Loading...
HomeMy WebLinkAbout02-0803 Register of Wills of Cumberland County, Pennsylvania Estate of HELEN M. JONES PETITION FOR GRANT OF LETTERS ~-O;.. YbJ No. Also known as HELEN F. JONES . Deceased Social Security No. MATTHEW J. MANNIX Petitioner(s), who is/are 18 years of age or older. apply(ies) for: (COMPLETE "A" OR "B" BELOW:) 201-18-5723 A. Probate and Grant of Letters and aver that Petitioners are the executors named in the Last Will of ..I the Decedent, dated March 10. 1998 and codicil(s) dated April 23. 2001. State relevant circumstances, e.g. renunciation, death of Executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not to victim of a killing and was never adjudicated incompetent D B. Grant of Letters of Administration (d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: I Name I COMPLETE IN ALL CASES:(Altach additional sheets if necessary). Relationship Residence Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at Messiah Village. 100 Mt. Allen Drive. UDDer Allen TownshiD. Mechanicsbura. Cumberland County. Pennsylvania (List street, number and municipality) Decedent, then 75 years of age, died August 19, 2002 at Messiah Village. 100 Mt. Allen Drive. UDDer Allen TownshiD. Mechanicsbura. Pennsylvania (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PAl All personal property.....................................................................$ (If not domiciled in PAl Personal property in Pennsylvania.....................................$ (If not domiciled in PAl Personal property in County....................................................$ Value of real estate in Pennsylvania ......................................................................................................................$ Total......................................................................................................... $ 140.000.00 140.000.00 Real Estate situated as follows: Wherefore, Petitioners respectfully request the probate of the last Will presented with this Petition and the grant of letters in the appropriate form to the undersigned: I /~. 11~J>~--~ Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner above-named swears and affirms that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioners and that, as personal representative of the Decedent, Petitione, will well and truly administer the~Lding to law, , Sworn to and affirmed and subscribed / vU.J ../ ~ MATTH WJ. MANNIX Before me this 6th day of September , 2002 ~)J1.Q/A/~~~ D.:>nna M. otto, 1st Deputy . ;--. ..., , I......' No. 21-2002-803 '-c~ I -:J Estate of HELEN M JONES a/Ida HELEN F. JONES Social Security No:201-18-5723 Date of Death: , I?~ceased August 19. 2002-::. AND NOW, September 6th , 2002, in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters./ Testamentary 0 of Administration d.b.n.c.ta.; pendente I~e; durante absentia; durante minorllate are hereby granted to MA TTHEW J. MANNIX in the above estate and that the instruments dated March 10. 1998 and April 23, 2001 described in the Petition be admitted to probate and filed of record as the last Will of the Decedent. Short Certificate(s) 5 $ Renunciation.............. $ Affidavit ().................. $ Extra Pages (5 )....... $ Codicil............................ $ JCP Fee....................... $ Inventory...................... $ Other.............................. $ TOT AL......... $ 15.00 :::72&tD ~~~~ ~'/)f FEES Letters........................... $ 2311.00 15.00 10_110 5.00 Attorney: EDMUND G. MYERS, ESQUIRE 1.0. No: 20558 Address: Johnson. Duffie. Stewart & Weidner. 301 Market Street. P.O. Box 109. Lemoyne, PA 17043- Telephone: 717-761-4540 280.50 MAILED LEITERS 'TO ATroRNEY ON 9/6/02 HI05.805 REV 9/86 This is to certify that the information here given is correctly copied fran: an original certificate of death dul~ filed with me as Local Registrar. The original certificate will be forwarded to the State VItal Records Office for permanent filmg. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. ~ft2~ Local Registrar Fee for this certificate, $2.00 p 8386623 AUG ~~ L~ Date .1<3_.21117 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH 75 COUNTY OF DEATH Vrs. UNllEIIl WIt -!........ SEX STATE FlU NUM8EA SOCIAl SECURITY NUMBER .. ;).0\ - \~ - 57;)3 \~ ')..U!) l. NAME OF DECEDENT {Fw... _.lllll) \-\e\eV"'\ {V'- \ AGE IlaslllW>doy) UNDER 1 YEAR - ! llayo ! ,. 2. Female ~(C.ly- SIaIe or F0I'8Igr1 Country) Harrisbur Pa :=-""10 !lACE -A_Indian. -. _.. Ole. I~I ... Cl.1rrt>E>..r lam DECEDENT'S USUAl. OCC\JlWlOH (<:-'::::~~~~~:f .".. Secretary 'II. Resco RefrigE'..rat DECEDENT'S lUolUNG AllllRESS {SIo.... (;;oy1Town. SIaIe. Z;p Codel DECEDENT'S ACTUAl. RESIDENCE (See_ 00 ofhet SIde) ... ,0. White SURVIVING SPOUSE tH WIle. Qlve rnad80 name) 17.. StIle Q;d -- ......in. nl!Tlberland 10_7 17d.o :....""='.:::.. MOTHEA'S NAME (fIfSl. MKkIe, Malden Surname) "_STATUS-_ Never Mar,.., Widowed. DN<<_I~ Widowed ". ~..r Allen ..... 100 Mt Allen Drive 11. Mechanicsbur Pa 17055 FRHEA'S NAME (Firll. Middle. lase) 1711. ...-., 1'. Helen Prowell INFORMANT'S MAII.ING AllllRESS {SIo.... CCyITown. _. Z'" Code) Removal 'rom SlateD UCENSE NUMBER e. DUE~ 231>. "",,S CASE REFERRED TO "EDICAl El<AMlNERlCORONER? _. CIf YuO "iA{ 28. I.4pp'oxNnilt. PART U: 0tJw IignifIcanl condiIioN contt'ibutlno\Oduth. buI ; inCeNa& ~ not ~ in the undfHfytng C8YM given in PART l- 10nMt and dNth I . I I :. d. DUE 10 (OR AS A CONSEOUENCE Ofl: DUE 10 lOR AS A CONSEOUENCE Ofl: WERE AUTOPSY FINDINGS MANNER OF DEATH -.....8lE PRIOR 10 COMPLETION OF CAUSE tii:.. 0 OF DEATH' ......... Homa. -- 0 PendinQ_1on 0 v.a0 No 0 - 0 Could not be drlItlN'fJlined 0 DATE OF INJURY (~. Day, 'fear) TIMe OF INJURY jHJIJRV AT WOAK7 DESCRIBE HOW INJURY OCCURRED. .... 0 NoD M. _ o 7 i:J 4" 3 2... 21ll. CERTIFIER ICMck any one) -CERTIfYING 9HYSSClAH (Phvsoan certifying cause 01 d8iIttllNt\erl anOlhef pI'IVSlCI8O has pronounced dea&h ana comp\eteo Item 23) To...beelofmtlutow.....athOCCWf..sduetoUMC8UN(...odm..-ne'......led....................,..... ..................... 29. PlACE Of INJURV - At home, larm, 51'_. factory, ollie. building, etC. (SpeclfV' _. .~~y":~~"::::O:C:~~:~.=~a:.ou~i=~:ld\aC=~:,~)u.S::m':::.'r...tat.d.................. 0 .MEDlCAL EllAloIlHEIlJCORONER On the~. 0' ..anNNltton and/or my..llgation, in my opmion, d.ath oc.CUU" al thetinl't d.t., Jnd piKe. and due to the cause(.)'nd manner.aatated............................. ..................................................................... :11.. REGIS o - J:.l,/~,/1/1 ... u. 004296-00001/3.3.98/EGM/DLM/107365 1!Iast 1Iill aub Wtstamtnt 21-2002-803 OF HELEN M. JONES I, HELEN M. JONES, also known as BELEN F. JONES, of the Borough of New Cumberland, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills or Codicils at any time heretofore made by me. ARTICLE I I direct the payment of all my legal debt and the expenses of my last illness and funeral from my Estate as soon after my death as conveniently may be done. ARTICLE II I give, and bequeath my silver flatware and silver plate serving dishes, and my L'ladro figurines unto CATHY ANN KUNKLE, of Camp Hill, Pennsylvania, provided she survives me. ARTICLE III I give, and bequeath the sum of ONE THOUSAND ($1,000.00) Dollars unto CAROLYN JONES, of Camp Hill, Pennsylvania, provided she survives me. ARTICLE IV I give, devise and bequeath all the rest, residue, and remainder of my Estate, of whatsoever nature and wheresoever situate, unto my nephew, MATTHEW J. MANNIX. If my nephew, MATTHEW J. MANNIX, predeceases me, I give, devise and bequeath all the rest, residue, and remainder of my Estate unto his then-living issue, per stirpes. ARTICLE V In the event that any beneficiary of my Will shall not have reached the age of twenty-one (21) years at the time for distribution of his or her share, distribution of said share may be made in the discretion of my Personal Representative after considering the age and needs of the beneficiary, either directly to the beneficiary or to a Custodian under the Pennsylvania Uniform Transfers to Minors Act, 20 Pa. C.S.A 95301 et seq., or the applicable Uniform Gifts to Minors Act or Uniform Transfers to Minors Act in the state of residence of such beneficiary as the case may be. My Personal Representative may designate as such Custodian any institution or person, including my Personal Representative, qualified to act as a Custodian for such beneficiary under such Act in effect at the time such distribution is made. A receipt for any payment or distribution so made shall be a full discharge therefor to my Personal Representative, who shall not be responsible to see to, or be liable for, the application of such proceeds thereafter. ARTICLE VI My Personal Representative shall have the following powers in addition to those vested in them by law and by other provisions of my Will applicable to all property, whether principal or income, including property held for minors, exercisable without court approval and effective until actual distribution of all property: A. To make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as they may determine. B. To retain any or all of the assets of my estate, real or personal, without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification or risk. C. To invest in all forms of property without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification or risk. 2 D. To sell at public or private sale, to exchange, or to lease for any period of time any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as they deem proper. E. To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper. F. To compromise any claim or controversy. ARTICLE vn I name, constitute and appoint my nephew, MATTHEW J. MANNIX, Executor of this my Last Will and Testament. In the event that my nephew, MATTHEW J. MANNIX, fails to qualify or ceases to so act, I name, constitute and appoint DAUPIllN DEPOSIT BANK AND TRUST COMPANY, Harrisburg, Pennsylvania, alternate Executor to complete the administration of my estate. I direct that no fiduciary appointed herein shall be required to post bond for the faithful administration of the duties required in any jurisdiction. IN WI~S WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this I D day of ~ , 1998. HELEN M. JONES /;' Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. ~t1~ V~n~ 3 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA : SS. COUNTY OF CUMBERLAND We, HELEN M. JONES, ~~ ~.~~nd . the Testatrix and the witnesses, respectively, whose names are signed to the attached or egoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of hislher knowledge the Testatrix was at that time eighteen years of age or older, of sound mind BELEN M. JONES II ~L (j1~Jv- Witness Subscribed, sworn to and acknow1e ~ ~'~~.J and. of~~ ,1998. ed before me by HELEN M. JONES, Testatrix, and ~ , witnesses, this ) ~"""'-'tlay ~.~ Notary Public " NOTARIAL SEAL DIANNE LENIG, Notary Public Lemoyne Borough Cumberland Co. My Commission Expires Dec. 21, 2001 4 004296-00001/4.4.01/EGM/KL T/144666.2 21-2002-803 <ltnbitil to mast mill an~ m.estam.ent of HELEN M. JONES I, HELEN M. JONES, also known as HELEN F. JONES, of Mechanicsburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be the sole Codicil to my Last Will and Testament dated March 10, 1998. Item I. I hereby revoke Article II and Article III of my Will and make no provisions in lieu thereof. Item II. In all other respects, I hereby ratify, confirm and republish my Last Will and Testament dated March 10, 1998. IN WITNESS WHEREOF, I have hereunto set my hand and seal on this the :z.yJ day of ~ ,2001. (SEAL) 004296-00001l4.4.01/EGM/KL T/144666.2 Signed, sealed, published and declared by the above-named Testatrix, as and for her sole Codicil to her Will dated March 10, 1998, in the presence of us, who, at her request, in her presence and in the presence of each other ha~;us as witnesses. ~~4~~ ACKNOWLEDGMENTANDAFnDA~T COMMONWEALTH OF PENNSYLVANIA : SS. COUNTY OF CUMBERLAND We, HELEN M. Sh~vr.l(.~ t/l F,st,~'^ JONES, ~ t{, F:~t1k- and , the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as the Codicil to her Last Will and that she had signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the sole Codicil to her Will as witness and that to the best of hislher knowledge the Testatrix was at that time was eighteen years of age or older, of sound mind and under no constraint or undue influence. ~4~~ Witness 004296-00001/4.4.01/EGMIKL T/144666.2 Subscribed, sworn to and acknowledged before me by HELEN M. JONES, Testatrix, and ~lfW Li. M1f;r and ~htir'Q.R If.~~ witnesses, this ~ day of ~ . ,2001. ~ Edmund G. Myers Pennsylvania Attorney ill No. 20558 ACKNOWLEDGMENT AND AFFIDAVIT ATTORNEY CERTInCATION COMMONWEAL TH OF PENNSYL VANIA ss: COUNTY OF CUMBERLAND On this, the e~ ~ ~ day of ~~~ ,2001, before me, the undersigned officer, personally appeared EDMUND G. MYERS, ATTORNEY I.D. #20558, known to me (or satisfactorily proven) to be a member of the bar of the highest court of Pennsylvania and certified that he was personally present when HELEN M. JONES, whose name is subscribed to the within instrument executed the same, and that the said person acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. .~~^~~ ~ Notary Public ~... (SEAL ) NOTARIAL SEAL . DIANNE LENIG. Notary Public Lemoyne Borough Cumberland Co. My Commission Expires Dec. 21. 2001 cI CERTIFICATION OF NOTICE UNDER RULE 5.6{a) Name of Decedent: Date of Death: Will No.: HELEN M. JONES a1k1a HELEN F. JONES AUGUST 19, 2002 2002-00803 Admin. No.: 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 September 19, 2002. Name Address MATTHEW J. MANNIX 215 A Winsor Lane Haverford, PA 19041 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None. Date: September 19, 2002 4 Signature Name EDMUND G. MYERS Johnson, Duffie, Stewart & Weidner Address 301 Market St. P. O. Box 109 Lemoyne, PA 17043-0109 Telephone (717) 761-4540 Capacity: Personal Representative ~ Counsel for personal representative \- ~ 07 IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE Whether you will receive any money or property will be determined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA IN RE: Estate of HELEN M. JONES a/k/a HELEN F. JONES, deceased, No. 2002-00803 TO: MR. MATTHEW J. MANNIX 215 A Winsor Lane Haverford, PA 19041 Please take notice of the death of decedent and the grant of letters to the personal representatives named below. The Decedent HELEN M. JONES a/kla HELEN F. JONES died on the 19th day of August, 2002, at Messiah Village, Mechanicsburg, Pennsylvania. The Decedent died testate (with a Will). A copy of the Will is attached. The personal representative of the Decedent is: Name MATTHEW J. MANNIX Address 215 A Winsor Lane Haverford, Pa 19041 Telephone 610-645-7700 x. 104 If the Decedent died testate, the Will has been filed with the Office of the Register of Wills of Cumberland County, Cumberland County Courthouse, Carlisle, PA 17013. Phone No. (717) 240-6345 Signatu~ Name EDMUND G. MYERS Date: September 19, 2002 Addr~ss Johnson. Duffie. Stewart & Weidner 301 Market Street P.O. Box 109 Lemovne. PA 17043-0109 Telephone (717) 761-4540 Capacity: Personal Representative ~ Counsel for personal representative )-,;,:1 e n ..--._ ----=a _._--~ Qtuhiril to mast mill anh Wtstamtut of HELEN M. JONES I, HELEN M. JONES, also known as HELEN F. JONES, of Mechanicsburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be the sole Codicil to my Last Will and Testament dated March 10, 1998. Item I. I hereby revoke Article II and Article III of my Will and make no provisions in lieu thereof. Item II. In all other respects, I hereby ratify, confirm and republish my Last Will and Testament dated March 10, 1998. IN WITNESS WHEREOF, I have hereunto set my hand and seal on this the 23v-J day of ~ ,2001. (SEAL) , .1 """""\ Signed, sealed, published and declared by the above-named Testatrix, as and for her sole Codicil to her Will dated March 10, 1998, in the presence of us, who, at her request, in her presence and in the presence of each other ha~2g as witnesses. S"'~ AI ~~ ACKNOWLEDGMENT AND AFFIDAVIT ! ;1 i C0Ml\10NWEALTH OF PENNSYLVANIA : SSe COUNTY OF CUMBERLAND We, HELEN M. Sh'-t1'-le~ M F,sc"er- JONES, Iht~ tt{~ FfitV-r-- and , the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as the Codicil to her Last Will and that she had signed willingly and that she executed it as her free and voluntary '"\ act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the sole Codicil to her Will as witness and that to the best of his/her knowledge the Testatrix was at that time was eighteen years of age or older, of sound mind and under no constraint or undue influence. Witness ~ 1/ ~h/ Witness -1. Subscribed, sworn to and acknowledged before me by HELEN M. JONES, Testatrix, and ffilrW Ci . .~h;r and ~hvV--fQR fl. ~ wlte.J.. witnesses, this ~. day of ~ . ,2001. ~ Edmund G. Myers Pennsylvania Attorney ill No. 20558 ACKNOWLEDGMENT AND AFFIDAVIT ATTORNEY CERTIFICATION COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF CUMBERLAND "\ On this, the ~:J ~~ dayof~:.......L , 2001, before me, the undersigned officer, personally appeared EDMUND G. MYERS, ATTORNEY I.D. #20558, known to me (or satisfactorily proven) to be a member of the bar of the highest court of Pennsylvania and certified that he was personally present when HELEN M. JONES, whose name is subscribed to the within instrument executed the same, and that the said person acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. .~~~ ~~ Notary Public ~ (SEAL) NOTARIAL SEAL . DIANNE LENIG, Notary Public lemoyne Borough Cumberland Co. My Commission Expires Dec. 21. 2001 -=-== ~. .,-4..~ 1Jlnst lIill nub mtstnmtut OF HELEN M. JONES I, HELEN M. JONES, also known as HELEN F. JONES, of the Borough of New Cumberland, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills or Codicils at any time heretofore made by me. ARTICLE I I direct the payment of all my legal debt and the expenses of my last illness and funeral from my Estate as soon after my death as conveniently may be done. ARTICLE II I give, and bequeath my silver flatware and silver plate serving dishes, and my L'ladro figurines unto CATHY ANN KUNKLE, of Camp Hill, Pennsylvania, provided she survives me. ARTICLE ill I give, and bequeath the sum of ONE TIIOUSAND ($1,000.00) Dollars unto CAROLYN JONES, of Camp Hill, Pennsylvania, provided she survives me. ARTICLE IV I give, devise and bequeath all the rest, residue, and !emainder of my Estate, of whatsoever nature and wheresoever situate, unto my nephew, MATTHEW J. MANNIX. If my nephew, MATTHEW J. MANNIX, predeceases me, I give, devise and bequeath all the rest, residue, and remainder of my Estate unto his then-living issue, per stirpes. i ~ ARTICLE V In the event that any beneficiary of my Will shall not have reached the age of twenty-one (21) years at the time for distribution of his or her share, distribution of said share may be made in the discretion of my Personal Representative after considering the age and needs of the beneficiary, either directly to the beneficiary or to a Custodian under the Pennsylvania Uniform Transfers to Minors Act, 20 Pa. C.S.A ~ 5301 et seq., or the applicable Uniform Gifts to Minors Act or Uniform Transfers to Minors Act in the state of residence of such beneficiary as the case may be. My Personal Representative may designate as such Custodian any institution or person, including my Personal Representative, qualified to act as a Custodian for such beneficiary under such Act in effect at the time such distribution is made. A receipt for any payment or distribution so made shall be a full discharge therefor to my Personal Representative, who shall not be responsible to see to, or be liable for, the application of such proceeds thereafter. ARTICLE VI My Personal Representative shall have the following powers in addition to those vested in them by law and by other provisions of my Will applicable to all property, whether principal or income, including property held for minors, exercisable without court approval and effective until actual distribution of all property: A. To make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as they may determine. B. To retain any or all of the assets of my estate, real or personal, without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification or risk. C. To invest in all forms of property without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification or risk. 2 i ~ D. To sell at public or private sale, to exchange, or to lease for any period of time any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as they deem proper. E. To allocate receipts and expenses to' principal or income or partly to each as they from time to time think proper. F. To compromise any claim or controversy. ARTICLE VII I name, constitute and appoint my nephew, MAITHEW J. MANNIX, Executor of this my Last Will and Testament. In the event that my nephew, MATIBEW J. MANNIX, fails to qualify or ceases to so act, I name, constitute and appoint DAUPHIN DEPOSIT BANK AND TRUST COMPANY, Harrisburg, Pennsylvania, alternate Executor to complete the administration of my estate. I direct that no fiduciary appointed herein shall be required to post bond for the faithful administration of the duties required in any jurisdiction. IN WI~S WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this / D day of;J1~ , 1998. BELEN M. JONES , /;' Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. ~tJ>>r- 0~ ()~k 3 i 1 I d ,~'" ACKNOWLEDGMENT cOMMONWEALm OF PENNSYLVANIA : SSe COUNTY OF CUMBERLAND We, HELEN M. JONES, ~ "".~~d ,S::)/v.,-.,-.. ~~ ' the Testatrix and the witnesses, respectively, whose names are signed to the attached or egoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of hislher knowledge the Testatrix was at that time eighteen years of age or older, of sound mind ~L fiUvIu- Witness Subscribed, sworn to and aCknOWle~ me by HELEN M. JONES, Testatrix, and ~ R). ~ ~ J and. ~ ~ ' witnesses, this 1 ~"""-'ffil.y of~~ ,1998. ~.~ NOTARIAL SEAL DIANNE lENIG, Notary Public lemoyne Borough Cumberland Co. My Commission Expires Dec. 21, 2001 4 COMMONWEALTH OF PENNSYLVANIA OEPARTMENT 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 LAWRENCE MEREDITH L 1550A LOVELL CT PA TUXENT RIVER, MD 20670 __h____ fold ESTATE INFORMATION: SSN: 201-18-5723 FILE NUMBER: 2102-0803 DECEDENT NAME: JONES HELEN M DATE OF PAYMENT: 02/14/2003 POSTMARK DATE: 02/12/2003 COUNTY: CUMBERLAND DATE OF DEATH: 08/19/2002 NO. CD 002169 ACN ASSESSMENT CONTROL NUMBER AMOUNT 02146591 I $751.14 I I I I I I I I TOTAL AMOUNT PAID: $751.14 REMARKS: MEREDITH L LAWRENCE CHECK# 2222 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS DONNA M. OTTO DEPUTY REGISTER OF WILLS ?Q'vU ~NWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. ZlI0601 HARRISBURG. PA 171Z8-0601 '* INFORMATION NOTICE AND TAXPAYER RESPONSE * REVISED NOTICE * * * FILE NO. 21 02-0803 ACN 02146591 DATE 11-26-2002 * REV-1545 EX AFP 109-DDl EST. OF HELEN M JONES S.S. NO. 201-18-5723 DATE OF DEATH 08-19-2002 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS o CHECKING o TRUST [X] CERTIF . . ') MEREDITH MANNIX 22512 IVERSDH-BR D~ ~ MILLS MD 211634 \'S'S--O 14 Lv" ELL c.ou(<.\ f>Ar\A~cN\ -g\-.Je~ I MD LDla'')O REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 ALLFIRST FINANCIAL SERVICES has prDvided the Departaent with the inforaatiDn listed belDw which has been used in calculating the PDtential tax due. Theil" recDrds indicate that at the death Df the abDve decedent. YDU were a jDint Dwner/beneficiary Df this accDunt. If YOU feel this infDraation is incDrrect. please Dbtain written cDrrectiDn frDa the financial institution, attach e copy tD this fD'" and return it tD the abDve address. This aCCDunt is taxable in accDrdance with the Inheritance Tax Laws Df the CDaaDnwealth D~ Pennsylvania. QuestiDns aay be answered by calling (717) 787-83~7. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 2183719 Date 06-19-2000 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 10.015.25 50.000 5.007.63 .15 751.14 TAXPAYER RESPONSE TD insure propel" credit tD YDUr accDunt, tWD (Z) cDpies Df this nDtice aust accoapany YDur payaent tD the Register Df Wills. Nake check payable tD: "Register Df Wills. Agent". x NOTE: If tax payaants are aade within three (3) aDnths Df the decedent's date Df death. you aay deduct a SiC discDunt Df the tax due. Any inheritance tax due will becDae delinquent nine (9) aDnths after the date Df death. Tax PART ill A. [ CHECK ] ONE BLOCK B. ONLY c. ~ The abDve infDraatiDn and tax due is CDrrect. ~ 1. YDU aay chDDse tD reait payaent tD the Register Df Wills with twD copies Df this notice tD Dbtain a discDunt Dr aVDid interest. Dr YDU .ay check bDX "A" and return this nDtice tD the Register Df Wills and an Dfficial assessaent will be issued by the PA Departaent Df Revenue. [] The abDve asset has been Dr will be repDrted and tax paid with the Pennsylvania Inheritance Tax return tD be filed by the decedent.s reprasentative. c=J The abDve infDraatiDn is incDrrect and/Dr debts and deductions were paid by YDU. YDU aust cDaplete PART ~ and/Dr PART ~ belDw. PART ~ TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due TAX ON JOINT/TRUST ACCOUNTS If you indicate a different tax rate. please state your relationship to decedent: OF 1 2 3 X 4 5 6 7 8 X PART @] DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID Line 5 of Tax Computation) $ have reported above are true. correct and HOME ("5IJ I ) 81Rro -( S8"b WORK (3/J I ) Z?IP& -(~ TEL PH E UMB R DATE ~ t j' l~\... ,"-:. .~ .. ., \ '* . 1 l " 1 i \ \ \ ! I ! \ II I I i \ ' I " I , . \ " \ \\\ .\\\\ \ .\'\\\\\ \\,\\\' \ t ; -~ ~r'...~}~i)\. "'" "". .'-. '" ..--" ~j ~~':,::.,A) '":.;,, ~ '"' J '0(1"'1 ~'};,.l' ~~~~r' (;, ':0 " S'. o r- \0 O' ~ .....'2"9- ~~l:4 ~';:) . ~<6~ $ ~ '7 · ta ~ '""'7 ~O~ '2"'""~ I-'- 4. ~ ~O? ~U' ~ ~~~ ~ tIl ? ~ ~~ .f'> ';:) ~ WOO ~Ur- I-'- ~ ~<6,d'. ~ ~ 0(:) . 'P ~,d'.~ ~~tIl e-'~I-'- tIli:O'"" '0$% ~DU .- ~ -: -: -: ~ -:: .. .. -: -:: -:;::::. ~ . -::::.: .. . -::::: ~ - - ...-; .. . - -::: . ,.;:. .. . ,,;,-,,\ .", '.... .....\ \,.., ,'" f':\ .-t" ,*(t ..." o \~.. ..... ~ ~ LAW OFFICES JERRY R. DUFFIE RICHARD W. STEWART C. ROY WEIDNER. JR. EDMUND G. MYERS DAVID W. DELUCE RALPH H. WRIGHT, JR. DAVID J. LANZA MARK C. DUFFIE MELISSA PEEL GREEVY MICHAEL J. CASSIDY ROBERT M. WALKER JOHNSON. DUFFIE, STEWART & WEIDNER A Professional Corporation 301 MARKET STREET P. O. BOX 109 LEMOYNE, PENNSYLVANIA 17043-0109 WEBSITE: www.jdsw.com HORACE A. JOHNSON COUNSEL TO THE FIRM KEIRSTEN WALSH DAVIDSON OF COUNSEL TELEPHONE 717-761-4540 FACSIMILE 717-761-3015 E-MAIL mail@jdsw.com E-MAIL dlw@jdsw.com February 19, 2003 Register of Wills Office Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re: Estate of Helen M. Jones SSN: 201-18-5723 Date of Death: August 19,2002 Your File No. 21-2002-0803 Dear Register: Enclosed for filing please find the following documents for the above referenced decedent: 1. 2 Original P A Inheritance Tax Returns. There is tax due in the amount of $20,250.37. An Estate check is attached to the Inheritance Tax Return 2. Check No. 8609 in the amount of $25.00 representing the filing fees for an Inheritance Tax Return and Inventory. 3. 1 copy of Pages 1 & 2 of the Pa Inheritance tax return, which we ask that you time-stamp and return to us in the enclosed envelope. 4. Inventory 5. Inventory (copy), which we ask that you time stamp and return to us in the enclosed envelopt::;. Should you have any questions, please do not hesitate to contact our office. Thank you for you assistance in this matter. Very truly yours, .rA ../. f), 1O~~ ~eman Legal Assistant 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 MYERS EDMUND G ESQUIRE 301 MARKET STREET POBOX 109 LEMOYNE, PA 17043 n______ fold ESTATE INFORMATION: SSN: 201-18-5723 FILE NUMBER: 2102-0803 DECEDENT NAME: JONES HELEN M DATE OF PAYMENT: 02/20/2003 POSTMARK DATE: 02/19/2003 COUNTY: CUMBERLAND DATE OF DEATH: 08/19/2002 NO. CD 002198 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $20,250.37 I I I I I I I I TOTAL AMOUNT PAID: $20,250.37 REMARKS: MATTHEW J MANNIX C/O EDMUND G MYERS ESQUIRE CHECK#102 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS DONNA M. OTTO DEPUTY REGISTER OF WILLS Register of Wills of CUMBERLAND County, Pennsylvania INVENTORY Estate of HELEN M. JONES No. 2002-00803 also known as Helen F. Jones Date of Death 08/19/2002 ,Deceased Social Security No. 201-18- 5723 MATTHEW J. MANNIX, 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 of 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. l!We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: Edmund G. Myers p""", R'P"~ ' Signature: 6./ ~ L MATT W J. MANNIX 1.0. No.: 20558 Signature: Address: P. O. Box 109 Address: 215 A Winsor Lane Lemoyne, PA 17043-0109 Haverford, PA 19041 Telephone: 717/761-4540 Telephone: 610/645-7700 x.104 Dated: Description Value (See continuation page(s) attached) (Attach additional sheets if necessary) ,,' Total: 132,506.73 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. Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form#RW-7 (1992) INVENTORY Estate of: Date of Death: County: HELEN M. JONES 08/19/2002 Cumberland CASH: A11first Bank Certificate of Deposit No. 8-000-000-2184174 118,799.78 Accrued income through date of death 70.47 A11first Certificate of Deposit Acocunt No. 87008140259500 5,000.00 Accrued income through date of death 6.73 A11first Relationship Checking w/Interest Account No. 0049686100 7,086.57 Accrued income through date of death 0.34 Reimbursement/Refund received from AARP Hea1thcare 411.00 131,374.89 STOCKS/LISTED: 32.000 shares Prudential Finacia1, Inc. Shares valued as per attached Estate Val Valuation 1,036.00 1,036.00 -1- BONDS: Series EE u.S. Savings Bonds. Valued as per attached Savings Bond Calculator 95.84 TOTAL RECEIPTS OF PRINCIPAL............... -2- 95.84 132,506.73 " I 7~ SL, - 't REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT REV-1500 EX + (6-00) CAPB HpRL EplO CRAC KOTK ES C P o 0 R N R 0 E E S N T C o M T ~ A T X A T I o N FILE NUMBER o E C E o E N T COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME {LAST, FIRST,AND MIDDLE INITIAL) G/ OFFICiAL USE ONLY 21-2002-0803 JONES HELEN M. DATEOF DEATH (MM-OO-YEAA) COUNTY CODE YEAR SOCIAL SECURITY NUMBER 201-18-5723 THIS RETURN MUST BE FILED IN DUPUCATE WITH THE NUMBER REGISTER OF WILLS SOCIAL SECURITY NUMBER X 1. Original Return 4. LImited Estate X 6. Decedent Died Testate 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust 1 (Attach copy of Trust) (Attach copy of WUl) D 9. Litigation Proceeds Received 3 date of Bath . Remainder Return prtorto 12-13-S2) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes D 10. Spousal Poverty Credit D 11. Election to tax under Sec. 9113(A} (date of death between 12-31-91 and 1-1-95) (Attach Sch 0) ';"',]t~J~;~~]t!!!!81M!i!$'ttl!!~;!;l!lMPJ!e!i!iQ\\1~~.ltl!!~~e$~f.j[\ENCE.&:;C;()NFiDeNi\!AL.'jiAX';!~~MA'jiI!!lIl~HOl'1t;f"lBalij".." NAME COMPLETE MAILING ADDRESS Edmund G. M era FIRM NAME (If Appllcable) Johnson, Duffie, Stewart & Weidner TELEPHONE NUMBER P. O. Box 109 301 Market Street Lemoyne, PA 17043-0109 R E C A P I T U L A T I o N 6 - 4540 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (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) 14. Net Value Subject to Tax (Line 12 minus Line 13) (1) (2) (3) Nome 1,131.84 None (4) (s) None 131,396.69 (6) 22,967.65 None 9,420.45 11,073.25 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a}(1.2) 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. OFFICIAL USE ONLY (8) 155,496.18 (11) 20.493.70 (12) 135,002.48 (13) (14) 135,002.48 x .0 0 (15) 0.00 X .0 45 (16) 0.00 X .12 (17) 0.00 135,002.48 X .15 (18) 20,250.37 (19) 20,250.37 EFUND OF AN OVERPAYMENT.,. STIONS ON REVERSE SIDE AND TO REc;HECK MATH i:'~";"\ Copyright (c) 2000 form software only The Lackner Group, Inc. "'."""'::>''':: <,<.,.. . FOim REV-1S00 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS Mess iah Village 100 Mt. Allen Drive CITY I STATE I liP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 20,250.37 Total Credits ( A + 8 + C) (Z) 0.00 3. Interest/Penalty if applicable D.lnterest E. Penalty ~allntereSI/Penalty ( 0 + E) (3) 4. If Line 2 is greater than Line 1 + line 3, enter the difference Thi~ is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 20,250.37 A. Enter the interest on the tax due. (SA) 0 . 00 B. Enter the total of Line 5 + SA This is the BALANCE DUE. (58) 20,250.37 Make Check Payable to: REGISTER OF WillS, AGENT . .. .. . 'j;iii>il:iH::i[i::i::;ii::i:::::!i;:nHHj::l:iiH1hi;ji\iiiii:!!:i!!!!i!!i!j:jjiiiji:Hiii::i:iniiiiii::Hi:i:nii::;::nn::ini!!U:nU:HiiHU::::::,::'?:,""i:i:::i:ii:iiHUV/:"U:U:iii:i:ni:n::::::iii:!miiii: iiii:::i::!ii:::iil!imiliiii::i::iiii:::iiii::i;,i;i;:;;ii!iii!il!iii;iil!!iilIJll\llm;;:ii!:i:m:::: "PL"EASEANSWER'THEFOiIOWiNGQUESTI()NS BY PLACING AN "X,iiN THE APPROPRIATE BLOCKS 1 Did decedent make a transfer and: Ye" No a. retain the use or income of the property transferred; b. retain the right to designate who shall use the property tran"ferred or its income; . . c. retain a reversionary interest; or . ~DO' ~X' d. receive the promise for life of either payments. benefits or care? fiJ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 4. Did decedent own an Individual Retirement Account, annuity. or other non-probate property which contains a beneficiary designation? IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN. 0.00 o o o IT] IT] IT] Under penalties of perjury, I declare that r have examined this return, Including accompanyinq schedules and statements, and to the best of my knowledge clnd 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 EOFPERSONRESPONSIBLEFORFllINGRETURN MATTHEW J. t'1ANNIX DATE 215 A Winsor Lane - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~ - - - - - - - . - - - - - - - - - Haverford, PA 19041 Duffie I Stewart & Weidner DATE lU9 PA 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 Of for the use of the surviving spouse is 3% [72 P.S. 9116 (a) (1.1) 0)]. 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. 9116 (a) (1.1) (iO]. The statute does not exempt a transfer to a surviVing spouse from tax, and the statutory requiremerLts 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 fen the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as no~ed in 72 P.S. 9116( 1.2) [72 P.S. 9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent"s siblings is 12% [72 P.S. 9116(aXl.3}]. A sibling is defined, under Section 9102. as an individual who has at least one parent in common witn the decedent whether by blood or adoption. Copyright(c) 2000 form software only The Lackner Group, Inc. Forni REV-1500 EX (Rev. 6-00) 'REV- 1503 EX + (1 -97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER HELEN M. JONES SSlf 201-18-5723 08/19/2002 21-2002-0803 All property jointly-owned with right of survivorship must be disclosed on Schedule F. 32 shares Prudential Finacial, Inc. Shares valued as per attached Estate Val Valuation, CUSJ? #744320102 32.375 VALUE AT DATE OF DEATH 1,036.00 ITEM NUMBER 1 DESCRIPTION UNIT VALUE 2 Series EE U.S. Savings Bonds. Valued 8S per attached Savings Bond Calculator 95.84 TOTAL (Also enter on line 2, Recapitulation) (If more space IS needed, Insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems. Inc. 1,131.8/, Form REV-1503 EX (Rev. 1-97) 'REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HELEN M. JONES SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY 5511 201-18 - 5723 08/19/2002 FILE NUMBER 21-2002-0803 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 VALUE AT DATE OF DEATH 118,799.78 DESCRIPTION A11first Bank Certificate of Deposit No. 8-000-000-2184174 Accrued income on item 1 through date of death 70./,7 2 A1lfirst Certificate of Deposit ACOCUflt No. 87008140259500 5,000.00 Accrued income on item 2 through date of death 6.73 3 Al1first Relationship Checking w/lntercst Account No. 0049686100 7,086.57 Accrued income on item 3 through date of death 0.34 4 Refund of unearned Premium 21. 80 5 Reimbursement/Refund received from AARP Healthcare 411 . 00 TOTAL (Also enter on line 5, Recapitulation) $ 131,396.69 (If more space IS needed, Insert additional sheets of the same size) Copyright (e) 1996 form software only CPSystems Ine , . Fonn REV-15GB EX (Rev. 1-97) 'REV-1509 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HELEN M. JONE5 SCHEDULE F JOINTLY-OWNED PROPERTY 5511 201-18-5723 08/19/2002 FILE NUMBER 21-2002-0803 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Meredith Mannix 579 Golf Road South Burlington, VT Grand Niece B. Catharine Mannix 579 Go 1 I Road South Burlinton, VT Grand Niece c. Jamie Mannix 579 Golf Road Sou"th Burlington" VT Grand Nephew JOINTLY-OWNED PROPERTY, LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bilnk DATE OF DEATH DECO'S VALUE OF account number or similar identifying nUlT1ber. NUMBER TENANT JOINT Attach deed for jointly-held real estal,' VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1 A A11first Bank Certificale 10,000.00 50.00% 5,000.00 of Deposit Account No. 80000002183719 A Accrued income on item 1 15.25 50.00% 7.63 through date of death 2 B A11first Bank Certificate 7,931. 99 50.00% 3,966.00 of Deposit Account No. I 80000002183717 B Accrued income on item 2 13.23 50.00% 6.62 through date of death 3 B Allfirst Bank Certificate 10,000.00 50.00;; 5,000.00 of Deposit Account. No. 80000002183721 B Accrued income on item 3 14.30 50.00% 7.15 through date of death 4 C A1lfirst Bank Certificate 10,000.00 50.00;, 5,000.00 of Deposit Account No. 80000002183715 C Accrued income on item I, 17.16 50.00X, 8.58 through date of death 5 C Allfirst Bank Certificate 7,931. 99 50.00% 3,966.00 of Deposit Account No. Tot 1 of Contim ation 5chedu1e(s) 5.67 TOTAL (Also enter on line 6, Recapitulation) $ 22,967.65 (If more space IS needed Insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Fo,r~ REV-1509 EX (Rev_ 1-97) Estate of: HELEN M. JONES Soc See #: 201-18-5723 Date of Death: 08/19/2002 Item Ltr for II Jt Ten Date Joint Continuation of Schedule F (Jointly Owned Propecty) Description of property Total Val of Asset Decd;j % Int Dollar Val of Deeds Interest c 80000002183720 Accrued income on item 5 through date of death 11.34 50.00% 5.67 5.67 REV 1511 EX+(l 97) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21-2002-0803 ESTATE OF HELEN M. JONES SSlI 201-18-5723 08/19/2002 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. ADMINISTRATIVE COSTS, 1. Personal Representative's Commissions Name of Personal Representative(s) _____ Social Security Number(s) / EIN Number of Personal liepresentative(s) Street Address City Slale Zip B. 2. 3. DESCRIPTION I AMOUNT 1 FUNERAL EXPENSES, Myers-Harner Funeral Home 5,911.00 Year(s) Commission Paid: Attorney's Fees Johnson, Duffie, SteWiJrt. 0: Weidner (If decedent's address is not the same as claimant's attach explanation) 3,000.00 Family Exemption: Claimant Street Address City Relationship of Claimant to Decedent Zip Slate 4. Probate Fees Register of Wills 280.50 S. Accountant's Fees 6. Tax Return Pre parer's Fees 7. 1 Other Administrative Costs Cumberland County Register of Inheritance Tax Return Inventory Additional Short Certificates Wills 0 L flee $15.00 $10.00 $ 9.00 Filing Fees: 34.00 2 The Cumberland Law Journal - Estate Advertising 75.00 3 The Patriot News Company - Estate Adver.tisement 119.95 I I TOTAL (Also enter on line 9, RecaPitulatioC!~J_~___ (rf more space is needed, insert addltionill sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. _2.,420.45 Fori'll REV-1511 EX (Rev.1~97) REV-1512 EX + (1-97) COMMONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HELEN M. JONES SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SSfl 201-18-5723 08/19/2002 FILE NUMBER 21-2002-0803 Include unreimbursed medical expenses. ITEM NUMBER 1 DESCRIPTION AARP Debit from Checking Account for Hea1thcare AMOUNT 1- 205.50 I I I I 0.0/, 906.53 1 560.33 288.05 645.00 8,467.80 2 Allfirst bank fee deducted from AccouTtt. 3 Checks clearing after date of death 4 Final Medical/Pharmacy Invoices 5 Final Medical/Pharmacy Invoices 6 Johnson, Duffie, Stewart & Weidner - Legal Fees for Estate Planning prior to Death 7 Messiah Village Retirment Home - Final Billing ! I I ( . TOTAL (Also enter on fine 10, Recapitulation) $ 11,073.25 . If more space is needed, insert additional sheets of the same size) COPYright (e) 1996 form software only CPSystems Ine , . For;)) REV-1512 EX (ReV'. 1-97) . REV-1513 EX f (9-00) SCHEDULE J BENEFICIAR IES COMMONWEALTH OF PENNSYLVANIA INHERIT ANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HELEN M. JONES SSjl 201-18- 5723 08/19/2002 NUMBER I. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116{a)(1.2)] MATTHEW J. MANN1X 215 A Winsor Lane Haverford, PA 19041 1 RELATIONSHIP TO DEqqENT Do Not List Trustee(s) Nephew FILE NUMBER 21-2002-0803 AMOUNT OR SHARE OF ESTATE Entire Estate ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON RoV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS, A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space IS needed, insert additional sheets of the same size) Copyright (cl :2.000 form software only The Lackner Group, Inc. 0.00 Form REV-1513 EX (Rev. 9-00) LISTING OF EXHIBIT FOR ESTATE OF HELEN F. JONES EXHIBIT A Last Will and Testament dated March 10, 1998 EXHIBIT B Codicil to the Last Will and Testament dated April 23, 2001 EXHIBIT C Estate Val Valuation for Prudential Stock listed on Schedule B EXHIBIT D Savings Bonds Calculator valuing Savings Bonds listed on Schedule B -==- -~ roast mUI anll ijlestam.ent OF HELEN M. JONES I, HELEN M. JONES, also known as HELEN F. JONES, of the Borough of New Cumberland, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills or Codicils at any time heretofore made by me. ARTICLE I I direct the payment of all my legal debt and the expenses of my last illness and funeral from my Estate as soon after my death as conveniently may be done. ARTICLE II I give, and bequeath my silver flatware and silver plate serving dishes, and my L'ladro figurines unto CATHY ANN KUNKLE, of Camp Hill, Pennsylvania, provided she survives me. ARTICLE ill I give, and bequeath the sum of ONE THOUSAND ($1,000.00) Dollars unto CAROLYN JONES, of Camp Hill, Pennsylvania, provided she survives me. ARTICLE IV I give, devise and bequeath all the rest, residue, and ;emainder of my Estate, of whatsoever nature and wheresoever situate, unto my nephew, MATTHEW J. MANNIX. If my nephew, MATTHEW J. MANNIX, predeceases me, I give, devise and bequeath all the rest, residue, and remainder of my Estate unto his then-living issue, per stirpes. ARTICLE V In the event that any beneficiary of my Will shall not have reached the age of twenty-one (21) years at the time for distribution of his or her share, distribution of said share may be made in the discretion of my Personal Representative after considering the age and needs of the beneficiary, either directly to the beneficiary or to a Custodian under the Pennsylvania Uniform Transfers to Minors Act, 20 Pa. C.S.A ~ 5301 et seq., or the applicable Uniform Gifts to Minors Act or Uniform Transfers to Minors Act in the state of residence of such beneficiary as the case may be. My Personal Representative may desigoate as such Custodian any institution or person, including my Personal Representative, qualified to act as a Custodian for such beneficiary under such Act in effect at the time such distribution is made. A receipt for any payment or distribution so made shall be a full discharge therefor to my Personal Representative, who shall not be responsible to see to, or be liable for, the application of such proceeds thereafter. ARTICLE VI My Personal Representative shall have the following powers in addition to those vested in them by law and by other provisions of my Will applicable to all property, whether principal or income, including property held for minors, exercisable without court approval and effective until actual distribution of all property: A. To make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as they may determine. B. To retain any or all of the assets of my estate, real or personal, without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification or risk. C. To invest in all forms of property without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification or risk. 2 D. To sell at public or private sale, to exchange, or to lease for any period of time any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as they deem proper. E. To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper. F. To compromise any claim or controversy. ARTICLE vn I name, constitute and appoint my nephew, MA'ITHEW J. MANNIX, Executor of this my Last Will and Testament. In the event that my nephew, MA'ITHEW J. MANNIX, fails to qualify or ceases to so act, I name, constitute and appoint DAUPHIN DEPOSIT BANK AND TRUST COMPANY, Harrisburg, Pennsylvania, alternate Executor to complete the administration of my estate. I direct that no fiduciary appointed herein shall be required to post bond for the faithful administration of the duties required in any jurisdiction. IN ~S WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this / D day of ~ , 1998. HELEN M. JONES . /; Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. ~uIIP>>r- J)~ ()~k 3 i ~.. ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND : SS. We, HELEN M. JONES, -&~ )-:::l.~~d ' the Testatrix and the wilnesses, respectively, whose names are signed to the attached or egoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the wilnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of hislher knowledge the Testatrix was at that time eighteen years of age or older, of sound mind Subscribed, sworn to and acknowle "4S;J~ R:l.~~, and. of~~ ,1998. !_-----~,- Witness fJbJ/J{~. fl(?4jv Witness ed before me by HELEN M. JONES, Testatrix, and ~ , witnesses, this I ~ '"'-\lliy 4 ~~ Notary Public " NOTARIAL SEAL DIANNE LENIG, Notary Public lemoyne Borough Cumberland Co. My Commission Expires Dec. 21, 2001 ~ <ltnbitil to 14a5t Bill null Wt5tamtut of HELEN M. JONES I, HELEN M. JONES, also known as HELEN F. JONES, of Mechanicsburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be the sole Codicil to my Last Will and Testament dated March 10, 1998. Item 1. I hereby revoke Article II and Article III of my Will and make no provisions in lieu thereof. Item II. In all other respects, I hereby ratify, confirm and republish my Last Will and Testament dated March 10, 1998. IN WITNESS WJlEREOF, I have hereunto set my hand and seal on this the 23v-J day of ~ ,2001. (SEAL) --.\, Signed, sealed, published and declared by the above-named Testatrix, as and for her sole Codicil to her Will dated March 10, 1998, in the presence of us, who, at her request, in her ....0000"'" in "" _~OO of=h ""'" hav&2U ~ .._" ~~N#~ ACKNOWLEDGMENT AND AFFIDA VlT COMMONWEALTH OF PENNSYLVANIA : SS. COUNTY OF CUMBERLAND We, HELEN M. Sh"fCle~ tll FISL?lIl" JONES, fr>t~ f{, rv.~ and , the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as the Codicil to her Last Will and that she had signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the sole Codicil to her Will as witness and that to the best of hislher knowledge the Testatrix was at that time was eighteen years of age or older, of sound mind and under no constraint or undue influence. ~ Witness ~i/~~ Witness """""l Subscribed, sworn to and acknowledged before me by HELEN M. JONES, Testatrix, and .ffi.~ lei. .f01't;r and ~hI/0'QR If. ~1/j1te.r witnesses, this ~ day of ~ . ,2001. ~ Edmund G. Myers Pennsylvania Attorney ill No. 20558 ACKNOWLEDGMENT AND AFFIDAVIT ATTORNEY CERTIFICATION COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF CUMBERLAND , On this, the .