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Home My WebLink About04-0976 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: A-\~ev-\- W ~o..\\~\ou~ (j <:. -\ - a), - d- DOL! Date of Death: Will No. d. 00 y - 00 q 7 Lo Admin. No. ;;'OOCj- COO '7 7(0 To the Register: I certify that notice of (beneficial interest) estate administration 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 Ii I h-("". -i- I A I :""" I ' :> b v. "'1 Name Address ~'t-\V\,('\ {V\ .TV\Mc-^,,^ ~lj ~\-\.n_ V,'(>\~~ \' -fNc.C-t" t\\QWVI II f.- Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: \: ~ '0 - l.j . ?ci")~ _ ~~M.\) Ie] 0\ Signature S)~o.----. Address 8.-.1.\ ~u-J \t'\\ <<- ~ \, IY \~ '" t'\.. ~ A,YV\o '" \ \J"\:\-1^ '{ I v~" ~ Vila ( L Yo, n ;;J..'f/ Name ......0 Telephone (/17 L./Vu 3<-111.,. Capacity: / Personal Representative ~ ,. ",' _Counsel for personal representative cr Cumberland County - Register of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717)240-6345 Date: 02/01/2005 INMAN SHIRLEY MORTON 24 MTN VIEW TERRACE NEWVILLE, PA 17241 RE: Estate of SALISBURY ALBERT W File Number: 2004-00976 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) 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 ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 02/07/2005 Your prompt attention to this matter will be appreciated. Thank You. ~~~ GLENDA FARNER STRASBAUGH Clerk of the Orphans' Court cc: File Counsel Judge Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/14/2006 INMAN SHIRLEY MORTON 24 MTN VIEW TERRACE NEWVILLE, PA 17241 RE: Estate of SALISBURY ALBERT W File Number: 2004-00976 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: 10/22/2006 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, Gl~~~:;rt Clerk of the Orphans' Court cc: File Counsel ~ STATUS REPORT UNDER RULE 6.12 BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND , PENNSYLVANIA Name of Decedent: ALBERT W SALISBURY Date of Death: 10/22/2004 File No. 2004-00976 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to the 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: 1/31/2007 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 Orphan's 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. Date: It- ~ l \^~ Signature ~ 'vd LC<..,.LJ:,/in8 'I 1:1"('.(", ..-"\ [, :\,jl I IUO J..tH k)~.J '0i \;,~' nGu :10 W::l3l) MARK A. MATEYA. ESQUIRE Name (Please type or print) P.O. BOX 127 Address BOILING SPRINGS PA 17007 12 :E lid 22 d3S 900Z 717-241-6500 Tel. No. ~') 'Vi" 'O~(1 ~!~j: :~;CY:iH U F ,II ~, _J U......~L.....t\......_~"...., jO 381dJO 03000DJ8 Capacity: _ Personal Representative ----X- Counsel for personal representative J oS. 1Sb MATEYA LAW FIRM A PROFESSIONAL CORPORATION P.O. Box 127 Boiling Springs, Pa 17007 Phone: 717-241-6500 Fax 717-241-3099 www.mateyalaw.com September 19, 2006 Cumberland County Register of Wills Cumberland County Courthouse Hanover & High Streets Carlisle P A 17013 Re: Estate of Albert W. Salisbury No. 21-04-00976 To Whom it May Concern, Enclosed herewith, please find an original and one copy of the Status Report Under Rule 6.12 for the above-referenced matter. Please accept the original for filing and return the remaining time-stamped copy to me in the enclosed self-addressed stamped envelope. Thank you for your usual fine service. If you are in need of additional information or have any questions, please contact my office. I may be reached at (717) 241-6500 or bye-mail at mam@mateyalaw.com. Sincerely, lJ.- f\-, ~ Mark A. Mateya, Esq. mam@matevalaw.com MAM/aa enclosure cc: Shirley Inman Executrix 24 Mountain View Terrace Newville PA 17241 ~ o g ::tJ _ 0 c:::n j , '"T1 F_~,~ _~_- r--.. ~ 2'T~ 8 "< '" -0 ;" ;; ::t:) , ci.c:: tTl " .. ~.""; CJ . 'oJ r-'.' r",., ~ c./i ~ N ~r:J 0 "J(.)O -0 ~-::) 0 >d -n :J:: n +l :.Jl~e a L~acy ~ ~, N T1 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES OEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MA TEY A MARK A ESQ POBOX 127 BOILING SPRINGS, PA 17007 -------~ fold' ESTATE INFORMATION: SSN: 177-24-6906 FILE NUMBER: 2104-0976 DECEDENT NAME: SALISBURY ALBERT W DA TE OF PAYMENT: ~0/02/2007 " POSTMARK DATE: 10/02/2007 COUNTY: CUMBERLAND DATE OF DEATH: 10/22/2004 NO. CD 008769 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $ 1 , 1 47.44 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTORNEY CHECK# 07 SEAt INITIALS: AJW RECEIVED BY: REGISTER OF WillS $1,147.44 GLENDA FARNER STRASBAUGH REGISTER OF WILLS REV-1 SOO EX + (6-00) '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I- Z W C w o w c W I- ~ ~Ul olll::~ wl1.0 ::t:Oo olll::..J ~U1 c( DECEDENrs NAME (LAST, FIRST, AND MIDDLE INITIAL) SALISBURY ALBERT W. DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) o OFFICIAL USE ONLY FILE NUMBER 2 1 -0 4 0 0 9 76 COuNTY"Coi5E --VEAR- - - NuMeER- - SOCIAL SECURITY NUMBER 1 7 7 - 2 4 - 6 9 0 6 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Return (date of death prior to 12-13-82) D 5. Federal Estate Tax Return Required 1... 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) 12,498.24 393.60 (11) (12) (13) 0.00 X _(15) 0.00 22.165_~3 X .045 (16) 997 . ~/l 0.00 X .12 (17) 0.00 1 ,000.00 X .15 (18) 150.00 (19) 1,147_44 10/22/2004 02/03/1920 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) 00 1. Original Return D 4. Limited Estate 00 6. Decedent Died Testate (A\lachcopyofWiIl) D 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (date of death afler 12-12.82) D 7. Decedent Maintained a Living Trust (Attach copy of TrusQ D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) (8) (14) PA 17007 29,900.00 I I f~o j'=g "",0 6,662.15.: )~ g::j "I' :~~~ 8 ..':)-n 'h: :::0 d---l ~;;~ OFFICIAL USE ONLY I- Z W C Z o l1. Ul w Ill:: Ill:: o o COMPLETE MAILING ADDRESS P.O. BOX 127 NAME MARK A. MATEYA ESQUIRE FIRM NAME (If Applicable) MATEYA LAW FIRM TELEPHONE NUMBER 717 241-6500 BOILING SPRINGS r--...J = (::::::') --.. z o i= <C ..J ::::) l- ii: <C o w 0:: 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) C) ,) -l , N :b* :JJ: Q:) N Ul 36,562.15 13.396_<)2 'l'.tJ16~.2.3 ?371G!i.;n 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o i= <C I- ::::) 0.. :E o o X <C I- 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under See. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT o d · C Add ece ent s omDlete ress: STREET ADDRESS 588 NORTH MIDDLETON ROAD CITY I STATE I ZIP CARLISLE PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 1,147.44 Total Credits (A + 8 + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + 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) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check to: REGISTER OF WILLS, AGENT 0.00 0.00 1,147.44 1.147.44 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; ........................................................................... 0 !Kl b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 !Kl c. retain a reversionary interest; or ...................................................................................................... 0 !Kl d. receive the promise for life of either payments, benefits or care? ............................................................. 0 !Kl 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration?.................................................. ... ......................................... 0 !Kl 3. Did decedent own an 'in trust for" or payable upon death bank account or security at his or her death? ................. 0 !Kl 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate properly which contains a beneficiary designation? ....................................................................................................... 0 !Kl IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. CO Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. _ Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. ~ SIGNATURE OF R ON RESPONSIBLE FOR FlUNG RETURN DATE C . ADDRESS PA 17241 DATE j ~ P- o.,. ~ 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% N [72P.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) (i1)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are still applicable even if ~ the surviving spouse is the only beneficiary. o For dates of death on or after July 1, 2000: r- 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, I or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)]. <J c-- 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)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an . .... _'u'-_ '--- _. IM"I nn<> n"lrAnl in common with the decedent, whether by blood or adoption. REV-1502 EX + (6-98) . SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER SALISBURY. ALBERT W. 21 04 00976 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 exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with riaht of survivorshio must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION 588 NORTH MIDDLETON ROAD, NORTH MIDDLETOWN TOWNSHIP, CARLISLE APPROX. 1/2 ACRE VACANT LOT SEE ATTACHED REAL ESTATE SETTLEMENT SHEET VALUE AT DATE OF DEATH 29,900.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 29900.00 REV-1508 EX + (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF SALISBURY. ALBERT W. FILE NUMBER 21 04 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. 00976 ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 1,391.37 M & T BANK CHECKING ACCOUNT NO. 825743-01 2. M & T BANK SAVINGS ACCOUNT NO. 015004200930277-01 ACCRUED INTEREST $0.03 MONUMENTAL LIFE INSURANCE COMPANY PRE-PAID FUNERAL EXPENSE INSURANCE POLICY 2,526.90 3. 2,743.88 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 6662.15 REV-1511 EX + (12-99) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SALISBURY. ALBERT W. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. FILE NUMBER 21 04 00976 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. HOFFMAN-ROTH FUNERAL HOME, INC. 6,324.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State lip Year(s) Commission Paid: 2. AttomeyFees MARK A. MATEYA, ESQUIRE 2,000.00 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City State lip Relationship of Claimant to Decedent 4. Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS 70.00 5. Accountanfs Fees 6. Tax Retum Prepare(s Fees 7. CUMBERLAND LAW JOURNAL - ADVERTISEMENT 75.00 8. THE PATRIOT NEWS - ADVERTISEMENT OF ESTATE 246.24 9. CUMBERLAND COUNTY REGISTER OF WILLS - ADD'L SHORT CERTIFCATES 8.00 10. JACK GAUGHEN REAL TY - REAL ESTATE COMMISSION 3,000.00 11. MATEYA LAW FIRM - DEED PREP 150.00 12. MISCELLANEOUS EXPENSES RELATING TO TRASH REMOVAL 500.00 13. PECKS SEPTIC - SEPTIC SYSTEM PUMPING IN PREPARATION OF SALE 115.00 14. NORTH MIDDLETON TOWNSHIP - ZONING VARIANCE FILING FEE 10.00 TOTAL (Also enter on line 9, Recapitulation) $ 12498.24 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (6-98) *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SALISBURY. ALBERT W. FilE NUMBER 21 04 00976 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. ANDREWS & JOHNSON LEGAL FEES FOR PRPARATION OF POWER OF ATTORNEY INVOICE 419 2. YORK WASTE DISPOSAL INC YORK, PA TRASH SERVICE - ACCT NO. 14-096207 3. SPRINT TELEPHONE SERVICE ACCT NO. 717-249-4214-867 VALUE AT DATE OF DEATH 75.00 37.77 50.72 4. PP&L ELECTRIC UTILITIES ACCOUNT NO. 98300-74004 37.34 5. PP&L ELECTRIC UTILITIES ACCOUNT NO. 98300-74004 OCTOBER 2004 INVOICE 6. PP&L ELECTRIC UTILITIES ACCOUNT NO. 98300-74004 FINAL INVOICE 7. YORK WASTE DISPOSAL INC ACCOUNT NO 14-096207 ADDITIONAL DUMPSTER FEES FOR CLEAN UP OF PROPERTY SITE 8. PP&L ELECTRIC UTILITIES ACCOUNT NO. 98300-74004 7/05 INVOICE 9. PP&L ELECTRIC UTILITIES ACCOUNT NO. 98300-74004 8/05 INVOICE 10. PP&L ELECTRIC UTILITIES ACCOUNT NO. 98300-74004 9/05 INVOICE 11. PP&L ELECTRIC UTILITIES ACCOUNT NO. 98300-74004 10105 INVOICE 12. PP&L ELECTRIC UTILITIES ACCOUNT NO. 98300-74004 12/05 INVOICE 13. PP&L ELECTRIC UTILITIES ACCOUNT NO. 98300-74004 2/06 INVOICE 14. PP&L ELECTRIC UTILITIES ACCOUNT NO. 98300-74004 3/06 INVOICE 15. PP&L ELECTRIC UTILITIES ACCOUNT NO. 98300-74004 4/06 INVOICE 31.65 13.34 277.38 17.04 8.30 8.30 8.94 9.21 8.48 8.19 11.74 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 898.68 Continuation of REV-1500 Inheritance Tax Return Resident Decedent SALISBURY, ALBERT W. Decedent's Name Page 1 21 04 00976 File Number Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens ITEM NUMBER DESCRIPTION AMOUNT 16. PP&L ELECTRIC UTILITIES 17.90 ACCOUNT NO. 98300-74004 1/07 FI NAL 81 LL 17. YORK WASTE DISPOSAL 58.56 ACCOUNT NO. 14096207 8/15 INVOICE 18. YORK WASTE DISPOSAL 57.00 ACCOUNT NO. 14096207 9/05 INVOICE 19. YORK WASTE DISPOSAL 40.05 ACCOUNT NO. 14096207 10/05 INVOICE 20. YORK WASTE DISPOSAL 40.05 ACCOUNT NO. 14096207 4/06 INVOICE 21. YORK WASTE DISPOSAL 41.67 ACCOUNT NO 14096207 10/06 INVOICE 22. YORK WAST DISPOSAL 40.05 ACCOUNT NO 14096207 1/07 FINAL INVOICE SUBTOTAL SCHEDULE I 295.28 GRAND TOTAL SCHEDULE I $ 898.68 '~-""".(* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER f:AI If:BL RY ALBERT W. 21 04 00976 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. SHIRLEY M INMAN Lineal 22,165.23 24 MOUNTAIN VIEW TERRACE NEWVILLE PA 17241 2. STARR KENNEDY Collateral 1,000.00 588 N MIDDLETON ROAD CARLISLE PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, 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 $ (If more space is needed, insert additional sheets of the same size) LF235-04 R235-04 LAST WILL Al\TD TESTAMENT BE IT KNOWN that I, Albert WarnCr Sed ;SbLuy ,aresidentof _ C.2'.....rGll'5l~ . County of Cu-mb"""t...r\ a.nd- ,in the State of Pe.n(\~8i Vavt \ a.. ' heing of sound mind. do make and declare this to be my Last Will and Testament expressly revoking all my prior Wills and Codicils at any time made. 1. PERSONAL REPRESENTATIVE: I ~int Sh 1(le~ ,HOf..ton Jnm'a(l of ()ewvj He..) , ~~ \ \J a:h \ a.. ' as Personal Representative of this my Last Will and Testament and provide that if this Personal Representative is unable or unwilling to serve then I arpoint 'JCcr.:JOie. ~eoo "J:t1rY1Qf) n\dC;e..L{ of ()CWV; \ L) 11:nl'lSqIVQ....r\ ~ ' as alternate Personal Representative. My Personal Representative shall be authorized tol:Urry out all provisions of this Will and pay my just debts, obligations and funeral expenses. I further provide my Personal Representative shall not be required to post surety bond in this or any other jurisdiction, and direct that no expert appraisal be made of my estate unless required by law. II. GUARDIAN: N} A In the event I shall die as the sole parent of mipor children, then I appoint as G1lardian of said minor children. If this named Guardian is unable or unwilling to serve, then I appoint : as alternate Guardian. I III. BEQUESTS: I direct that after payment of all my just debts, ~y property be bequeathed in the manner following: 'Y!eal/G -the tre8ide17ce of 53B fl;~1 /vIidOf/e~r; f1d. (bflIY~ PA fI'1a/ o rnlf d8t1j'I1Ier ShINer U~t:.-/vI7:Ii1/:YJaf7 a!o113 With OJ/ tJp /l7f Jer:5{)()o) teltJfJg J nfS ' ~ I-- eo.. vt ihe tiJta I ()-P /.) Gn S It> rry Scm - ill - /alO fflbe.d:: Uc- Tn('(1an J r. r- /e'4"V~ J-I:ae:e:Ix!17ff'dy ~ tJdd. 0'0' fI/JOl7 mtj cletllb. - i!:PfXJmt CY7/,etey I-ftJ.ebn --1.nrnan as tt(tt lj.dtdeIC..- /P r 110 !or7gen::an bke &Jre 01' 177j'<'5ell'. dtwlS( Testator's Initials {).j1 alfctfC/ltr( J Page _ of _ pages Execute and attest before a notary. Caution: Louisiana residents should consult an attorney before preparing a will. ~ 1992-2001 Made E-Z Products, Inc. Rev. 10101 This product does not constitute the rendering of legal advice or services. nlis product is intended for informational use only and is nOI a substitute for legal advice. Swc laws vary. so consult an anomey on all legal lIl3tt.:cs, This prodUCI was nOl necessarily prepared by a person licensed to practice law in your stale. .....HAS IN WITNESS WHEREOF. I have hereunto set my hand this (year), to this my Last Will and Testament. IV. WITNESSED: 5 daYOer 03 ~~w~ Testator Signature The testator has signed this will at the end and on each other separate page. and has dec1ared or signified in our presence that it is his/her last will and testament, and in the presence of the testator and each other we have hereunto subscribed our names this day of ~~n~€l 7~~ Witness Signature ~ Witness Signature ,20 568 (}()rrn Mltid/e-h:JrJ Jet;( (}JrjJ.;/~, ;:::{;( /713/3 Address /~f~ 6.&htlHQ'WcWd Ad IJ~(/I/;I/e /t? /7c2~1 Address it. /</6, 1/Ic'<<.J "lCrm c ( 'tI.}//; -; / e ~t? / 'Z:'JL// Address ACKNOWLEDGMENT , and the testator and the wiroesses. respectively, whose names ~ signed to the attached and foregoing ins nt, were sworn and declared to the undersigned that the testator signe~ the instrument as hislher Last Will and that each of the witnesses. in the presence of the testator and each other, signed the will as a wiroess. Testator. Atk1J:; (;) ,.-k~ \J State of R;nr64htU11 a... } Count}'of~1~ We. 'Srl.rr E, Kt:Y\necl'1 ~-\- l. "Inma (\ iJa Witness On J U JJ E 5/ a :3 befo;e me, ~H /,if'C~ /~. E,v .u.l:~ Y , appearedh'L8~r aJ. S?fi~::5B UrY . personally known to me (or proved to me on the 6asis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in hislher/their authorized capacity(ies). and that by hislher: ir signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, ex ted the instrument. WITNESS my h CJ cial seal. Signatu ----_.__....---~...--.,..........._-- -,-, ._~,-- .. . ..," Affiant ----KnownLProduced ID TypeofIDt16 668 .003 DRIll E,('S Llc... (Seal) \ . Page _ of _ pages '-.',jl i.: . . . . .w., ;\!".' " 'w ',,_ C. NOTE: 1'1*..... """'III/11w )DlIe"""'lIf 01 diM...".. 0lNfa. AmotIIICe,.lIIellllby ...--.,...,_--.. ..... ....'J"OCl"- ptI/fI,... lire....., - --,.. 1llr1.......AItAI "",.,... ...,."iIt....... ,. - D. sa BUYER: E. NAME AND SS OF SElLER: Noll) 0118 NO. 2102.... A. u.a. DIP~ t1' ___. ......IIlftI!LCP-.n 8Em..EM19fr ITATEIENT s.[]coNv. ..... DOUGLAI L. ZOOK _1tUNMNG PIJI.- ROAD I.JINCA8TI!II.P 17801 ALB!Rr W. SAUSIlURV ESTATE Go MOPIIt''f'LOCATICH: .. NCIImI MIlI:lLa'lON ACW) CMtJS\.lE.PA 1?013 ~~.,..,....-- .. NClftTtt.....1OtfftCW> NOrml......'"* ....... . COI.lN1Y H. RTTLEMENT AGENT: 23-2Ilt1,. M1STRACT ASSOCIATES OF LMCASlER. INC. fIVoCI OF 81mU!Ml!Nr ,. LITl1Z PIKE lNICA$TIR, PA 17101 I. SETIUMENT ~lE: s.p...... 24, 2Oll'7 ./ ~ 3,111.20 The~~ I HAWCAREFUU.YN! ACCuAA1E STATEMENT THAT 1 HAVI! RECeIVED ACO Buy. \ s.n.r ALBERT W. SAUSIlURV ESTATE BY: IHIRLEY MCRTClN 1NMNf. Ea.clllrix TTl.EMENT STAlEMENT WHICH I HAIlE PftI!PNlED IS A TIlUE NfIO NXURAlE ACCOUNT OF TME N at WlU. B! DlS8URSED BY THE UNDf!R8IGNI!D /IS PART OF THe lIE1T1.INENTOF lHlS ~~TlSOFLANCABlER. ..C. WARNING: IT IS "CRIME 10 IQIIOWINGLYMt\ICEFALSE STATEMENTS TO THE UHI'1eOSTATESON1HI8ORANYSIIoIlARFORM. PEIW.TlESUPON CONVlCTlON CAN INCl.UDE A FINE HlDIMPRISONMENT. FORDETAIlSSEE: TITLE 1au.S. CODE SECTlON1ClO1 &SEClIOH 1010. LSElTLEMEHTCHARGES % a.DO -- IInMI FIIIIDIAT __Ilf LOMI III III lei III 10." It $ III III %) .., Ie lei Ie lei lei Ie ~$ ABSTRACT ASSOCIATES OP LANCAS'TER,lNC. SIIIMllIlII..... Cer1Il\lCIle1 ba alNallllPY. .... 2 -- _lUllS ..- AT --.. ~ ./ 1_'_'1) INVENTORY Estate of ALBERT W. SALISBURY No. 21 04 00976 ALBERT W. SALISBURY SHIRLEY M. INMAN , Deceased Date of Death 10/22/2004 Social Security No. 177-24-6906 also known as Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Personal Representative: Name of Attorney: MARK A. MATEY A I.D. No.: 78931 Address: P.O. BOX 127 -).~ !1 ~~ Dated 9/28/07 BOILING SPRINGS PA 17007 Telephone: 717-241-6500 Description REAL ESTATE LOCATED AT 588 NORTH MIDDLETON ROAD NORTH MIDDLETON TOWNSHIP, CARLISLE, PA Value 29,900.00 M & T BANK CHECKING ACCOUNT NO 825743-01 1,391.37 M & T BANK SAVINGS ACCOUNT NO. 015004200930277-01 ""'" C~;I C:;::l --.J S26.QO --l I N MONUMENTAL LIFE INSURANCE COMPANY PRE-PAID FUNERAL EXPENSE INSURANCE POLICY WITH HOFFMAN-ROTH FUNERAL HOME, INC ~43.8a : :.Ji: co N C..rl Total (Attach Additional Sheets if necessary) 36,562.15 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 ~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 INMAN SHIRLEY MORTON c:::::' " ") -~I Date: 9/26/2007 I h) 24 MTN VIEW TERRACE NEWVILLE, PA 17241 v..) U1 -.I. RE: Estate of SALISBURY ALBERT W File Number: 2004-00976 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: 10/22/2007 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, ~d"-~,~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYL VANIA In Re: Estate of SALISBURY ALBERT W NO. 2004-00976 NOTICE OF FAILURE TO FILE STATUS REPORT Personal Representative: INMAN SHIRLEY MORTON Counsel for Personal Representative: Date of Decedent's Death: 10/22/2004 t~ _,) --j ?.... (,,,,,] The Orphans' Court record indicates that neither the above named personalrepresentati\~ nor the above named counsel for, the personal representative have filed with the Register of \Vi1ls or Clerk of the Orphans \ Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme O)'Jrt Orphans' Court Rules, is hereby given by that the you have ten (10) day to file the Status Report. lfthe required 6.12 form is not filed in accordance with Rule 6.12 the Court will be notifid of such delinquency and the undersigned will requests that a Court conduct a hearing to deter-nine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. ~(f (- q j ~ . J'", 1Y ,. I? r ~f" . ..1 ~"P<'"I.!>' ",'" I fi ", ,I " ~d$f_. "~~'(1Zj;,\..j.~ L.. - ,t; , ~ Date: 10/31/2007 Glenda Farner Strasbaugh Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File ! -I.. STATUS REPORT UNDER RULE 6.12 Name of Decedent: ALBERT W. SALISBURY Date of Death: 1 0/22/2004 Will No. Admin. No. 21-04-00976 Pursuant to Rule 6. 12 of the Supreme Court Orphans I 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: 3 . If the answer to No. 1 is Yes, state the following: a. account with the Court? Did the personal representative file a final 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 I Court and may be attached to this report. Date: 11/612097 1.J A- ~:r;:p,- Signato;. - ,.~ MARK A. MATEYA. ESQUIRE Name (Please type or print) P.O. BOX 127 BOILING SPRINGS PA 17007 Address ( 717 ) 241- 6500 Tel. No . Capacity : Personal Representative j. X Counsel for personal representative 1 f~ :.' ! I ("'\ ~ ...", ~, .J (.. i ; I:; :-j-l , ;,Co/ i 4 LI..I0.::'" ) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INOIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX( 11-961 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MA TEY A MARK A PO BOX 127 BOILING SPRINGS, PA 17007 -------- fold ESTATE INFORMATION: SSN: 177-24-6906 FILE NUMBER: 2104-0976 DECEDENT NAME: SALISBURY ALBERT W DATE OF PAYMENT: 12/21/2007 POSTMARK DATE: 12/20/2007 COUNTY: CUMBERLAND DATE OF DEATH: 10/22/2004 NO. CD 009105 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $174.98 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTORNEY \ CHECK# ~8 ~ oU\. INITIALS: AJW RECEIVED BY: SEAL REGISTER OF WILLS $174.98 GLENDA FARNER STRASBAUGH REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRIS8URG PA 17128-0601 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 12-17-2007 SALISBURY 10-22-2004 21 04-0976 CUMBERLAND 101 APPEAL DATE: 02-15-2008 ( See reverse side under Objections) Amount Remittedl I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701~ ~ :::.- c::;:) ~!'-~! CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS ~~Q -..,l :'.' ,:ji - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - _ _ _ _ _ _ _ _ _ _ _ _._.~1_ _ _ _ _ 0 ' '.~'-. ~ REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE:'!~ ,,,-----:-')-- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX' 'S:r-- n '. '! /1'11 f'..) "'-,) ALBERT W FILE NO. 21 04-0976 ACN 101:J~~TE -+2-17,:"2~97 c'--'" -0 " ~~ MARK A MATEYA ESQ MATEYA LAW FIRM PO BOX 127 BOILING SPGS PA 17007 ESTATE OF SALISBURY TAX RETURN WAS: (X) ACCEPTED AS F I LED 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. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets ) CHANGED (1) (2) (3) (4) (5) (6) (7) 29,900.00 .00 .00 .00 6,662.15 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests: Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 12,498.24 f:'[: ",e.. 898.68 (11 ) (12) (l3) (14) REV-1547 EX AFP (06-05) ALBERT w '---r.... ~::j , . ,~ "" N ;-r-1 a n NOTE: W insure proper credit to your account, submit the upper portion of this form with your tax payment. 36,562.15 ]~.396 9~ 23,165.23 .00 23,165.23 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) .00 X 00 .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 22,165.23 X 045 = 997.44 17. Amount of Line 14 at Sibling rate (17) .00 X 12 = .00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 1,000.00 X 15 = 150.00 19. Principal Tax Due (19)= 1,147.44 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 10-02-2007 CD008769 .00 1,147.44 BALANCE OF UNPAID INTEREST/PENALTY AS OF 10-03-2007 TOTAL TAX CREDIT 1,147.44 BALANCE OF TAX DUE .00 INTEREST AND PEN. 174.98 I TOTAL DUE 174.98 * 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 HAY BE DUE A RI='I='IINn. C:;I='I=' R~V~D~r ('Tnt':' ",.. TII'9'ro. ---.. --- ---~-- . ~' ,>.;.,.J. 8~ ~~.c~. f~f!\. ,f."J. i' ~~ -",#~;;, ,""*4. " . ft" i.... I ;::i "_'f':,, .- ~. t-" .' :':5 ~~1 M f"', M 4. n... ~ tb I)) M " tt .s q,. .)# J,. F '1--..\ ;t \.,;>. 1'-', r\ "Q !"l iJ u.l D ("'I V c-1 ~z t-- $ g 0 ~ g ........It" 'j ~Ol.." ,',_ (L_LJI l~,,' ~a: t-- !i::'" \" I~B ~~/ W~..ti,. '~ ..(goo/) ~~;W1':'f!\ ~ ~ U//1! - 'w.. \Ih ) - ,...,.1 ,)'~'V' '0 (L ~ <t == - - - - -:: 'iV, ,(IJ ,i.wa ',-, -:: -:: -:: -:: -:: -:: - - ::::: == ~ ::::: - - - - ''"I t.,. ." t.~ '''t I,~ 1.-' \'fl ii'l (n i'yl .t- it) .,-1 \i.:' \ \'00 ,,-I 12-17-2007 SALISBURY 10-22-2004 21 04-0976 CUMBERLAND 101 APPEAL DATE: 02-15-2008 ( See reverse side under Objections) Amount Remittedl I MAKE CHECK PAYABLE AND REMIT PAYMENT REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 2B0601 HARRISBURG PA 1712B-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ,~.-.'. -,- NOn-GE.p.F,- tt'!t'ERIT ANCE TAX 'AfiP'~*t..$l;"'Eitr~ "ALLOWANCE OR DISALLOWANCE '-OF DEDUCT! ONS ANb ASSESSMENT OF TAX 'j.. ,"" ) 'lr.n"l ncr ? I L 1; U f .J l~.:J '- r' l-c~ n~i I: agATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN MARK A MATEYA ESQ MATEYA LAW FIRM PO BOX 127 BOILING SPGS (:! r::< OF 0,0=<'-;, '('dRT ..fll f"" ' \.;..' PA 17007 * REV-15~7 EX AFP (06-05) ALBERT w TO: 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 SALISBURY ALBERT W FILE NO. 21 04-0976 ACN 101 DATE 12-17-2007 TAX RETURN WAS: (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. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) 29,900.00 .00 .00 .00 6,662.15 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (0) 12,498.24 898.68 (11) (2) (3) (4) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 36,562.15 13.396 9? 23,165.23 .00 23,165.23 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of Abh 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 OS) .00 X 00 .00 (6) 22,165.23 X 045 = 997.44 (7) .00 X 12 = .00 (18) 1,000.00 X 15 = 150.00 (9)= 1,147.44 TAX CREDITS: PAYMENT RECEIPT DISCOuNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 10-02-2007 CD008769 .00 1,147.44 BALANCE OF UNPAID INTEREST/PENALTY AS OF 10-03-2007 TOTAL TAX CREDIT 1,147.44 BALANCE OF TAX DUE .00 INTEREST AND PEN. 174.98 TOTAL DUE 174.98 * 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 DU~ A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE iNHERITANCE TAX STATEMENT OF ACCOUNT *' REV-1607 EX AFP (03-05) \;" H ?;':~ '-' .. \,'~ ,- '... P'; I'): '5:) I ,'" ,.. DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-22-2008 SALISBURY 10-22-2004 21 04-0976 CUMBERLAND 101 ALBERT W MARK A MATEYA ESQ MATEYA LAW FIRM PO BOX 127 BOILING SPGS r'l" Amount Remitted PA 17007 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS +- REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT *** ESTATE OF SALISBURY ALBERT W FILE NO. 21 04-0976 ACN 101 DATE 01-22-2008 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND. IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-10-2007 PRINCIPAL TAX DUE: 1,147.44 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 10-02-2007 CD008769 .00 1,147.44 12-20-2007 CD009105 174.98- 174.98 TOTAL TAX CREDIT 1,147.44 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 * SIDE 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 DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. > (\ 1 STATUS REPORT UNDER RULE 6.12 Name of Decedent : ALBERT W. SALISBURY Date of Death : 10/22/2004 Will No . Admin . No . 21-04-00976 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 l . State whether administration of the estate is complete Yes ~ No 2 . If the answer is No , state when the personal representative reasonably believes that the administration will be complete 3 . If the answer to No . 1 is Yes , state the following: a . Did the personal representative file a final account with the Court ? Yes TJo ~ 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 . ~~`~ ~ ~ Date : 10/3/2008 t- Signature N c~ _ - - ~- ` cL w i - ;-`;.- ;~ __ ~- ~ == c _ C.: ~~ MARK A. MATEYA. ESQUIRE Name (Please type or print ) P.O. BOX 127 BOILING SPRINGS PA 17007 Address ( 717) 241- 6500 Tel . No . Capacity : Personal Representative ~ Counsel for personal representative Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 9/26/2008 --? .~~ :._ INMAN SHIRLEY MORTON "~ `" _, - ~,;. _~ 24 MTN VIF;W TERRACE c.~ NEWVILLE, PA 17241 - , =^. ,= _ ~.~ _~~ `.~ ..- ~J -, .~' RE: Estate of SALISBURY ALBERT W File Number: 2004-00976 Dear Sir/Madam: This notice is to serve as a reminder that the St~~tus 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. 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 witYi the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 10/22/2008 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 Farzler Strasbaugh Clerk of the Orphans' Court cc: File Counsel ~~ Cumberland County - Register Of Wi=Lls One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/:?6/2008 MATEYA MARK A PO BOX 12'7 BOILING SPRINGS, PA 17007 RE: Estate of SALISBURY ALBERT W File Number: 2004-00976 Dear Sir/Madam: c`7 r., [~ <,;-~ C _ O c:~ , -~ ; cra __ ~-' ~_. - - ;~~~ ~ - t _ _ .~ _ . _,- ~ . , :~ W 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. 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 witYi the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 10/22/2008 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, cc: File Personal Representative(s) Glenda Farrier Strasbaugh Clerk of the Orphans' Court