to funeral home........ 924 05 ...-"\-,,.... ;:.:" d N 3: ==< ~ .--J - ',0 0'. $ 11,376 ~ COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 11128-060'\ REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT YOCUM WILLIAM A 3001 MARKET STREET CAMP HILL, PA 17011 _____n_ fold ESTATE INFORMATION: SSN: 204-01-0488 FILE NUMBER: 2102-0395 DECEDENT NAME: HARRO LILLIE C DATE OF PAYMENT: 05/17/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/11/2002 NO. CD 001194 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $148.07 I I I I I I I I TOTAL AMOUNT PAID: $148.07 REMARKS: KATHRYNE E O'HARE C/O WILLIAM A YOCUM ESQUIRE CHECK# 1740 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS '{?->6-ff-~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. za0601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEKENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSKENT OF TAX '0,' DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-24-2002 HARRO 03-11-2002 21 02-0395 CUMBERLAND 101 JJL -1 :L5 WILLIAM A YOCUM 3001 MARKET ST CAMP HIL L '*' RU-1547EX AFP [l1-0n LILLIE C PA 1~1l (,\ i:' AJlount Rellitted 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 ___ REY=is4j-Ex--"FP-foFiizY-NlfficniF-iNHERITANci-YAX-ApjiRA-iSEiiENT~--"LDiwAN-CnfR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF HARRO LILLIE C FILE NO. 21 02-0395 ACN 101 DATE 06-24-2002 TAX RETURN WAS: I X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Hor~gag.s/No~es Receivable (Schedule D) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) &. Jointly Owned Proper~y (Schedule F) 7. Transfers (Schedule GJ 8. Total Asse~s (1) 12) (3) (4) (5) (6) In .00 .00 .00 .00 7,576.50 4,825.56 5,014.27 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Deb~s/Hortgage Liabilities/Liens (Schedule I) 11. Tot.1 Deductions 12. Net Value of Tax Re~urn 13. CharitRb18/GoY.rn..n~al Beques~si Non-elected 9113 Trusts (Schedule J) 14. N.~ Value of Es~at. Subject ~o Tax (9) 110) 7,683.80 6.268.96 Ill) 112) (13) 114) NOTE: I~ an assessment was issued previously, lines re~lect ~igures that include the total o~ ~ ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal ra~e (15) 1&. Amount of Line 14 taxable at Lineal/Class A rat. (16) 17. Alloun~ of Line 14 at Sibling r.~e (17) 18. Amount of line 14 ~axable at Collateral/Class B rate (18) 19. Principal Tax Due X TS: NOTE: To insure proper credi~ to your account, submit ~he upper portion of this form with your tax P&YIIent. 17,416.33 13.QIi? 76 3,463.57 .00 3,463.57 14, IS and/or 16, 17, 18 and 19 will returns assessed to date. .00 X 00 = 3,463.59 X 045 = .00 X 12 = .00 X 15 = 119)= DATE 05-17-2002 INTEREST/PEN PAID 1-) 7.79 AKOUNT PAID 148.07 NUKBER CD001194 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 155.86 .00 .00 155.86 155.86 .00 .00 .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1, NO PAYKENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU KAY BE DUE A REFUND. SEE REVERSE SlOE OF THIS FORK FOR INSTRUCTIONS.) . Register of Wills of Cumberland County Date of Death: STATUS REPORT UNDER RULE 6.12 Iv ; II ; e c... fJo, r r 0 -..:3-/1-0.1- Name of Decedent: Estate No.: .;;2,0 0;2 -0 03 '1-5" 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 wbether administration of the estate is complete: Yes 00 No 0 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. I is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 00 No 0 b. The separate Orphans' Court No. (if any) for the personal representative's account is: ,;?OO;? -00:; 93- c. Did the personal representative state an account informally to the parties in interest? Yes JZl No 0 c. 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. it: r-j; ~rv-I. (r~' i/d~ fi / 1 ature ~jj,"'U' e E:, (')/-1-0. ro.. Name I L- ~ 'Jd ..6::<4Cf A., / rIYJd/2- Ii " Address /'17 e C!;J C? /71(]. 5 b ({ r'J, fIJ / 7 <J -:5- c) Date: 2ft) '1 -DY , t- C") Lt.. c:r"~ I !flt-"!?'/' -hCljg Telephone No. ,-"", () Capacity: 0. Personal Representative o Counsel for personal representative J Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 2/02/2005 YOCUM WILLIAM A 3001 MARKET STREET CAMP HILL, PA 17011 RE: Estate of HARRO LILLIE C File Number: 2002-00395 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: 3/11/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, " ~ub-~~~ GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge J