Loading...
HomeMy WebLinkAbout01-0735 " PETITION FOR PROBATE and GRANT OF LETTERS '.. Estate of PAUL G. KEENER also known as No. To: 21-01-735 Register of Wills for the . Deceased. County of Cumber land in the Social Security No. 174-20-7962 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age o.J."8lder an the executor in the last will of the above decedent, dated 1 November and codiciI(s) dated n/ a named , 19-12- (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumber land County, Pennsylvania, with h ; ~ last family or principal residence at 812 Market Street, NEW Cumberland. PA (list street, number and muncipality) Decendent, then 74 years of age, died at Harrisburg Hospital. Harrisburq. PA Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: 812 Market Street, New Ctm1berland, PA 15 March 2001 ,~ $500.00 $ $ $ 4 U , UUU . 00 WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters h~~+-~mpn+-;::ny (testamentary; administration c.La.; administration d.b.n.c.t.a.) theron. '" 'df u C !lJ :2~ '" '-' QJ .... c.::v c ~a c'= C'j'= 3~ Q) '- :; a t\1 c OIl U5 Iii~ ~ St. Bonaventure, NY 14778 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I sc"o COUNTY OF CUMBERLAND J ~ The petitioner(s) above-named sw~ar(~) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer e estate according to law. affirmed and 1st ~ ~. :3 t:l - s::: ~ ~ /t-r:::>-Y'P- / ( . ~o. 21-01-735 " Estate of PAUL G KEENER , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW AUGUST 8 JV) 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 NOVEMBER 10, 1976 described therein be admitted to probate and filed of record as the last will of PAUL G KEENER TESTAMENTARY ROGER E KEENER and Letters are hereby granted to '7#Y~:~?/J~ J~ R~ ter of WI FEES Probate, Letters, Etc. ......... Short Certificates( ).......... x-pag~s . RenunCIation JCP $ 80.00 $ 12 . 00 . . . . . . . . . . . . . . .. $ 6.00 $ 5. 00 TOTAL _ $ 103.00 .... ... .~P~q~T. .1.,. .?9P.~.......... SAMUEL LANDES A ITORNEY (Sup. Ct. I.D. No.) 525 NORTH TWELTH ST. LEMOYNE PA ADDRESS Filed PHONE ~/U~~ 21-01-735 REGISTER OF WILLS OF CUr-1BERLAND COUNTY OATH OF SUBSCRIBING WITNESS Samuel L. Andes ~ (eaek) a subscribing witness to the will presented herewith, ('8aGb.) being duly qualified according to law, depose(s) and say(s) that he was present and saw PAUL G. KEENER the testat or , sign the same and that he signed as a witness at the request of testat~ in hi s presence and (iR the pregeRee of saGh ether) (in the presence of the other subscribing witness(es)). ~) n Sworn to or affirmed and subscribed before ~ me this 1st day of (Name) Samuel L. Andes '?~UST U2001 525 N. 12th Street, Lem:>y!!e, PA 17043 -~.u"~~~"'''r (Address) Register (Name) (Address) REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS ROGER E. KEENER (.eael=t) a subscriber hereto, (eaeIt) being duly qualified according to law, depose(s) and say(s) that he is familiar with the signature of PAUL G. KEENER ~ testat or of (eRe 6f tHe g\l"~{'rihing witne~~e~ to) the will presented herewith and coQieK that he believes the signature on the will is in the handwriting of PAUL G. KEENER to the best of his knowledge and belief. -P~.- / (Name) ROGER E. KEENER P.O.Box lOS, St. Bonaventure, NY 14778 (Address) Sworn to or affirmed and subscribed before me this Is t day of ~ AUGUST ~2001 '~r~-{~~~~"jA' 74..~ Register (Name) (Address) 005.905 REV.(09/00) f h d h' h ' fil the Pennsylvanl'a Division of Vital Records In accordance This is to certify that this is a true copy 0 t e recor w lC IS on 1 e in with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953. WARNING: It is illegal to duplicate this copy by photostat or photograph. No, ~/I~ Charles Hardester State Registrar C\~s. ~~ ~~~..... /5Jr' Robert S,~erman, Jr., MPH Secretary of Health APR 1 3 2001 1797885 Date 21-01-735 (9 HeJ5.'43_.2Illl COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH TYPEIPAlNT IN 'ERMAH€NT RACK _ 2. Ma 1 e STAlE f'lE NUIOIlEA SOCIAl. SECURITY NUMBER 3.174 - 20 i1J SEX 8lRTHPlACE lCoIy ....d ,..... 01 fcr_ Coun/f'" HOSPITAL Lewisberry, PA ~o 1. ... FACIlITY NAME (II....~. ~...... ono""",,*o ... z ~ w ~ o .. o .. :E 0( z .. Dauphin DECEDENrS USUAl 0CC\lI'IV10N (~":=:~'::'.:::2:::r uLElectrician U/;:!im Electric DECEDENT'S loIAllJNG AODAESS CSlr_~. -. ZipCoclel 812 Market Street New Cumberland,PA 17070 ,a. RlrHEIl'S NAME tF".... _ L-'I tL Paul G. Keener lIlFORIoUoKT"S tWoolE (f W*f'nnIl aL C. Bernice Keener UEntOO Of' IlISPOSlTlOH O _e9 ~O __$1...0 ~ 0Ih0N~ 2'L MAAITAl.SWUS ._ __, WIdowM. ilMIn:ed (Spec:lIyI Married ~o RACE. _Indion...... WIllIe..... ~ 10. Whi te SUfMVING SPOuSE (.----- .Bernice Welle 1-". ~ ~ - lYe.. . Cumberland --'1 17..rn~:::.. New Cumberland IolOTHER'S _IF..t. _. _s...name) ~JCordilla Altland 1NF0000000'S IolAIUNG AIlOAESS CSlrWI. ~ Sltoo. Z"op Codal ~812 Market Street, New Cumberland,PA 17070 PI..ACE OF lll$POSlT1()lol. _..~, Ct--.wy LOCRlON. ~,~. ZiI>~ 0< Oth<< _ 2001 2.c.Emanuel Cemetery 2lJ...ewisberry, PA 17339 tWoolEAHOADDRESSOFFACLlTY 1707 n L ~tone&MurrayFH408 3rd St New Cumberlana, PA LICENSE N\lM8ER DATE SIGNED p.tonf\. Ooy. - ) \ \ 1\ \ NoD 24. \C>~ 1. 3 It M. 25. 3 ,s \\ u. MIlT I: E.....IN_......or ~_ea"'.lll'" ""alii. Do _ _..Iho _oI~, suc'...ca'cliac: or '.....alory ..,ost. shock or...... '....... liol_ _ caustOft ...".1iM. 3000. 3010. M. 3Oc. _. PlACE OF INJURY. AI ......... tann. SI'.... toc:lory. otfica LOCATION _. c.o,flown. Stala' buildIol9. _. ,_, aL _ 3000. CERTIFER tCNd< .".,. onoI "CERTlFYlNGPKYSICIAIltphysooan~__d_......,aror. pI1_"'" haspr~de"'" """C~ n.... 231 ,....._of""~,...___.....ceuae(.,__.._....................................... ........ \,,-no. r&\OI\ I : DUE 10 (OR AS" CONSEQUENCE OF): d. MANNER OF DEATH ......... J4 Hornalo 0 - 0 Pendiftg _igalion 0 ...0 NoD Su;cido 0 CoulcInot~_ 0 2t. . AppoJeitMle '-- l....-- : PART .: Olho< ~_<OnI1ibullngIO_. buI not rwsultinQ in 1M ~.... g;.... in PlIlRT l. DATE OF INJURY lMonlh. Osy. _I TIME OF INJURY INJURY /Il WORK? DESCRIBE KOW INJURY OCCURREO. ... 0 NoD .l'AONOUtlCIlIG AHO CERTIFYING PHYSICJAN tphysooan ""'" ",orouncong _ _cOf\llyonQlO ~ 01 de..., To.. beet oC ""~. ._.. oec""," at........ .... Md ptKe, and due to the cauM(.. aftI!t mannef as st.'eeI., 32. lMTE fH.EOIMonlh DaV._1 \\ "trdb"r \\o~. -.DlCAL EllAMIHEIlICOAONEA On the bultI of .._....Ioft and/<< Inve.tlgation,1n my opinion, de"" occu"ed III lhe tbM, dale. and placa, and duato the cauH(a' and _.. sl.Ied... . .. .. .. . .. . .. . . . . . .. . .. . . .. .. . . .. . .. . . . . . . ... . . . .. . .. .. .. .. . 31.. o 34. J\ ,S \ I 3}~), / ~ REGISTRAR'S SIGNATURE AND NUMBER ~~ I'), II~/ /1 # - ~ 21-01-735 WILL OF PAUL G. KEENER I, PAm. G. KEENER, of the Borough of New ClUllberland, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. Item I. I direct that all my just debts and fnneral expenses, including my gravemarker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. Item II. In the event my wife, CLEO B. KEENER, shall survive me, I devise and bequeath our home real estate located at 812 ~brket Street in the Borough of New Cumberland, Cumberland County, Pennsylvania, or any other home which may be our principal place of abode at my death, together with all policies of insurance on said real property, to my wife, CLEO B. KEENER, without liability for waste, for her life or until her remarriage or nntil she no longer uses said premises as a home for herself. Upon the death of my wife, Cleo B. Keener, or upon her remarriage or her no longer using said premises as a home for herself, whichever first occurs, I devise and bequeath the said real estate to my son, ROGER E. KEEl'JER, of New ClUllberland, Pennsylvania, provided he shall survive the death, remarriage, or no longer using said premises as a home for herself of my said wife, whichever occurs first, by sixty ( 60 ) days. -----; 6;;;/~ ~ Paul G. Keener /C~ /?J 1926 Page I of 3 Pages ,. Should my son, Roger E. Keener, not survive the death or remarriage of my wife, Cleo B. Keener, or the time when she stops using the property as her horne, then upon the death of my wife, Cleo B. Keener, or upon her remarriage or her no longer using the premises as a home for herself, which- ever first occurs, I devise and bequeath the property to my daughter, TRACY L. KEENER, of the Borough of New Cwnberland. I direct that my wife, Cleo B. Keener, snaIl not be required to glve bond as a life tenant and shall not be liable for any loss, damage, or destruction of said property, real or personal. I direct that, for purposes of this Item II of this my last will, any sale or attempted sale of the property by my wife shall be interpreted as her no longer using the property as her home. Item III. I devise and bequeath the rest, residue, and remainder of my estate of every nature and wherever situate to my wife, CLEO B. KEENER, provided she survive my death by sixty ( 60 ) days. Should my wife predecease me or be deceased on the sixty-first day following my death, I devise and bequeath all the rest, residue, and remainder of my estate of every nature and wherever situate to my daughter, TRACY L. KEENER. Item IV. I appoint my son, ROGER E. KEENER, executor of this my last will. Should the said Roger E. Keener fail to qualify or cease to serve as executor, I appoint my daughter, TRACY L. KEENER, executrix of this my last will. Item V. I direct that my personal representatives, as well as their successors, shall not be required to give bond for the faithful performance of their duties in this or any jurisdiction. IN WITNESS WHEREOF, I have herelIDto set my hand this , 1976. 10 day of /t~ /...."..-...._~.._..........._- _.../// . / ~ I ~ //t:/ ~. ~:~;G. Keener · // .... Page 2 of 3 Pages The preceding instrument, consisting of this and two other typewritten pages, each identified by the signature of the testator, was on the date thereof signed, published, and declared by Paul G. Keener, the testator therein named, as and for his last will, in the presence of us, who at his request, in his presence, and in the presence of each other, have subscribed our names as witnesses hereto. (~- Q~ ! JUl (\\ /: I' I,.J- "- "-L -~~, (ry-LU; Page 3 of -3 Pages . . ~ 1r E -- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Paul G. Keener Date of Death: 1 5 March 2001 Will No. Admin. No. Z J -ol-OJ sS 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 7 August 2001 . Name Address Cleo Bernice Keener Roger E. Keener Tracy L. Keener 812 Market Street, New Cumberland, PA 17070 P.O. Box 105" St. Bonaventure, NY 14778 812 Market Street, New Cumberland, PA 1 7070 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: 5)0J ~rfr~ Name: Address: Samuel L. Andes 525 N.12th Street Lemoyne P A 1 7043 Telephone # 717761-5361 Capacity: Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX( 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ANDES SAMUEL L 525 N 12TH ST LEMOYNE, PA 17043 -------- fold ESTATE INFORMATION: SSN: 174-20-7962 FILE NUMBER: 2101-0735 DECEDENT NAME: KEENER PAUL G DATE OF PAYMENT: 10/03/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/15/2001 NO. CD 001684 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $211.98 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: SAMUEL LANDES CHECK# 4333 SEAL INITIALS: DO RECEIVED BY: REGISTER OF WILLS $211.98 MARY C. LEWIS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION OEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX SAMUEL LANDES 525 N 12TH ST LEMOYNE DATE ESTATE OF DATE OF DEATH FILE NUMBER ,Q9UNTY 'AtN 11-19-2002 KEENER 03-15-2001 21 01-0735 CUMBERLAND 101 * REY-1547 EX AFP CDI-D2) PAUL G PA 17043i,. Allount Rellitted / cJ'i '13 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 ~ RE-Y=is4j-i3f-iFP--fol-:021--No'Tici--oF-'rtiHiifiTANcE-TAX-APPRAisEifENi"~--AL1-oWAiicE-oR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX PAUL G FILE NO. 21 01-0735 ACN 101 ESTATE OF KEENER TAX RETURN WAS: (X) ACCEPTED AS FILED DATE 11-19-2002 ) 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) S. 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) (S) (6) (7) 21,000.00 .00 .00 .00 4,403.49 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax I~ an assessment was issued pr-eviously, lines 14, 15 and/Dr- 16, 17, 18 and 19 will re~lect ~igures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due (9) (10) NOTE: 6,842.63 1,110.25 (11) (12) (13) (14) 12,739.86 X 00 = 4,710.75 X 045= .00 X 12 = .00 X 15 = NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 25,403.49 7.952 88 17,450.61 .00 17,450.61 (19)= .00 211.98 .00 .00 211.98 TAX CREDITS: . ~" ..on. ....-..... . I (+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 10-03-2002 CDOO1684 .00 211.98 BALANCE OF UNPAID INTEREST/PENALTV AS OF 10-04-2002 TOTAL TAX CREDIT 211.98 BALANCE OF TAX DUE .00 INTEREST AND PEN. 10.43 TOTAL DUE 10.43 . 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 REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) 'v /~-r:JY9-~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH ~) FILE NUMBER COUNTY ACN 11-19-2002 KEENER 03-15-2001 21 01-0735 CUMBERLAND 101 SAMUEL LANDES 525 N 12TH ST LEMOYNE PA 170-43 *' REV-1541 EX AFP (01-02) PAUL G Allount Rellitted ) CHANGED (1) (2) (3) (4) (5) (6) (7) 21,000.00 .00 .00 .00 4,403.49 .00 .00 (8) 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 ~ RE-Y-=is4j-EX--AFP--foi-':oi-f-NOTicE--OF-i-tiHERiTANCi-TAX-APPRA-isEii€Ni'~--Aii-oWANCE-oi----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KEENER PAUL G FILE NO. 21 01-0735 ACN 101 DATE 11-19-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED 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 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax I~ an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due NOTE: (9) (10) 6,842.63 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 25,403.49 7.952 88 17,450.61 .00 17,450.61 (19)= .00 211.98 .00 .00 211.98 1.110.25 (11) (12) (13) (14) 12,739.86 X 00 = 4,710.75 X 045= .00 X 12 = .00 X 15 = TAX CREDITS: . ". ...... r . Kt:l;t:~rl (+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 10-03-2002 CDOO1684 .00 211.98 BALANCE OF UNPAID INTEREST/PENALTY AS OF 10-04-2002 TOTAL TAX CREDIT 211.98 BALANCE OF TAX DUE .00 INTEREST AND PEN. 10.43 TOTAL DUE 10.43 . 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).1 YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ANDES SAMUEL L 525 N 12TH ST LEMOYNE, PA 17043 ____n__ fold ESTATE INFORMATION: SSN: 174-20-7962 FILE NUMBER: 2101-0735 DECEDENT NAME: KEENER PAUL G DA TE OF PAYMENT: 12/02/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/15/2001 NO. CD 001900 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $10.43 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: SAMUEL L ANDES ESQUIRE CHECK# 4408 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS $10.43 MARY C. LEWIS REGISTER OF WILLS -'7 -~ 'Y9-/ ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-1n7 EX AFP (01-03) SAMUEL LANDES 525 N 12TH ST LEMoYNE DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNT)' ; ACN 01-21-2003 KEENER 03-15-2001 21 01-0735 JCUMBERLAND 101 PAUL G Allount Relli tted PA 17043 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, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-V = 16'ifj-ix--AFP--foi-:031-------...--iNirERITANc'E--yiX--sT~rfEM'E-tiY-O-F-ic-couirf--...---------------- ----- ESTATE OF KEENER PAUL G FILE NO. 21 01-0735 ACN 101 DATE 01-21-2003 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-19-2002 PR I NC I PAL TAX DUE: ........................................................................................................................................................................................................................... 211.98 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 10-03-2002 CDOO1684 .00 211.98 12-02-2002 CDOO1900 10.43- 10.43 TOTAL TAX CREDIT 211.98 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 Ii IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) SAMUEL L. ANDES ATTORNEY AT LAW 525 NORTH TWELFTH STREET P. O. BOX 166 LEMOYNE, PENNSYLVANIA 17043 TELEPHONE (717) 761-0361 19 April 2005 FAX (717) 761-1430 Glenda Farner Strasbaugh Clerk of Orphans' Court Cumberland County Court House 1 Courthouse Square Carlisle, PA 17013 RE: Estate of Paul G. Keener 21-01-00735 Dear Ms. Strasbaugh: I represent Roger Keener, the personal representative of the above estate. We recently received notice of a hearing in June because my client had not filed the final status report. I filed a First and Final Account on behalf of my client several weeks ago and it is scheduled for confirmation by the Court at the end of April. At that time I will file the final status report. I request that the hearing scheduled in June be cancelled. Sincerely, sa~ le cc: Mr. Roger Keener 41 (11 (JJ( .; Name of Decedent: STATUS REPORT UNDER RULE 6.12 PeA\}..\ 6. J(<.-e.Nt"r 3}/S/OJ Date of Death: Will No.: Admin. No.: 200/- 0013 S; 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 0 No~ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: ~\~~;..., 9 0 ~.'S 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 0 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 0 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~re . _..... Date: ~ 03 _ __J~ Si re 50'\ fV'.l.Ae , L. .A-t-J~ Name Sz-s tv. 12..~. S+~ Le(V'loYr-Je P A J 70'fI Address (. (II) r" I S;-3'" elephone No. Capacity: Cd Personal Representative .P9 Counsel for personal representative , .. Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 2/07/2003 KEENER ROGER E PO BOX 105 ST BONAVENTURE, NY 14778 RE: Estate of KEENER PAUL G File Number: 2001-00735 Dear Sir/Madam: It has corne 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. 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 will become delinquent on: 3/15/2003 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, DONNA M. OTTO DEPUTY REGISTER OF WILLS cc: JFile Counsel Judge REvlI50GEX(6_ODI COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 INHERITANCE TAX RETURN RESIDENT DECEDENT o 1 YEAR I- Z W o W () W o DECEDENT'S NAME (LAST, fiRST, AND MIDDLE INITIAL) Keener Paul G. DATE Of DEATH (MM-DD-YEAR) ..--- REV-1500 i:);,;;FICIAL USE Ol\j~_V FILE NUMBER 2 1 COUNTY CODE 0735 ----- NUMBER SOCIAL SECURITY NUMBER DATE Of BIRTH (MM-DD-YEAR) 174 20 7962 Q 1. Original Return o 4. Limited Estate o 6. Decedent Died Testate (Mach copy of Will) o 9. Litigation Proceeds Received THIS RETURN MUST BE fiLED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER w '"' ~:g;U) "",,,, ~~g ,,"'-' .... .. '" o 2. Supplemental Return 0 3. Remainder Return (date of death prior 10 12.13.S2j o 4a. Future Interest Compromise (date 01 death alter 12-12-82) 0 5. Federal Estate Tax Return Required o 7, Decedent Maintained a Living Trust (Mtocl'lOOflyclTrust\ B. Total Number of Safe Deposit Boxes o 10. Spousal Poverty Credit (dala oldealt1 between 12-31-91 and 1-1.95) 0 11. Election to tax under Sec. 9113(A) (Attach 500 0) !l')...J .' ,ili!' M.~f 9t.:1i'!;'TP;" COMPLETE MAILING ADDRESS 525 North 12th street Lemoyne, PA 17043 >- z w c z c .. .. w '" '" o " ,fI ',I NAME Samu 1 L. nd FIRM NAME (ll~} TELEPHONE NUMBER 717 761-5361 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) z o ~ ::l l- ii: c( () W 0:: 3, Closely Held Corporation, Partnership or Sole-ProprietQrship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Scl\edule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probale Property (Schedule G or L) 8. Total Gross Assets (total lines 1-7) 9. Funeral Expenses & Aclm.lnislralive Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) (1) 21,000.00 (2) (3) (4) (5) 4,403.49 --'OFFICiALUSE ONlV-- (6) \.'- (7) (8) 25,403.49 (9) 6,842.63 (10)1,110.25 (11) 7,952.88 (12) 17,450.61 (13) 12. Net Value of E:state (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) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 17, 45 0 . 61 z o !c( I-' ::l ll.. :!!: o () ~ 15. Amount of Une 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable al sibling rate 18. Amount of line 14 taxable at collateral rate 19. Tax Due 12,739.86 4,710.75 x.O_ (15) 0 x .042- (16) $211.98 x .12 (17) X .15 (18) (19) 211.98 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 20.0 >>' all URE; ToAtilllWl!RAI.L:QUESTIOIllS Ol'f l!VIi sf!. IP 'AlilllRECHECK'MATH<'<" Decedent's Complete Address: STREET ADDRESS Q12 Market Strppr CITY New Cumberland I STATE PA I ZIP 17070 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 2. CreditsJPayments A. Spousal Poverty Credit B. Prior Payments C. Discount 211.98 Total Credits (A + B + C) (2) 0.00 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the DVERPAYMENT. 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. (5B) Zf I. 'I &" 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 IZI b. retain the right to designate who shall use the property transferred or its income; ............................................ D [g] C. retain a reversionary interest; Dr.................. ......................m ......................m......................... ... 0 IXI d. receive the promise for life of either payments, benefits or care? ............ ........................................... ............. 0 IRI 2. If death occurred after December 12, 1982, did decedent transfer property wilhin one year of death without receiving adequate consideration? .. ...................... .................... D [K] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ... D IKI 4. Did decedent own an Individual Retirement Account, annuity, or other non~probate property which contains a beneficiary designalion? ... ................... .................. D [ZJ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of Iher than Ihe I representative is based on ail informalionofwhich preparer has any knowledge PONSIBLE FOR FILING N LfIIS DATE 2'1 S ADDR S2S NORT'H 12t-h Street-. LernovnEe. PA 17043 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 dealh on or after January 1, 1995, the tax rate imposed on the net value of transfers 10 or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)]. 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 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, Dr a stepparent of Ihe child is 0% [72 P.S. 99116(a)(1.2)]. The tax rate imposed on Ihe net value of transfers tD or for Ihe 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. 39116(a)(1.3)J. 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-l502EX + (1.97) . SCHEDULE A REAL ESTATE COMMONWEALTH OF PE.NNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Estate of Paul G. Keener 21-01-0735 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 prica at which property would be exchanged beween 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 right of survivorshi'" must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF OEA TH 1. Residence at 812 Market Street in the Borough of New Cumberland, Cumberland County, Pennsylvania. The residence was in an advanced state of disrepair. The value of the property on the date of death (see appraisal attached) $21,000.00 NOTE: This property, in accordance with the will of the Deceden a copy of which is attached hereto, was left in a life estate to the Decedent's wife and widow with a remainder to the Decedent's son. Please see Schedule K which is filed with this return. TOTAL (Also enler on line 1, Recapitulation) $ (If more space is needed, Insert additional sheets of the same size) $21,000.00 FraamanRealEstals ~ UNIFORM RESIDENTIAL APPRAISAL REPORT FU.No. 812 Markel Street New Cumberland t PA C e 17070 C u Cumberland 26-24-0 11.279 o 1 .0 00:" PUD Condomlnlum a eft ce42-41 Owne, AonI lenan'! KOA N/A susTract 108 NfA 0.00 Vacant F.. 8ora. a Current Owner Keener t leasehold PrDctT e f New Cumbertand DaN/A M D. 1.andu..ehaJIg. ~N"lIkaIy OUl<o~ Olnprocus To: reslden iat in character. Faclors that affect the markllabDIIyotthe properties lnth. ~ (prmtty \0 employrnam and amenltlss, employmonlslabUIty, appeattomaOOl~ etc.): The sub'ect ra ert Is situated in a nei hborhood in which the residential ro rties are for the m sl art similar and/or com atibJe with one an ther as to a desi n etc. The area en'o sase of access to ho in schools aod e \ mant centers. There are no adverse market trends. Addr" 525 N 12th S\ Lem ne PA 17043 Address 3920 Market Steam Hlll PA 17011 Predominant !l!l!e am y OUlI!Q P<<Ihnllanduu'% PRICE AGE"" occupancy $(Ooo} (yrs) One family eo o Owner 0-5 20 low ~5 2-4 family 5 o 1llnant 175 100 MulU-lamJly 5 OVacalllW.5%1 p,- Commamial 1 85 55 Market (:ondilions In the subject neighborhOOd Qncludlng &.uppart jar liIe a\l(We conclusions relale~ 10 !he trend 01 property values, demand/supply, and marlcetirw time - su(:h as data on competitive propll1ldS lor sam In the neighborhood, dascrtplion of the f1re~al8fltfl 01 sales and financing cClfmesslons, etc.): The demand/flU , ratio is in balance as evidenced b the e.bs r lion rata of those hcmes ex osed to Ihe market. ProJKt InfDrmatlon lor PUo. (H appBcable). -Is the developarlbulklar In cGlItml oj tile HOIl1ll Owners' Association (HOAJ? Yes No Approxlmatalotal numberot units in the subJecI project N/A Apllfoxlmate row number 01 units lor uleln the su1l18(:1 project N/A Dltlcrtbe common eI ments and recreallonal lacUltles: NfA Olmanskms 8OX100 Topography level SiIa area 8 000 Comer lol ~ Yas 0 No Size tical for area Specnlc zoning cIBsslllcatiOl1 and descrtpllon R-1 residefltial sin Ie fiilml1 Shape rec/an utar ZonIng compUanCfl ~ lBgal 0 lBgal nonconlorminQ (GrandtatMredusel 0 UllIVaI 0 N020nlng Drainage ade uale Pe e u er View avera e OlIlar Otl-ellelrnproVem6nll Type PublIc Prlvate Landscapll\\l ads uate Street macadClm [gJ 0 Driveway Sut1&c6 mace.dam Culb/gllttllr concrete [XI 0 Apparent easemanlll none Sklewalk N/A 0 0 FEMA Special Rood Hazard Area [8J Yes 0 No Street lights fgJ 0 fEW Zone B Map Date BI92 torm se Ie macadam M N. 420 66 ComlTlllnls (apparent adverse easemenls, 8Ilcroa(:hments, spltClal assessments, sUde areas, Illegal or legal rnmconkmnlllO:umlng Use, etc.): There are no il srent adverse easements conditions or encroachments. BENERAlDESCRIPTION No.afUnlls 1 No. af Stories 2 lypa(DetJAtt.) Det llasign(StjI.) 2 ErJslinWProllUud E::.;is\ifl Au' (Vrs.) 90 EflllctlveA II 11i. 70 ROOMS Fo Ilf vln B e nl 1 2 AnfshedBreaebDwe de (:onlalns: INTERIOR. Materials/Condltioll floors car et hrdwdlfair Walls lasterJfair- oor Trim/fInIStI wootlf oar BalhAoor as h tilelfalr BalhWalnsco! Ie ter/fair Doors wood/f ir OOERlORDESCRlI'1KlH FOUNOAllON BASEMENT Foundation stone SIal> AreaSlI.Fl 750 ExIeriorWaDs insulbrick CliwtSp'Ml6 % Anlshed 0% RoolSurlacll as h/shn I Basement 100% Bsmt CaIIIno Gult8rs & Ownspts. Iv.laluminum Sump Pump none W.. Windowlype double hun Oamp/llSs none Roar StmmlScr'6nli some Setllemont none OutsldeEn!ry ManlllacturcdHouu. no Infestation .s ni io n n F R R # . 3 INSULATION RDW_O Cel~ng_D Walls_D ADm_O __0 UnknoWlL...- {gJ O!tle Area 750 750 750 warm ajr coal on lair COOLlNG. Cenl1aJ 0111.. Coe oe AddItiooalfealus&s (sP8c1al8flergyefficientltelll5, etc.}: nOM 1 Bath S' 1500 S uaTllFeelolGros ll'Jin Area AMENlllES CAR STORAGE: fYtpl'Ml&(5},_ONone 0 Patio 0 GafiQIl # Gfcars aeel( 0 Attached Porch 0 Detached 1 Car fence 0 Bulll.ln Pool 0 Carport Mvewa macadam 7 Rooms' HEATING Type Fuel 3 Badrooms' KITCHEN EaulP. Rafffljeralor 0 R"'1I~Ov.. ~ Disposal 0 DIshwasher 0 Fan/HoDd 0 MIcrowave 0 Washe~ er CoodIIIonolthelmprovemenlS,deprllclatlOfl(pbyllcal,lunc.tIunal,arnltxtllmal},lepalrsnrmllell,ljUalityolconstrucUon,remodeUng/addltions,etc.: in a fair to oor slale of re air evidencin a low-level of care and maintenan Thedwellin is Adverse enw-Ol\I'Ml\IiI toI\dmoos (such n. but not DmlUld 10, hazardous wastes, toxic substances, etc.) pIIlsenlln the Improvements, on the site, or In Ihll immediate vlclnlty 01 the sub!m:t property.: None Ob eNed fraddle Mac Form 70 6193 PAGE 1 OF2 Foon UA2 -"lQTAl2000 f01Wlndows" appraisal software by a la mode, inc. - 1.800-AlAMODE Fann16 Matt Form 1004 6193 ~ V.'v"'"" ,,,,,,, UNIFORM RESIDENTIAL APPRAISAL REPORT FII.N,. ESllMA1F.O S/TEVALUE . ....._.. .. n_.. ..:= $ 20000 Commllnl5 on GostApproach (slIch as, source of costllslimate, aIta value., ESTIMATED REPRODUCTlOllI COST.NEW-OF IMPROVEMENfS: SQllaJItoot calcula~on BlKIlar HUn, VA and FmHA. Iha esllmatlld remainlnll Ol#relllnll Sq. Fl. @$ ... $ at:onoinlc Iik of 1tl& property): The co-"I annroach 10 value is not Sq. Ft. @$.. ulilized due to the extreme difficult in estimatin a ctude "" deorecialion bolh ohvsicsJ and functional. GaralleJCasport_Sq.FI.@$ T alai EsUmal8d Gosl New _ _ . less PhysIcal Oa.pceclatioll ! DllpnlllJatlldValulallmprovlRlIJI1s "As-fs'VahJe 01 Site ImplovlIment5 . INDICATED VALUE BY COST APPROACH. ITEM I SU8.lECT 812 Markel Streel . Address New Cumberland ProxlmitvloSuhlect SaJesPrice prir.A/GroscLllllnnArel DataanlVor VBrillc~llnnSourcA VALUE ADJUSTMEms Sales or Flnal\c\!\g Concecsjnns O:llenlS roll lm:alinn lllilsllhob1/fM.'llmnle "" VI.w n~~lnn and Anneal nllalltvnfr.nns1nlcllon '" CnMJtlon Abo~ll GladD Room CoWl! GrossUvlnaA.cell. Basemllnl& Finlshlld '"m. "I'w "0', FlIncllnnalllfilltv HnlinnJConlinn !to Porch,Pallo,Deck, AflInla..efsl ele. I. Functional Inspected DESCRIPTION . . ood Fee $imole rJood a\lera06 2Storu/(air averane 90 fair/noor lola1\ Brlrms: Baths 7 : '3 1 1 500 So. Fl 100% Bsmtl 0% Finish Ivoical CWAlnone none 1CarDelGar Palio none .-...$ ""mal -I ....... -I .. ............ ....-1 '......... .. COMPARASLEOO.1 6 UmbertoAva New Cumberland .5 miles NIA COMPAflABlE NO. 2 407 Water Street New Cumberland .Smiles COMPARABLE NO. 3 438.5 Water Slreet New Cumberland 5 blocks NIA '" II 15.00 <PI Multi List Service/Court House Records DESCRIPTION : +1-l$Adlusl CorlV. '9500 .. I. It.: 17.78 rfj Multi List Service1Court House Records OESCRIPTKlN : +1-)$ Must. Cash .IS 26000 26.00001 .... Mulli list Service/Court House Records DESCRIPTION + -$ AdIust. Cen\'. on 7/00 : nood : Fee Simole : oood : i1veraoe 2Slorvlfair averaae : 50 fair/averaoe lota1\Bd/Tlls\ Baths' 5 : '3: 1 " 1000S fl.: 100% Bsmtl 0% Finish eaual : EBB/none : 16000 none 1101 ood Fee Sim Ie 0000 averane 2 Storv/falr aver::uu> 50 falr/oor Tol:Il :Bd s: Baths: 5 : 3 ; 1 1300 Sn.Ft.: 100% 6smtl : 0% Finish Ivnica/ OFHAlnone none 2101 laoed fee Simols laaod 8veraae 2 Storv/fair 18ve(SOe 50 fair/coor Total : Bdtrns: fllI.ths: 5 : 2 ; 1 : 900 Sn.F1.: 100% Bsmtl 0% Finish tvoical OFHAlnone rlanl'l OffSlreet P,arkiT\o : Patio -10 000 +1000 +3000 +2 000 none 1 CarDet Gar Patio none none none +2 000 none Porch none 5000 ........ : +3 00 A . 10 + -:$ 1000 IX1 + 1 5000 Ad~."'SJI..P<lc. ., I. I '., 'II 01 ComDmbla '-',,' 'cis 20500" :It 21.000'-15 21000 CommM!s Oil SaIlS Comparison QncJudtllQ the subJectprap&tly's C(lmpl\tIbI~ to 1he neIghborhood, fic,): The three com arable sales studiad have an adiusted sale orfce ranae ~f 9;20 500 to $21_00'0. Aooraiser seteco.ts B va.lue of ~21 000. ITEM SUBJECT COMPARABlE MO. 1 COMPARABLE NO.2 COMPARABLE NO.3 Date. Price and Data SOUTClI, lor PIlar sales N/A N/A NlA N/A lIlilhln\l1larolannralBa\ Analysis 01 any ClUJ6I\t agrement ol salt. option, or Usling 01 subject property and analysis 01 any prior sales III subJecl and compaf1lbles witllln one ym of the ili\j olllPpra\saI: NIA INDlCATEDVALUEBYSALESCOMPARlSONAPPROACH _... ... .... ... ....._........,.__........._...............__..._. $ 21000 IHDICAlEDVALUE BY INCOLlE APPROACH fit AODUcablel Estimated Markel Rent - S. /Un. X GillS\> Rent Multiol\er - ThIs &pIO$a1ls made .~ 'as Is' ,U ,subject to the repairs. alIeratlolls, lnapscllons orcOtldlliQl1s IJsted below U liubjscl.to~tion per plus & spscllicalians. Comftllon! 01 AplKatsal: As nrevious\\l feferenced the dwellinn is in a fair 10 noor slale of reoair. Anal AecQllcmaUon: Full weinhl niven to the market dal::! annrOBcn. ThBll\IijIDSllollllls appl1llsal is to estimate Iha market value olll1e ruJ proj)llrty that Is the subject ollllls-report. based on the above ccmdit1orIs. &f\d tM ceflifitallon, cDn'ling,nt andlimJlingcondltlons.indmarl\etV'ilued8lln\1lDJ\lhatarestalsdlnlheallac~dfreddJeMacFonn4391FNMAlonnl004B(Aevjsed I. _ I (WEI ESTIMATE THE MARKET VALUE, AS DEFINEO, OF THE REAL PRCPERT'f THAT]S THE SUSJECT OFTHIS REPORT, AS OF JuJv 17 2001 (WHICH IS THE DATE OF JNSPECnON AND THE EFFECTIVE DATE OFTHlS REPORTj TO BE $ 21 000 APPRAISER; ~~ j SUPERVISORY APPRAlSEfl\OOLY IF REQUlREO): SIonabllll~" StanalLlTll Name Terrv E,... eeman Name OateReoortSloned Julv 18, Z001 leA 81 ed State Certification II R1..000563-l S\iIe PA S~rrtR rJlrtltlcrlllml,ij Or Slaw lilianse II Stale Or State lltwe" FreddleMacFonn70 6193 Om' DOIdNm llIspec.tProperly ". Slala PAGE20f2 Form UA2 - 'TOTAL 2000 for Windows' appraisal software by a III mode, irIc, - t.800-AlAMOOE FannIe Mae FOllll 1004 6.93 FW.73AW /df! .{,;4-f Cl 19BO Forms snd WOrmslr\<:. SKETCH ADDENDUM /,40v ~ -Z 5f: ,..,t '/cy ' 1- ,dfYtr: ' +- 4fhCv ?Q-' ;;?r.' , AU Fllghls Reserved 1 (8001243-4545 Ilem-II?910 [fuill DEFINITION OF MARKET VALUE. The most prabable price which a property should brlng In II competflive and DPIll markat llndor all condl\lons requlske to a lair sale, thllbIlYBf811dseJler,eachactlngprudenUY,lr.nowItd\leab\1andaS8umlngtllllprlcels nat alft<:ledllyundulIstimuJus.lmpJlcitinttlls. detlnilion Is the consununatton 01 II sale as of a speclffed dalB and the puslng of title trom ,ft to buyer under condllions whlflby: (1) buyer and seller are typIca\ly JnOfutalBd; (2) both parties are well iIlfosmed Dr well advised, and uch acling In what lit. conslders his awn basi inllIrm; (S) a reasonable Urns Is allowed lor llllpOStlre In 1t\e 0jlCJl market; (4) payment Is madam tenns 01 cash 1Il U.S. dollars or In terms 01 fInancial anangemems ComparablflthCfllIo; and (5) the plica f8pr8S11nls thBnosrnalconsldatl.tklnlotltlepropertysold unalfecled by sjlKlal or creative f1nancJng orures conca ssfons*grant&dbyanyOSl6llssDClatedwltt1 Ihasale. .. Ad~slm8nls 10 the comparables mllst be made: lor Sptclillll eJeatlvellnanclnll or sales concessIons. No adjustments 8JlI nllCtlSSalY lor those costs whlclJ II'lI nonnally paid by lleDers as a ruultallradltioo Of li.w ill a maikdt area; lhBS8 cos15 arll readUy Identiflablll slnclIthll sllnllrpays these cosls In vlrtually all sales transactions. Spec!al or ct6itj'lll llI\incllig adjus'anent& can be mada to tha cOmpaJable Jlfopafty by compasisD1\.6 to financing lerJlla offeredbya thfrdpartylnstilUtionall6rnllll"Uw,llsnol. ilfaally involved In lhe prGpllrty ar transaction. AAyadjustmllnlslktuldnotbecalcubiladonamechanlcaldollartordoUarcasta!ttle1inWll1l0fconclIss10n but !he do!lar amount of &rIY adjustment should approxlmalelhe mSlbt's re~cllon to lhllllnanclng or concuslons based an ItIt appra/ser'sJLldgllment. STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION CONTINGENT AND LIMITING CONDITIONS: 1M aPlKilser'5 ccrtille&llon '!hat appears In ths appraisal rsport Is subject 10 Iho following camllliOlls; 1. The appraiser will not be responsible lor matters of a legal mill thatatlact Iith6r UIt pmpel1y beinll eppralsed or IhB l1tle to It The appraiser assumes 1hat thIItltifIls good and mar'kelabJs and, thereforll, wiJI not render any opinions aboullhe We. Thepro~ Is ap~lslld onthll basis at ttbll]ng und8rresponslble owl\&shlp. 2. Thaapplllserl1asprovidedllskstchfntillJlppraJulreporttoshowapprOldmaledlmens]onsoflhalmproV6ffimtsllfldltlllllke\chlslncludltdonlytouslsl thereaderollhereportlnvisuall2lngthepropllI1yandunderslandlngtReappralse(sdetllrmlnationolllsslze. 3. ThII appraiser has exam1ned ths avaUable flood maps !hat arfI provIded by Iht Foderal Emergoncy Managemern. Agency (Of o\her datb sources) and has nottld Inlhc appr&lul report whfIther the sUbJsci sIlc Is localad In anldentifiad Special Floorl Hazard Ar8il. BecluS8 the appraiser Is not a SUNeYGr, l\8 or she- makes nogu81antees,eJqlressorlmplilld,regardklgthlsde\lIJTIlina1ltm. 4. Tha appt1.lsllf will not gln testimony or appsilf 1n court because ha or she mada an appraisal 01 the property In Question. unless speclfu: amJIg~15 to do sohavebellnllUldebelofllhand. 5. The appraiser has Mtimattd tt\6 va1u8 of the land In the casl approach at lis highest and best use and lhalmprovemenl/i at !heir contributory 1/ail14.1MtlI separalevaJuatiOllsoftheJandandlmprovementsmuslflGtbeusedmconjlmctionwlthanYolhsrappralsaJand are InvaDd " they are soused. 6. The appraiser has noled In 1M appral$i\ ftpO!tanyadversecomlllions (such as, needed flIpalrs, depreclaMon, the praunce of hazardous wastes, toxic 6ubstancas, elc.) obseNeddurinlltMlospeetionoflhesubject(lf Qjl6rty Of Itlat he or 8M became awara.o f during the normal research lnvolvad In parlormlnu lheappralsaJ. Unl/lssOtherv..ueslallldln!heapprafsalreport.theappraf5l!rhunoknowltdgeolllllYblddenorunapparan! coodlllonsofthepropanyor adverse environmental conditiorls (IncJudillg lI1e JlT8sellce ol hazardous wastes, toxic sllbslanca8. etc.~ that INOOld make the property more or less valuable, and lias assumed 1hat 1Im'e are no such condlllons and makes no guaranteea or warranties, express or implied. rllgacdlng the canditlon of the proparty. The appraiser will not be rell!)\lll&lblelor any such condIllons 'that do sxlsl or for any englnoering Of testinlllhat might be requirod 10 dlseover wMtMr sitch eondllionsexisl BecausatheappcalsarlslKltsneXjlertlnthsfleldotenvlronffientalhaz.ards, ttJeappralsallllportmuslnolbeconsldetadasan environmental assll5sment 01 the property. 7. 1he appraiser obla/ned Ihe Intonnation. 4atimaW, ern! opII\lorls 1ha1 W81ll expressed In !lis appraisal report from sources that he or she consIders 10 be reliable and b~Uev8s them to be true and cO/Tl!{;l The appraiser does not assume fe$pooslbllitt 10r the aGeuracy of such IIsms thai werelumlshed by other partles. o. The appraiser will not disclose the conlents 01 !he appraIsal report llXl:ellt as Pfovldad to\" lIllht UlIlfQfm Standards of Professional Appraisal Practice. 9. TheappraJsefhas bas8dhJs or her appreJsaJ report and vaJuatlon conclu&lontor an illIBsalthat Is sub)e cttosallslaclorycompJl5tloll,repalrs,ot allerallons on the assumption thai complellOll of the Improvements wIU be perlormed In a workmanlike ntafIMf. 10. The appraiser must provide hIs other prlorwrlllen consent bstore lha terKlsr/cU8nt.s~ 1n1lle BWI!8lsalf&pl)ltCill dlstribu18lhe appraisal report (lnclumnllconcluslonsaboutlhepropsr!yva/Ua,theiPpntlssr'sldenti!yandprolessJonaldealgnatlons,andrelerencestoanyproleslonalappralsal acgaffimltons or the f1l1ll with which the appraiser Is associated) to anyone other lI1an!hl bO/TOWer; the mortlla1l8e Dr lis successors and aulQrls: ll\e ffillrtQage !nsurer;consulf.ants;;prmesskmalappralGalOfganlzations;anystaleorlederarlyapprovedflnaneJaIInstltutlon; or any department agency, or Instrumentallty of Ihe Unfled Slates or any state or !hi Qlstrictal Columb\a: m&jll.thiltnfllender/cDenlmaydlsll1lNlle Ihe propertydascrJptlO/1secllonofther8portOfllyl!ldala c::oJfeclton or reporting servlce(s) w/lhout havlnu to obtalnttla appWser's pOOr wrll1ln clmSent lheappJi!ser'5Wll1'1tlnconsenlandapprovalmustalso be oblalnlld belora lIle applllsal can be conveyed by anyone lolhe publicthroullh ad vertlslna,publicrela.tlons,l\IlWi,saI&s,orothermildla. freddie Mac Fonn 4396-93 Palle1ol2 FannIe Mall Form 100486-93 FreemilllReaJEslate form ACR -'101&2000 lo(W1ndows' appraisal sollware by a la mods, Inc. -1-800-ALAMOOE ~ APP8AISE8'S CERTIFICATION: The Appraiser certifies and agroes that 1. I have r,searched the subject market arn and have saJectlld a minimum of three recentsal<< at propmies moat libnl1a, and prwimaUl W lhe subjecl property i'3f c(l(lsldOJiliDn in ltlo sales compartaon analysis and have made a dollar adjustment whOll apprclpflatfl to relJecllhe mafkat reaction to thGSflltems of ilgnllicant variatloo. It a &iglililcant Itmn In 11 comparable pl'oparty 15 superioJ to, Of more fa\IDl'lIbJe than, the subjBcl properly, I have made a negatlvelldjustmcnt IlJ raduce the adjUsted sates price of the cClffill8labtaand,Ka~tltamlnacomparablepfDperlylslnfeffoIto, or Ius lavorablll1tlan the subject properly, I naVe mad, aposIUv,adjustm8IlllolncroisetheadjuSl8dsalespriceoftnecamparibte. 2. I have taken Into consIderation the factors that have an Impact on vahle In my development ollho estimate. 01 maIbt value In 'lilt appraisal r,port. I have not lr.rumIr.gIy wl\hhtld any slgnltlcanllnlormation from the appraisal report and I believe, to the best 01 my knowledge, #\it all statements andlnfonnallon In the appralsal report are true and cWTrlCt 3. IstatedlnthsappralsalreportOlllymyownparaanal,unblas8d,anilplolasslonalanalysls,opln]ons, andcOllcluslons, which are subject only to 1110 continllenl and limiting conditlons specnJod In this 10/111. 4.lhllvanapresenlarprospectivelnl8resllflthepfOpertythalls!h&subJscttothlsreporl,andlhavsnopresanlarpro&ll8ctivepersonalinteles\orblaswiltt res~tto tll.epartlc\iWltli InlhBtransactlon.1 dld natbase, lilherpartiaUy arcamplelely, myanatYlils amllor!he eslimale of market value In the. appralsa!feport on the race,colar, re.Reloo,S6X, t1M\dlcap, tamlllal&tatus, O1na~01Ialo~glnoletthertheprospectiveowners01occupanlsoflhesubJoclpropertyorof 1110 present ownorsoraccupanbolthcllropellle.slnthe.vtclnWjcltilesllhj8clproperty. 5. I have. no presonl or conlomptaled fUlure Inlerest Ifllt1e subject property, and ne:IItw my current or l~ Ml'Iployme.nt nor my compensalloolor perfoming this apprai5a1isconllnglllltonthoappralsodvalueollheproperty. 6. I was notrequkad to feportl pl"ede\&fmlnod value or direellon In vaJu&thalfavOltithocauseoflhectle ntoranyroJal8dperty,thoamOlJntollhevalullosdmate, tho attainmenl of a specific r&sult, or ll\6 0GCUfI"mCI cia. subhqu&m evenlln ardor 10 receive my compensation anllfor &mproymenl t01 pllrlorml~ tho appraisal. I did nal baselhe appraisal report on a requested minImum valuation, a 6pwi& ~alua\ion, orthe need to approvo a spoclllc martgagllloan. 7. I periormed thIs appralnl In conlonnlty wfIh the UnlIormStandilTds 01 Prof83sloJlalAppralsal Pract!cathat. ware adapl!darnlpromulgatadby lhaIIppralsal Stafldaros 60ard oj The AppI8lsal Foundallon and !hat Were In place as of !he effeetlve date oIlh1s appraisal, wllh the exception 01 the. dapartufe. p{o'Jlslo(l 01 those. StalIdards., wtI!e~ does JIQl.8W\Y. tllclinowl8dge1hatan esDmale of a reasonable limefOf exposure In the open markolls a condlllon in !he dellnlliOll of mark.e.t value and the estimata I developed Is COIlSisteRt wilh Ihe. mWting tim" noted In the neighborhood secllan ot IhIs report, unless I /lavo otherwIse staled In the roconciDationsecl101l. B. I have personaUy Inspected the lnlefior and exterior areas 01 tho subject property and the 8XIadar 01 all ptcp6(ties Ilswd as compalab\asln1he appraisal report. llurther cortily lhit I haVfl noled any appiITllIlt Of known adverso (:ondftlon~ In the sllb;acllmprovemenls, on th, sublllctslta, or on any slta wiltlln tl\& immediate vlckllly at th6 subjeet property ol whlch I am aware and have mads ad]usbllenls 100thsse adverse coodlllona In my analYSis of 1110 property value to tOO ,l1ent tl\at I had mwl evidence to lUwort them. Ihllve alia tommontsd aboul the enect of tho adverse conditions on lI1e nwketabllity of th, subject prop,rty. 9. I personally prepared all concJuslons andoplnlolls aboIJllherealutalfllhatwe fesetlorthln'lilaaplllalsa1reporlUlrel'redonslgnlllcanlprofesslonal assistance from any individual or individuals In the porfafTTJance 01 the appraisal or lI1e preparation of the a.pil feport, \ hi'lo namatl such IndMdual(s) and mfic\osed the spec'rllc tasks perfomtlld by them In the rllConclllallon ucllon of this appraisal report. I certify thai any Indlvldllal so (lamed Is qualllled kI pmoon the. tasks.l ha'l& ool. aullloJiIfld anyono to make a chango Ia any Rem In !he report; therefore, If an unauthorbed change Is mada 10 Iha appraisal rapart, t will taI;e no responslbiltty lor II. SUPERVISORY APPRAISER'S CERTIFICATION: U a supervlsol}' aplllaisorslgned lIle appraisal report he orsho certifies and agrees that I dirscUy supervlsll the appralserwlio preparlldltle aplll'alsalceport. I\a'le reviewed the appralsa!repor\, agreowlthlheslaittmenlsandconcluslonsotlheappralser, agree to be hound by the appraiser's eerltflcallons numbered 4 Ulrough 7 abo~e., and am taking lull respons\bllllyfor 1M appraIsal and the appraisal roport. ADDRESS Of PROPERTY APPRAISED: B12MarkalStreet New Cumberland PA17070 APPRAISER: ~":::'~e"v E F,::::;~---r~ DatoSlgned: Julv1a2001 Slale Certification t/: RL000563.L orStalol\cortSe#: Stale: Pellrlsv\vania ExplrallonDa1B01 GIlrtifica1itm01" UceTlSe: SUPERVISORY APPRAISER (only It required): SIgnature: Name: Da\eSloned: StataCertlflcitkln#: orSlatllUcense#: Slate: EllplrationOal8ofCertlflcallanorUcense: DOll! o DldNollnspeclProperty Page2012 FannleMaefoml1004B6.93 FrecklieMacFomt4396-93 Form ACR - "TOTAl. 2000 lor Windows" apprai&alsottwm by a Ii mode, Inc. -1.aoo-ALAMODE PHOTOGRAPH ADDENDUM Borrower/Client Property Atklress ChI' Lender County SllOle o ADDITIONAL PHOTOGRAPHS ON REVERSE SIDE FW 90AS ~'19a4 Form$ ano Worms"" Inc. All Rights Reaerved 1 IBM) 243-451)5 ZIP Code ~ FRONT OF SUBJECT PROPERTY REAR OF SUBJECT PROPERlY STREET SCENE Item II j14500 PHOTOGRAPH ADDENDUM Borrower/Client PraperWAddrilss Clly Lender County Slate Zio Code COMPARABLE SALE #1 COMPARABLE SALE #2 COMPARABLE SALE #3 o ADDITIONAL PHOTOGRAPHS ON REVERSE SIDE FW 90C#S <C'1984 Forms and Worms~ Inc. All Alohts Reserved 1 (BOO) 243-4545 ItRm#114Rnn lY1llp~Ues[ : t'nnrer-rnendly :)treet Map Page I of I WWW.MAPQUEST.COM M~'~~ES1i. < Back 1.,i:t.'hlhl:J'II,ll1~'. 812 MARKET ST, NEW CUMBERLAND, PA, 17070-1640, US ~ Q . ;p Print Ootions ~ , '"" ",0... .,' '\1,." ~ ~...." S.......- 1} ,p, 1", <; _h,'" "o~ '(<' a "C, AllonSl/ ~~ 'w. " #',. ',"~' '~ ""1\ '. " "~'\;~"',',,,,,,'/ " \~" ',\'''7q~ h\% '\R ";'110, ~ '! i. ~ "', , _'~"'~I~.e._~<:Q,, i\~, \'-',<tjJ',,~<-~f- i .\~% ,,I "'~, '.&\ ~j,~,/,'D:~' (' l't, \i. 'fA,," ~~,;,f ~ ,0- \~'~'<'l'~ '. '....." I" -, I 01 ----~~.5CO Ino.'C2001"DTnc. I, ",,--' 1:1.' qrl,1 ,f!', 1<1' --\\'"lr^ ,", '$/ .' 0' All Rights Reserved. Use SlIbiAr.! 10 I iCAn"e/C":nnvrlnht (J( I ellhere! This map Is Informational only. No representation is made or warranty given as 10 lis conlen\. User assumes aU risk of use. MapQuesl and Its suppliers essumeno responslbllily for any loss or delay resulUng from such use . http://www.mapquest.com/cgi-binJia _find?link=btwn/twn-map yrint&mapsize=large&eveI... 7/18/2001 WILL OF PAUL G. KEENER I, PAUL G. KEENER, of the Borough of New Cumberland, ClJlIlberland COlmty, Permsylvania, declare this to be my last will and revoke any will previously made by me. Item 1. I direct that all my just debts and funeral eJo.-penses, inCluding my gravemarker and all expenses of my last illness, shall be paid from my residuary estate as Soon as practicable after my decease as a Item II. In the event my wife, CLEO B. KEENER, shall survive me. 1 devise and bequeath our home real estate located at 812 ~~Tket Street in part of the expense of the administration of my estate. tlie Borough of .New Cumberland, CUmberland. County, Pennsylvania, 01' any oU1er home which may be our principal place of abode at my death J together with all policies of insurance on said real property, to my wife, CLEO B. KEENER, wi thoU! liability for Wtiste, for her life or until her remarriage or \.U1til she no longer useS said premises as a home for herself. Upon the death of my wife, Cleo B. Keener, or upon her remarriage or her no longer using said premises as a home fOT herself, whichever first occurs, I devise and bequeatJl the said real estate to my son, ROGER E. KEENER, of New Cumberland, Pennsylvania, provided he shall survive the death, remarriage, or no longer using said premises as a home for herself of my said wife, whichever occurs first, by sixty ( 60 ) days. /~~~f// '..~./aMA..... "'. LL4~ Paul G. r eeney /Z>'-" /c) 197,{ Page 1 of 3 Pages Should my son, Roger E. Keener, not survive the death or remarriage of my wife, Cleo B. Keener, or the time when she stops using the property as her home, then upon the death of my wife, Cleo B. Keener, or upon her remarriage or her no longer using the premises as a home for herself, which- ever first occurs) I devise and bequeath the property to my daughter l TRACY L. KEENER, of the Borough of New Cumherland. I direct that my wife, Cleo B, Keener, shall not be required to give bond as a life tenant. and shall not be liable for any loss, damage, or destruction of said property, Teal OT personal. I direct that, for purposes of this Item II of this my last will. any sale OT attempted sale of the property by my wife shall be interpreted as her no longer using the property as her home. Item HI. I devise and bequeath the rest, residue, and remainder of my estate of every nature and wherever situate to my wife, CLEO B. KEENER, provided she survive my death by sixty ( 60 ) days. Should my .,'ife predecease me or be deceased on the sixty-first day fal.lowing my death, I devise and bequeath all the rest, residue, and remainder of my estate of every nature and wherever I appoint my daughter, TRACY L. KEENER, executrix of this my last will. situate to my daughter. TRACY L. KEENER. Item IV. I appoint my son, ROGER E. KEENER, executor of this my last will. Should the said Roger E, Keener fail to qualify or cease to serve as executor, Item V. I direct that my personal representatives, as well as their successors, shall not be required to give bond for the faithful perfonnance of their duties in tl1is or any jurisdiction. IN WITNESS WHEREOF, 1 have hereunto set my hand this , 1976. /0 day of 7t~-,~.... /------), ~ 1'/7 'AJ /.k -^ Paul G. Keener L/ / .. ~....../ Page 2 of 3 Pages The preceding instrument, consisting of this and two other typewritten pages, each identified by the signature of the testator, was on the date thereof signed, published, and declared by Paul G. Keener, me testator therein named, as and for his last will, in the presence of us, who at his request, in his presence, and in the presence of each other, have subscribed OUT names as witnesses hereto. ~ --jp" i ---I.. \'--- ~...! t,J.......~,'_, Page 3 of -3 Pages REV-j!iG8EX~11-97) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DE DENT ESTATE OF FILE NUMBER E:€tate of Pa'll G I<PAnAr 21 01-0735 Include the proceeds of litigation and the date the proceeds were racelved by the estate. All property jointty-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 1990 Chevrolet 8-10 pickup truck (2-door, 2wd, standard cab, poor condition) $1,300.00 Miscellaneous items of tangible household furnishings, clothing, and other personal effects $500.00 Checking Account No. 700039359 with Waypoint Bank, owned solely by the Decedent (see statement attached) $2,603.49 TOTAL (Also enteron line 5, Recapllulation) $ (If more space Is needed, Insert additional sheets of the same size) $4,403.49 ~IWaYR.qint LOOK FOR US. WE'LL GET YOU THERE. SAMUEL ANDES 525 NORTH TWELFTH ST LEMOYNE P A 17043 The information which you requested on the PAUL KEENER ESTATE (Social Security Number 174-20-7962) is as follows, Account Number(s) 700039359 Class of Account CHECKING Date Opened 110498 Principal Balance 2603.49 Accmed Interest Balance at Date of Death 2603.49 Account Ownership SOLE Name of Joint Owner, if any Date Ownership Was Established 110498 Additional Information Requested PLEASE COMPLETE W-9 i(;;l.elp :/r'411j' kettll:. Young Senior Services Rep. ~~ ~9- 5~~.-p^ t \lf~ ~V \P vA c/ 4.. \,'- Cll~ ') V-~& P.O. Box 1711, HARRISBURG, PeNNSYLVANIA 17105-1711 Toll Free 1-866-WAYPOINT (1-866-929-7646) . www.waypointbank.com REV-1511 EX+ (12-99) _ ~~~ COMMONW~Al....TI-\ OF PE.NNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF E~tat8 of Paul G Keen"" FILE NUMBER 21-01-0735 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Stone and Murray Funeral Home, New Cumberland, PA $4,812.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representatjve{s) Social Security Numberls}/EIN Number of Personal Representative{s) Street Address Samuel l. Andes $1,500.00 City State _ Zip Year(s) Commission Paid: 2. Atlorney Fees 3. Family Exemption: (If decedent's address is not th~",~~m'e Claimant Freeman Real Estate (app Register of $103.00 Street Address City Relationship of Claimanl to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Estate Advertising: The Sentinel Cumberland Law $77.63 $75.00 $275.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of Ihe same size) A. CHARGE FOR SERVICES SELECTED 4f/SD . Traditional Funeral Package . . . . . . . . . . . . . . . . . Basic Services of FuneflJl DifBCIor & Staff. . . . . . . . Embalming. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other Preparation of Body . . . . . . . . . . . . . . . . . . . . ". . / '''-''ft/ion - / c:x:::;., ~ Use of Facilities & Staff for vieWIng vI",... . . . . Use of Facilities & Staff for Funeral Ceremony. . . . Use of Facilities & Staff for Memorial Service . . . . . Use of Equipment & Staff for Gravesicle Service . . . Use 01 Equipment & Staff for Church Service . . . . . Transfer of Remains to Funeral Home .......... Hearse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Limousine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -;;2;C2ctD Sedan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Service fUtility Vehicle. . . . . . . . . . . . . . . . . . . .,. - 50. ex:::::> TOTAL OF SERVICES SELECTED (Al . . . . . . . . . . . ..$ 137~-n.oj B. CHARGE FOR MERCHANDISE SELECTED . </-J.::f. ~/cC....{f"7'..... / Casket (or olher receplacle) ~.~. ~~: . . . . . . . . . . . _ ~.~ Quler Burial Container~. ACkn~:::~.~~~ If Regisler Book. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Memory Folders I Prayer Cards.. tf................ Cremation Urn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Clolhing . . . . . . . . . . . . . . . . . . . . . . . . . TOTAL OF MERCHANDISE SELECTED (B). ........$ t;':>?J, ~ /~ / WCC' /~ Stone & Murray Funeral Home JAMES E. MURRAY. JR. F.D. 408 THIRD STREET NEW CUMBERLAND, PENNSYLVANIA 17070 (717) 774-2750 Iwut-G /~ . DECEASED' NO. OATE OF DEATH ~ /s-: /?cx:::>) . DATE OF S/TATEMENT " STATEMENT OF FUNERAL GOODS ANO SERVICES SELECTED Charges are only for those items Ihat you le!B~ted or that are required. If we are requiTed by law or by a cemelel)' or CTemalol)' to use any items, we will explain Teasons in writing below. C. SPECIAL CHARGES FOlWarding remains to < I'J ~ Receiving remains from "ltlt':'f.41( Immediate burial. . . . . . . . . . . . . . . . . ... Direct cremation. . . . . . . . . . . . . . . . . TOTAL OF SPECIAL CHARGES (C). . . . . $ 0, CASH ADVANCES ...Gertjjied Copies of.Oe~Certificate o e;,.-: ~ /J?, c:>c> @ $ . . each. . . . . . . Ciergy RE;O_~ /~ Musician Newspaper Notices Cemetery ~(,p C6 TOTAL OF CASH ADVANCES (D). . . . . .. ... We charge you for our se!Vices in obtaining (specify cash advance items:) SUMMARY Total Funeral Home Charges (A+S+C) Sales Tax, if applicable. . . . . . . . . . . . $ Total Cash Advances (D) . . . . . . . . . . . : # 5~ COMPLETE TOTAL ....... .., .... ... _ = ~_- PAYMENT RECEIVED FROM . 1JS.>5 C~ C:o- VfJ:-/o6. BALANCE DUE.................. .$ 7'~/ ..:<~ DISCLOSURES If you selected a tuners/fhat may require embalming, such liS a funeral with viewing. you may have 10 pay for embalming. You do not have 10 pay (Of embalming you did nof approve if you selected arrangements such as a direct cremation or immediate burial. If we charged lor embalming, we will explain why be~ ..A-....,. __ __ R.~.mbalming: ~ ~ ~ I ?)~ If any law, cemeltuy or crematory requirements have required the pur- chase of any items listed. the law or requir6ment is explained below. . ACKNOWLEDGEMENT AND AGREEMENT I hereby acknowledge that I have Ihe legal righl 10 arrange the final services tor the deceased, and 1 authorize this funeral establishment to perform services, furnish goods, and incur outside charges specified on this Statement. , acknowledge that 1 have received the General Price List and the Casket Price List and the Outer Burial Conta.iner Price List. Terms of Payment: Full paymenl is due no laler Ihan If any payment Is nol paid when due, an unanticipated LATE CHARGE 01 % per monlh (ANNUAL PERCENT AGE RATE _%) on the unpaid balance will be due. I agree to pay the Balance Due Iisled on this Slelement, plus any Lele Charge. In the evenl 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' . Iy imposed by law upon Ihe eslale of the deceased. By' nalure below. I hereby ag~ee \0 all Oltha above and ackno d receipl or a copy . St m l. By REV.t5t2EX-!t.g7j .'~~. ., ., , SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Estate of Paul G. Keener FILE NUMBER 21-01-0735 Include unreimbursed medical expenses. ITEM NUMBER 1. DESCRIPTION AMOUNT Quest Diagnostic, Inc. - medical testing $114.30 PP&L - electric utility bill $86.26 PA American Water Co. - water bill $82.86 Verizon - phone bill $ 21 .27 Comcast - cable bill $63.29 Stephenson's Flowers - flowers for funeral $51.94 West Shore EMS - emergency services (net of insurance payment) $100.00 Sears - balance owed on charge account $590.33 TOTAL (Also enter on line 10, Recapitulation) $ 1 , 11 0 . 25 (If more space is needed, insert additional sheels of the same size) INC'. HDC:;' F(}U~1"t'H i:i(;"7'iCE "t:\.';( LJ, 22-2137'283 ',1''''.:''''''''''' <:1:: F" ,"iF j'} "fJ ,~\UL g'I'~': j',:/.,Ri<E."f ST NEW CI!MBERl_~ND PA iliilli1uIlJlil!lu!,ILI1:IJiLOI 1-2013 CJ2,' 'I:~ C'3/D3/2iJiJ/J [(;: ',,'~::l<::d CI5?'/~~) '.)l'IL DiD2053flL,. -""w.',,,, 'I 'lel 7",~)~ '1640 .JUULlliIIILlt,11IJili ~) i)C ""'"""""'.~... "; D /' (' 7 / 'li)/'~~?/2t)()U rJ ~J i h ENTER IN-s:.nL<1.J1CE !i",IFCiiii'i1AnCJN em F1EV:::~1.sf ;:.;IDE, 'il- THlS 31LL L'3 ;';EP.c,.FiATt: FF10; I YClUj] .wHY;;:;,(;JAN';; 8,L1_. .,~"~~-,-_....- --'.."-",,,'.' '-~-"'--". nU'J :'; -j 6, -Co,: H ,., e. '~"" (J(.l )'.! EL.ECTf;OI.YT'E ,J/,';<"JEL. ,:JCC J'1 .: ) -, .j,,; S'ODIUH/ ,sEF:UM POT}~SSlU;'.').., 5'~:..~Ur,"j ;::HL(ir~.lf)E.~ -SEr~Uj'lj C02 SEnU)!.-i ^....~.-._.._"--~---,_.-- n"ls,JJ!){J D'at,,~), ,;",,';&1;",;. ;1'J"d6 nt.Jth>::< 'fj'pa1'meirTi hB..f~ :~..I "ilS~. t::,rd,'!0Jd.;or "tf~j)(1r;:':f,~ 'i!ie pEl'rn<;lii~! (!;i~ i,n-'o<(;", by th.;o i'53!J,,'r !der'!li!led b"j,)w, ,I ,(l i ;",c"."", j.., ';O.-"li;ly 'tilll; ~il~ "b!i:)~ltCln., '~8( ,'Uj';::1I th1i CerUi"i()I(JI';' <ofl";)~;n.enl witlllh<il !S.;JJH. ;"A"E Cflh'" jOAYABLe ., [) "Ulo$T DIADNQSTICS "'CORPOflA,'Ff: ". ['FTAC" Ail[' HCC;I.)"N;~"; "::JF:T:Otl Wi "~I 't()!)" i'< YME,n. f1Li:A5c Whln~ THE h\(;Gz,H.Ji'n NUMBER ON YOUR CHECK. I-rn-/ L_.__._..... rJ/..-1 ,:OT;;:-SC,"i':O !'TTT'! I-TTrrrnTfr-l J__..'_.-..l,~_L__L. -..._~-........~.._~._,..."_._. ,--_LJ t.-:':ijire,t].0r1 ,:-::':R[)!j'o~-c;'S~:;SSi~~i'-I;-;;l"i1~----'-~--" ~,-_. _._----._'"_.._._.._..__.~-".."'-.~-,-" ('.i,F:DHOLDEil'S foI,q.1E (PL'::ASE ;;'Ri:iT) 001020536~01000114306 KEl'NER,o,~LJL 81~~ ~.1AFn(ET ST NEW CUMBERLAND PA "; 7070--1640 Ri],1IT TO: OUEST DIAGNOSTIC<:; l~jCOr:f"()FiArEr) F)() BOX 64537 E3.'~\LTlivIORE ~~D 2') ~>;.';,-4537 !11!i!lllllllljIJllf.111,jjdlilillJ;J,!Jdiill"lldlllJdll .'--1 CI'];::Ci~ HERE JF ADDFiESS HA~; C!-U,i',lGED, _"J li.]I)IC.<r-E CHt.i'iGf-: Cj\J ElACi( (:'iF FORM. fl"'}1 ,("~"..,,~-~....; F. _;r._'il'f",iLci.J. cl i;"._ , jee l',_',r: i-'.lJ,iL (i )::LF:';ER Yi:'. \'L-\)U~i':T S i' ;'<E\V (.t',\jELRU) f'_~. 1~"'7ii PjiL Ui;'~'t;,t:.:; r-,'-lJ.::i.j,)j;)~:j' :-;,r::rv i-ct' :')27 H~lU, ,-~i,\I\ F~;J. ,-:',!kn!u\\'~l. ::'/\ I,') i n~~-')J~<~ .:~;~.'d)..J--:~~ <: 77 S . '''\',/' k;',:! rl~\:((:r ;'(;~idiu:2 (' i ','if ~lht:; l~ I :\[:'1- .J :J i-~--'~''=r;I~1-;:f!);,:,-,,;~ \: 1:1~-iJ:;~~-~- i~'~-""",-,,"-~ ~~-'~"'_~'_'._~"'_~_~~b__ ;'-!I ~~,':~_::C:;:,',-i,,;G::~T~;~~~'[jDI:h':d~':~~-: 'T;ht[ f')':)J}l Ln.>t n it! ;:.: :C.2:'! l~~~'Y!}I'!! .~i.LB:.~':3:J::.'.!!.;:LL' e h~_;~':f..~L~~f/ n J~_.r~~:=.._~.,..o.".: _," ~f;.tld;j=,...._..--,.~..~.,_~%.,,~~~ fJetmJJs BUlil l~~e ~,5 III ;\iar 61 2fW1 ' ':-i,' ---"-'---'-'~--'-~__'________'___~___~_, _n__._.._.._ ..___...._..._____,,-..__,.__....__.__ .____ ll,.f'" ~; ."~U T,')!,:d ?PL 'J'Tq.rcn<< "J':; ....,.) ',1 ,XI''--i't'l.13~b!ji .lei I'll-: !i~ :,',Liii!~,~l );, J.".Jf \'Ol1.r '-~On\'dn(t'nc;:. vou can HOV-, rocll,' '/Ollr hdi ~V~j;?~_s.~:B:r~~~ J-{ ~~;.~~(!~'ilh:ri~/~~jj~~l ~l~ i !~;t~: h ~;Y:~,:~.; II r niclki1!'; tJli::; pli}'m,.:nt. - itJl C!,~an rh<.: ,:,,,jJ:; DL1.~it '-'-.)\'t~r,-~(\ till: L-n\:L, ur hC,[k;;'l ,:>1' ',,',:01.\;' rdi !~\:'(,-HI)r i;'\'~~r~J " r1101.1t;'l~ \'/;:i:;tC c'ne-'rgy. ><-f',.'l' P(;~;L1::):L' <:mn l~lt,._, - ::;It:.:n ur~ l>:l\' .-"d,\': iYUl,;tJ \3il\ 1\F;(\!<:;il Cusi.'tJtru::f' ACC(;),r.H~t Jniortnation BlUing SUJ1#rni:!ry ;=01' .sB(lJ~Ce "10: P Kesner B 12 j\Aaiket .51 .t..'G~~,-:,unt j'..,jumb,,)T: 24-0'022755-9 Prernj,s:o NumbE,r: 24-0368251 n .~..~..~__p rioI' 8::'i1;;a1'1 c. en...n~U"~h"_' "~~._'u~.. 8;;:i!,;;un:.:;; korn last bill -,:..' BjJfjng Period & IJ/!;eier lniorr.-n:Bi"i-orJ t~illinfj Dtlt1:'!: Mar 0:5,2001 tlHling P.t=;I'jod: Feb 0-1 10 ;\.1ar Crt (23 days) l',j6;[t r<?ading on/ab;;l(Jl: i\pr 02, 2.00i Flale TYP<3: FtesirJ;:lntlo.\ Payments prior to A4ar 05. 2001. Thanksi Tot::!! p:rio!" bttlancF.\ M-ai' Uf., 200"1 /~? ,..' ,\ ~ "-,,"..~~~~C un,,) f'JI 'tv;:,; koer Ch;:;j' j~)S~".~~~~._~-"~~~O~"~.~~""~_ "~.~. o~'__'n~' Service Charge ? . I'~, Watei Volume ($.00)8;,1<1 x 6/)00) 29. Sf;;;'ii'e Tax SUfchq \Naler -OA3~s OS! - Charge 1..J.;D":';; It,tal 'lf~.ti;t~l' dlar~jBS, ]:ADr 05, 20lli :)9" '3 fJ1etel' i':)ading~j in cur;-en\ b11llng perl;Qd: l\iletE:r ["lumber 1')045'140800 is ,:J, SiB-inch mHti;Clf. Pri:.'"l:,,,':"!nj-actual 119600 Last-actual 113600 a~..a"-'-~'~J-\MOUN1' DUE e~.';o..,,",....,~...h~u~~ r~-- Callons u5ed 6;JOO V'd,~t~r U~Y:i~Je lviqll ,-'1' ~'"a(]e II) ilunClrec' ( iLOilS. ::~--- ~i~.~~~:O-_I!fi~I-(it(l~: [coJ '0" '''''~~" ,d :;t'1 "'cf~jt""'J ~ .'" '1I1~i,I-;~l;:~1'1~~Wt~L~ ~9 ;"f~ !4~L-~J~~~l-~fi~~H~H~~@-~i~J1-in~i ~ i&"~j;:?;L~L~.J~2L;.;~_tf-E._fit~L~~~.J~L!g:;,- _ M t, ~'i1 J :s c, (,! D ,.I F M :.3 [) _. U ;j U iJ <-' <3 ~, r . l' (I ' 9 pi " C iI b J c, o 8 -,.,--~---~--'---~-----~--------'-----'''---~--''-'---------_._._------~- --_._~-----,,------- ----_.-,._--_.._-_._----~----..-. ,flJjCiJ$:SiJq.t;,';" to :" .,,;f'l? P&-nI'J:'fJ1/;",b}j~i ,. -, Any portion 0/ this 'eVEltat bill vl/hich [W!;..1 ; _I 615 JT .//02/0! will t 9 ~Uj)r2: tin" --;;:. (Y'~~ ~ AVe')/[) caSIt)-, SEFi\!/CE LINE F1EF1lJr:.:;._. To le8m how you ('.:.:zn prote(:tJ'ou(s~.'1l ClOD/i)"', nno' C,'o.:';dy s8fl/ice /i,nc:: rc:p.eirs, call (800) 56::;-,'?2,92, <J.nd 25k ;,iiloUi llJ8 Water Line f!'''i::>ta:lion Prcgrdr,1. lH::1~c:e 0/ rnino' is 'North fr. "~Pen~.I:Wlvanf;]-Arn:;mcan VVt.j{;?T Company hi a proud lOG/plant of the 2000 r..;Civ~FnCrl$ /\'i/~::f::f ;'or En,iironrn-9ni::;.! Exc~:'/lei7ce. '~i,~r;~I:;:~:~~r;~-\'~,~~~~;~o;~~ri:~~',,:r~::r~;:;<~;,~) ,~~~i(~: i ;~~r;~~.~:-;;~~l~~:~~:- ~~~~~;.:'!~~~,;D~~)t.ii i'(lrm;~i,~;};\~~-i~I~;:'~~~I:,~, !'~~:;;;;:r')G'ja tf'3 Pi.\ \,,~/(; seivice cedis tire schecJuleCf in PldVWif,\9 lor the -:~om/~H1jenC;J or JJ6' cust:Ji!i.'91'. ,-_._-----_...__._-----_._~_.~ ._-~----_..---"-_._,--~----~--_._- au,~stions? CaJli..800-l'il-7?82 \filn~lkc\ays-B:-(S am t.o G:30 pm -Satlll'cla.y-8:"IE.; am to 2:UO pm [m(1rgencie;~: -/17-';, 4~2420 P/WVG, 852 'fIJesley Dr., MBchanicshurg, Pa. '\705~)-4436 Intoi'i"lOt: www.pav,.'c.cof"(; ;',.1 1,,1. "'.C_'_.-.. [""",,'c.',,", ,..-.- , c " \:""'.\ ,-, ,-D c'; c,' ,,-, in r",; () "".t' I:.... i'1 ,-- ; "I.~ ;......, " . , r;- ,C', ':'J .~,.' ~~ '.;..- p ~,I '... c! J:"" '.j- u, ;1.' ..," -" fi ~ > i,; ,. . . "'" ~ , ':.,~,' C;" t',:> ,.") '-- " ,- ~ g.1 '" U ;) .", , i; ,:;; ':.,/ ~\f.'\. ._u I;; I."} ;:) ,1' ;J') r" 'i, .0 r, " :;:: l.e, ~~ '0 9)-~': G:; {~ ~i2~' ;~ ii~ ~:!:' >., n. r:: -f--"' ,]', J '- 0) cj en' Vi m C " 0-:;' r:: i1) f5 ~ ";:' ~_, i":~~ ",; =J ''71 U () ,J,\ 0; ,~ ?: ~;~' ,-"~ ,) o i-i" ;-i? 0" ,',') it. ,D L:: ,-,", " l!} 'I' (; " <lj ':J O"i ...' --l" ,~; r\, ,-, '-'> :\;; ::W,C\O'.\'1':ir"U,,'Hcl . ~:Iuitc Ol~\ C:iinp Bin,?_t\. }"iCil.l Ac~ounL' I',hu:r;e: Pg,I(eene1', S~,~rvjce' l~"d,d.~'~: S,'S'; E1.2 JvIazl';cc"t ::'~', :r\'I2j'~,h 17.2C01 l'.x.\C(~H}l.t I'~n1'ii.1)(~:c O.:.}:807I}O~[\1 C1J.'~!'mJ.H,l' ;"- ,cn'":;"'('. ?I7-r,..j.i)-!"1f10G ',l\'I.r,pbo;~e riG.]',','; :!4 BOllI-', l~ '/ r'lo'."r, n -g;\i!'",lf',,; l'l{ :iln;i,.J!. ~~.1,~ ri:,' ~":T2"'~J ;~1if;:;'p'-e:_' "''2,''.'0,', ~,,: !;::1 7;~~ ::~~U'.' ~rnxC ." '\ ~, . i j "" 1\"i:H'" ~VI-.' 'Jl::~. ~..:-1::.:n'r,n; C~hll:i.-.;/,""(:: Ji:Jf\-.jil',' :>)-~,rtiB.I I\::'_ml~]) '~;::;''-;':::;~~'''i: ,'1(;G 'X:<l.;O"", ~nl':11'9',,;:,~, gil.b-<l.!:,'j' lc(.,.. i,",'" n,.1>n-',..'" . 8~'j 0nl, 'L'itr;n'; '.:<Co''-' ~7:" ,,,';'J;'" ,-,~', :S~i;i;1::: ,)n;'" P""f' l.'e:" ,'3Vndn oJ,. nn :r' Lnl' roh,; ':_:,;,'c';,\H~. \ '1w":S<_'" , li"G'1Jnl;p;ry F?e. 'II-A", :;-'-<;<~0?-: TK\:N'," ,. T,~, od /';1\\~,,1",:: ;:')1(,,; hy .;)fHNY! ..,";' I,,". ,1.'" . 5~1 ,+'1.-1 . ~~';.i:;2 r!f: , :~n. ~17 ..F.','G .....2 C'O ..\/.n F"""l'hi.(,i"o; Ad\,.w\l-y, 1:-<1<;''''' f',lnI\W';iU,,,NDnnH( .2ni'.{A!l.]'~fJ;1' STNf::W Cl1JH'i~fi:n-:,i,-fi;l, PI, l;()'lO m.l1D,'1 p,\n"..::JG i\UFnUJt Dn,,-' :~'0;J.2~1 "'!."" , "^~; . .:~ .J:, ;'~:~.a i :1! ..~ 1:;j.'73 ;\,\04 63.2:) S~.<:':'~ ' '_i_i. .~ jr;:{i ~~;.2 c;;~~jJU'~ :J ;..J. 01\/ rjF~': ./,-,,","! ';-:::0,::;'':: , " ;-jJ - .-~,- _____.___n_.._ ,.:, ,.-" I _~ " -'''-.,J I::.:: " c . . . "'''''''''''''''w COMMONWEALTH OF PENNSYLVANIA INHERJT ANeE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER 21 01 0735 "f P""I G. Kp.ener - - RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY 00 Not List Trustoojs) OF EST P,TE I. TAXABLE DISTRIBUTIONS (include oulright spousal distributions) 1. Cleo Berniece Keener Wife/Widow Life Estate in 81 2 Market Street real estate New Cumberland, PA 17070 plus residue of estate Roger B. Keener Son Remainder P.O. Box 105 Interest in St. Bonaventure, NY 14778 Real estate 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 n. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ " (II more space IS needed, Insert addlllonal sheels of the same s,zo) REV.""".".",. COMMONWEALTH OF PENNSYLVANIA INHERl1ANCE TAX RETURN RESIDENT DECEDENT ESTATE OF PAUL G. KEENER SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN Check Box 4 on Rev.1500 Cover Sheet FILE NUMBER 21-01-0735 This schedule is to be used for all single life, joint Or successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5 .1-89. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. i2l Will . .... .0 Intervivos Deed of Tru~t 0 Other UFE:eST ATE INTEREST CALCULATION' NAME(S) OF NEAREST AGE AT TERM OF YEARS LIFE EST ATE IS LIFE TENANTIS) DATE OF BIRTH DATE OF DEATH PAYABLE Cleo Berniece Keener 10/20/1936 64 [XJ Life or 0 Term of Years _ o Life or 0 Term of Years - o Life or 0 Term of Years _ - o Life or 0 Term of Years _ 1. Value of fund from which life estate is payable 2. Actuarial factor per appropriate table Interest table rate - 031/2% 06% 010% 0 Variable Rate 6.2 % 3. Value of life estate (Line 1 multiplied by Line 2) -- .6.NNOi'tY1NTERESrCALCuCA'1'I0N $21,000.00 .60666 $ 12,739.86 NAME(S) OF NEAREST AGE AT TERM OF YEARS ANNUITANT(S) DATE OF BIRTH DATE OF DEATH ANNUITY IS PAYABLE o Life orD Term of Years _ o Life or o Term of Years _ o Life or 0 Term of Years _ o Life or 0 Term of Years _ 1. Value of fund from which annuity is payable 2. Check appropriate block below and enter corresponding (number) Frequency of payout. 0 Weekly (52) 0 Bi-weekly (26) o Quarterly (4) 0 Semi-annually (2) 0 Annually (1) 3. Amount of payout per period 4. Aggregate annual payment, Line 2 multiplied by Line 3 5. Annuity Factor (see instructions) Interest table rate 031/2% 06% 010% 0 Variable Rate 6. Adjustment Factor (see instructions) 7. Value of annuity - If using 3 1/2%,6%, 10%, or if variable rate and period payout is at end of period, calculation is : Line 4 x Line 5 x Line 6 If using variable rate and period payout is at beginning of period, calculation is : (Line 4 x Line 5 x Line 6) + Line 3 $ NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13,15,16 and 17. $ o Monthly (12) o Other ( ) $ % $ (If more space is needed, insert additional sheets of the same sIze) JRD/June30, 1992/17858 Date: February 03, 2005 ORPHANS' COURT DIVISION Samuel Andes, Esquire 525 North 12th Street Lemoyne, PAl 7043 COURT OF COMMON PLEAS OF RE: Estate of Paul G. Keener File Number: 21-01-0735 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: 03/15/2005 Your prompt attention to this matter will be appreciated. Thank you. Sincerely, ~~~ GLENDAFARNERSTRASBAUGH REGISTER OF WILLS cc: File Judge vA II IN RE: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS COURT DIVISION ESTATE OF PAUL G. KEENER, Deceased NO. 21-01-0735 FIRST AND FINAL ACCOUNT OF ",,-) "'.,} ROGER E. KEENER. EXECUTOR FOR ESTATE OF PAUL G. KEENER. DECEASED D,ate of [}$ath: 15 March 2001 Date of Executor Appointment: 8 August 2001 Date of Advertising of Appointment: 21 and 28 September and 5 October, 2001 (Cumberland Law Journal) 17 and 24 September and 1 October, 2001 (The Sentinel) Accounting for the period: 15 March 2001 through 31 December 2004 Purpose of Account: Roger E. Keener, Executor, offers this Account to acquaint interested parties with the transactions which have occurred during his administration of the estate. This Account also sets forth the proposed distribution of the estate. It is important that the Account be carefully examined. Requests for additional information or questions or objections may be addressed to: Samuel L. Andes Attorney-at-Law 525 North 12th Street Lemoyne, PA 17043 ~ II I. RECEIPTS OF PRINCIPAL The Executor charges himself with receipt of the following principal assets of the Estate: Residence at 81 2 Market Street in the Borough of New Cumberland, Cumberland County, Pennsylvania, in an advanced state of disrepair 1990 Chevrolet S-1 0 pickup truck in poor condition Checking account with Waypoint Bank Miscellaneous items of tangible household and other personal property TOTAL PRINCIPAL RECEIVED II. INCOME RECEIVED $21,000.00 $1,300.00 $2,603.49 $500.00 $25,403.49 The executor received no income during his administration of the estate. III. DISBURSEMENTS OF PRINCIPAL AND INTEREST During the administration of the Estate, the executor made the following disbursements: Stone and Murray Funeral Home (funeral expenses) Samuel L. Andes (attorney's fees) Register of Wills (probate fees) Advertising the grant of letters Freeman Real Estate (real estate appraisal) Quest Diagnostic, Inc. (medical testing) PP&L (electric utility bill) PA American Water (water utility bill) Verizon (phone bill) Comcast (cable bill) Stephenson's Flowers (flowers for funeral) West Shore EMS (emergency services net of insurance payment) Sears (balance owed on charge account) $4,812.00 $1,500.00 $103.00 $152.63 $275.00 $114.30 $86.26 $82.86 $21.27 $63.29 $51.94 $100.00 $590.33 II Real estate tax TOTAL DISBURSEMENTS $211.98 $8,164.86 The assets of the estate were insufficient, without conversion of the real estate, to generate adequate funds to pay these expenses and debts. The executor advanced his own funds for the payment of these items so the administration of the estate could be concluded. RECAPITULATION: TOTAL PRINCIPAL RECEIVED: LESS: TOTAL DISBURSEMENTS $25.403.49 ($7,952.88) BALANCE ON HAND AVAILABLE FOR DISTRIBUTION The only assets remaining for distribution are the pickup truck and the residence in New Cumberland. During the administration of the estate, one of Decedent's relatives destroyed the pickup truck in a motor vehicle collision and it is no longer available for distribution. The New Cumberland residence was, in August of 2003, transferred to your executor pursuant to Item II of Decedent's Will when the Decedent's widow, Cleo B. Keener no longer used that property as her residence. II IN RE: Deceased ) ) ) ) ) ) ) IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS COURT DIVISION ESTATE OF PAUL G. KEENER, NO. 21-01-0735 PROPOSED SCHEDULE OF DISTRIBUTION Roger E. Keener, as executor of the Estate of Paul G. Keener, deceased, proposes to distribute the remaining assets of the estate as follows: 1 . 1990 Chevrolet S-1 0 Pickup Truck. This vehicle was abandoned because it was essentially destroyed in an automobile collision following decedent's death. The vehicle has no remaining value. 2. Residence at 812 Market Street in New Cumberland, Pennsylvania. Previously distributed to Roger E. Keener, pursuant to the terms of the Decedent's will. Roger E. Keener, Executor under the will of the Decedent, Paul G. Keener, hereby declares under oath that he has fully and faithfully discharged the duties of his office; that the foregoing First and Final Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the estate have been paid in full; that to his knowledge, there are no claims now outstanding against the estate; and that all taxes presently due from the estate have been paid. ~~~~" - r - l-' OJ i( ~ ~ >: . [f) _OJ Z ~ :>- ;g ~ !!I ., ;s: " p '" g L; " as .; Z i:! rn 0 ~ t.rJ .' >{ ~ f!! >{ >-< ~ ;; ::! > ~ ~ 0 '" 'l ~ .... 00 t"I Z > .; > ... ~ >i v ~ t>1 .; 1Jl ., o t- O> ;':~iJ!I"" o :) < . ~ ::T ......: ..' "a'" _..3w' ','~Q:.5 ::i lfjgi:r '.:~i\( go ",1 i~ It ~ g8: ~ & ~ <,5 .>.ilf3~' ~~"Q.;ai it; ~, ~ s:t. E g. () ~ fL)} WifUflf ~~~I!f~I~1J f '~j ,~Ii J ltil.;~(i"!: rt:)i Ji!i~i;l p i sf "Iii 1/ I 1/ ,i-2~-d)- - ""'" Q~<:.!2:Q:l: 5'- o3~ (t)()%Ci.::r ....i4';:, og5 CD iE 3-01- ~~'Of6'8. ~-'Of "''lili8< aiili '80i1!:!5" ":ll(!g~;j OJ ii~~'~ ~ g--- :) ~~ li '" ~ ! ,... ~'>ll, g.ii ~s~iar It; . ;l; ~ co 9l. ." 1 <I> 5l Ii" '" '" ~ Q-<",,<,,"~g .~Q::>5u"Q. , _ 5-<0 _ 'l'::> '" -.3 <]) <_..=ro 0.- ro ..... (tI Q .<,""~:l:()~'" ;:) ~ _ :!. g ~ 3; t/) C\;:;:..... iX',,-, S g; - ':' L II - J ~ - - -1' '-'--Iff ~..lil~~.~',.;;;.;f';;,~iES-;~i<<:t:~",.<;;,<,,",_.~_,_,.~,~ Estate of KEENER PAUL G Late of NEW CUMBERLAND BOROUGH ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA Estate No.: 21-01-00735 Date: 4/08/2005 NO.: 21-01-00735 ANDES SAMUEL L 525 N 12TH ST LEMOYNE PA 17043 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: KEENER ROGER E Personal Representative Counsel: ANDES SAMUEL L Date of Decedent's Death: 3/14/2001 Date of Delinquency Notice: 3/15/2005 The undersigned, Glenda Farner Strasbaugh, Clerk of Orhans' 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 Orhans' Court Rules, was given by the Clerk of Orphans' Court on 3/03/2005 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 ~l~JtU~ Glenda Farner Strasbaugh Clerk of Orhans' Court A hearing is scheduled for June 03, 2005 at 9:30 AM in Courtroom No. 03. If the Status Report is filed prior to the hearing date, the hearing will automatically be cancelled. ~~ if' Geor~ep;,J,f e P. vA SAMUEL L. ANDES ATTORNEY AT LAW 525 NORTH TWELFTH STREET P. 0. BOX 168 LEMOYNE, PENNSYLVANIA 17043 TELEPHONE (717) 761.!'5,361 19 April 2005 FAX (717) 761.1435 Glenda Farner Strasbaugh Clerk of Orphans' Court Cumberland County Court House 1 Courthouse Square Carlisle, PA 17013 RE: Estate of Paul G. Keener 21-01-00735 Dear Ms. Strasbaugh: I represent Roger Keener, the personal representative of the above estate. We recently received notice of a hearing in June because my client had not filed the final status report. I filed a First and Final Account on behalf of my client several weeks ago and it is scheduled for confirmation by the Court at the end of April. At that time I will file the final status report. I request that the hearing scheduled in June be cancelled. Sincerely, sa~ le cc: Mr. Roger Keener ,....,- ~~_... -.,.,_. .....--.. t" " :.: ~ ~ N Ul ~ 2( .. t. > ~ 0 ;3: .. ... .. .. ... 0 c:: " " .. :0 t'l z .. ... Z t'" Z " ~ '" III ~ t"" -< ~ " t;; 0; S t. >- ,.. ~ " 2( ~ t" ~ ... ~ ~ ,.. " t'l ~ ~ rn 0 ... I> OJ o S5"~\~ ~ CD (II' ( :l Q) .., , '\ 9..g~~ 0-;;- ~~a.~'\' . (p j.!) '< r-. -" ~ ~g ~ \Ln ~..o 0.'\ o~o. =' -::.-\ - ~\ ~ .... i -.!.~ a:1:J> A' 0 C 1:') r--. .. 'Cl .- (') (~.....~_Oog >:~" S~::~ <') . c. 0 r-- -. a.- ~ :;~Q~ . 0" = ,~ :;..l .., -, _<tlitl~ i9-~~ 8lii\~i~i~.. ~{ig6 S21!!3'" '.i2o.! Q.S,Ii''':Ji'' ;<l!.' g.g.;O'.....,,}" \1O~ 3 ~ h'~5l:!Q ~igi~~~lPi HU\in\\ !~ilstii~l a. lIS} :'-g" i i~ laoll6'li rY\. ~ ~ U 1\4' 1\S. W: ~ ~ if ~ :~ B" . sf hl. ....._.~lUO-~-- &a:]Gr:r<a;r;t::r "'. 'l! 'i 'l1 Q' !o .,,1> '~ ~ ::> -< ~. ~ \~ ,,__\15'a.~ "" ",,,.0 '5_li () r.- ..~ 11> ?~~ a~~?-l ""l.\\ie~l~ '" \lS.;;;;Q,.~ ~~g~ n t\) ;; <,..'ll ~;1.o.13' ~gQ.'" \"'~ ~i~il ?~ Q.:<~UJ ~'C; . ",;r, q i' ::l ~ i9..2 ~< '0<$ i ::>",o,,5<!'~" ~s-~o -roc..... if; ~" . _.;:a ..... 0 ii\3';(~"'()~~ 2"1S-~g"'~ ~_~~_tt't;.., l;!?....' ~ - c ,... -::' " - Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: ? Q.. \.) \ G- ~e-~f\ e.. C- D.", O!!Joajh, 3 J -' 5 f OD \ Estate No.: ~ \ - 0\- 7 5 PursWU1t tO'Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the admiDis1ration of the above-captioned estate: 1. State whether adminis'lratiou of the estate is complete: Yes~ No 0 :t If the answer is No, state whc:D the personal representative reasonably believes that the administration will be c:omplete: 3. rrtlie 'ansWc:t' to No.1 is Yes, state the following: ' a. Did the personal representative file a final account with the Court? Yes~ No 0 h. The sepll%2l.te Orphans' Cotnt No. (if any) for the personal representative's account is: IV/A . c. Did the personal representative state an account informally to the parties in interest? Yes 0 No 0 AI/A c. Copies of receipts, releases, joinders and approval of fomal or infocna1 acc:olmts may be filed with the Clerk .ofthe Orphans' Court and may be attached to this repQrt. Date: ~D ..J""''''1fJ Os ,~~ Signature N I-- 75 cr ::Se, ll_ 0 C.~',I 000'-' ::x::: '~c Er: Vl ~c lJ.J2~'., --' g: 6~'; 0*1'; ...... c.:; 0:::..". o~ :::> o SFHVW. ELL. A tlO E.$ Name 52..> t-J. n."""" rftue..+ Lt MO pole PA If 1)'11 Address , , 0'\ c.::: , I.[) w...; --. .. C.)-. f2 Ff: ~~~..~ =r: ~ --l .:::::> --:> U":> = = C'J "\1 1~1 53(,,1 Telephone No. Capacity: 0 Persona.l Representative ~ Ccrunsel for personal representative cd