~ ~ ~ day of ~U- , 2001, before me, the undersigned officer, personally appeared EDMUND G. MYERS, ATTORNEY I.D. #20558, known to me (or satisfactorily proven) to be a member of the bar of the highest court of Pennsylvania and certified that he was personally present when HELEN M. JONES, whose name is subscribed to the within instrument executed the same, and that the said person acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. '~N..Nvv-L ~~.:... -<:s,'.~"E;.' Notary Public (SEAL) NOTARIAL SEAL DIANNE LENIG, Notary Public Lemoyne Borough Cumbelland Co. My Commission Expires Dec. 21. 2001 Estate Valuation Date of Death: Valuation Date: Processing Date: 08/19/2002 08/19/2002 11113/2002 Estate of: Jones, Estate of Helen M. Account: 4296/1 Report Type: Date of Death Number of Securities: 1 File ID: JONES Shares or Par Security Description High/Ask Low/Bid Mean and/or oiv and Int Adjustments Accruals Security Value 1) 32 PRUDENTIAL FINL INC 1744320102) NYSE 08/19/2002 32.75000 32.00000 HIL 32.375000 1,036.00 Total Value: Total Accrual: Total: $1,036.00 $1,036.00 $0.00 Page 1 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300. (Revision 6.4.0) . Savings Bond Calculator Page 1 of I I;Upillite1 j)Y}e {, ~ 1!l1l'if!!l1~;!1l1 t)lyl1 , Savinc Value As or 108/2002 CALCU U Error - required fields missing. Bond Info Series I EE Bonds Denomination Serial Number Issue Date ~ $150 m Results Serial Number Issue Date Series Deuom Issue Price Interest TotlilViiiirn ,~ Interest Value Rate YTD Inl $2.8 # Bonds Total Price 2 $50.00 Total Interest $45.84 Next Final Accrual Maturity L477472034EE 04/1991 L477588011EE 06/1991 EE EE $50 $25.00 50 25.00 $22.92 $47.92 22.92 47.92 6.00% 6.00% 10/2002 04/2021 12/2002 06/2021 le end Note Description NI Not Issued NE Not Eligible for Payment P5 Includes 3-month interest penalty ME Matured (Exchangeable for HH) MN Matured (Not Exchangeable for HH) Please rate this service. (Please print and/or save this page before submitting your survey) Service Excellent Good Fair Poor Savings Bond Calculator r r r r httn:/lwwws.oublicdebt.treas.gov/BC/SBCPrice 10/15/2002 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 MANNIX JAMIE 3022 PENN ESTATES EAST STROUDSBURG, PA 18301 -------- fold ESTATE INFORMATION: SSN: 201-18-5723 FILE NUMBER: 2102-0803 DECEDENT NAME: JONES HELEN M DATE OF PAYMENT: 02/21/2003 POSTMARK DATE: 02/19/2003 COUNTY: CUMBERLAND DATE OF DEATH: 08/19/2002 NO. CD 002201 ACN ASSESSMENT CONTROL NUMBER AMOUNT 02146588 I $595.75 02146592 I $751.29 I I I I I I I TOTAL AMOUNT PAID: REMARKS: JAMIE MANNIX CHECK# 715 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS $1,347.04 DONNA M. OTTO DEPUTY REGISTER OF WILLS ~ ~. ~ ~ ~ '" ~ t' \ .J ~ -.. ~ ~ ~ \L ~ ""- ;, ~ ~ ~ ~ \ ~ ~ QiL~ ~ . '() ~ ~. '1-. ~ '- ~~~ ~ .... . ~ ~ - ~ ~. , ~ .~ \\\ ~ ~ . ~'-t2l ~ ~ 4.. ~~ I\!' \ I.' ,..("\ c:::;; "? -:: ~ ; ~ ....;;. "": ... ~ ~ ... -== ~ -=i ~ i il :. ~ ~ .. - ~ ," ~..... t.., ..... '" to' ..... ~ ~\ <\ ~ \, BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 1712B-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLONANCE OR DISALLONANCE OF DEDUCTION~, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV~1548 EX AFP <01.03) JAMIE MANNIX 3022 PENN ESTS E STROUDSBURG PA 18301 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 03-24-2003 JONES 08-19-2002 21 02-0803 (:UMBERLANI) .. 201-48 - 5723') 02146592 HELEN M Amount Remitted 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=is4i5-E3f-AFP--coi-:03l------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 03-24-2003 ESTATE OF JONES HELEN M DATE OF DEATH 08-19-2002 COUNTY CUMBERLAND FILE NO. 21 02-0803 TAX RETURN WAS: S.S/D.C. NO. 201-18-5723 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 02146592 FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT NO. 2183715 TYPE OF ACCOUNT: DATE ESTABLISHED ( ) SAVINGS ( ) CHECKING ( ) TRUST ()() TIME CERTIFICATE 06-15-2000 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due x 10,017.16 0.500 5,008.58 .00 5,008.58 .15 751.29 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." x TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-19-2003 CD002201 .00 751. 29 TOTAL TAX CREDIT 751.29 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER THIS DATE, 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 DUE A REFUND. ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 2B0601 HARRISBURG, PA 1712B-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLONANCE OR DISALLONANCE OF DEDUCTION~, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-l.5ti8 EX AFP (01.03) MEREDITH MANNIX 1550 A LOVELL CT PATUXENT RIVER MD 20670 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 03-24-2003 JONES 08-19-2002 21 02-0803 CUMBERlt~ND 20T~' 18::5723 02146591 HELEN M ~' .l Amount Remitted 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=is4-i-E3f-AFP--coi-:03l------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 03-24-2003 ESTATE OF JONES HELEN M DATE OF DEATH 08-19-2002 COUNTY CUMBERLAND FILE NO. 21 02-0803 TAX RETURN WAS: S.S/D.C. NO. 201-18-5723 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 02146591 FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT NO. 2183719 TYPE OF ACCOUNT: DATE ESTABLISHED ( ) SAVINGS ( ) CHECKING ( ) TRUST ()() TIME CERTIFICATE 06-19-2000 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due x 10,015.25 0.500 5,007.63 .00 5,007.63 .15 751.14 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." X TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-12-2003 CD002169 .00 751.14 TOTAL TAX CREDIT 751.14 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER THIS DATE, 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 DUE A REFUND. ~,..,.. n,..".r-,."...r- ............. ...,.. .......... ___.... ___ ..~.___..____~._ .. /7-P6-P COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX OIVISION DEPT. 280601 HARRISBURG. PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEKENT~ ALLOKANCE OR DISALLOKANCE OF DEDUCTION~, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV.l54& EX AFP <01-03) JAMIE MANNIX 3022 PENN ESTS E STROUDSBURG PA 18301 DATE ESTATE OF DATE OF DEATH FILE NUMBER COU""TY SSN/DC ACN 03-24-2003 JONES 08-19-2002 21 02-0803 CUMBERLAND 201-18-5723 02146588 HELEN M Amount Remitted 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=is4-i-EX--AFP--coi-:03J------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 03-24-2003 ESTATE OF JONES HELEN M DATE OF DEATH 08-19-2002 COUNTY CUMBERLAND FILE NO. 21 02-0803 TAX RETURN WAS: S.S/D.C. NO. 201-18-5723 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 02146588 FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT NO. 2183720 TYPE OF ACCOUNT: DATE ESTABLISHED ( ) SAVINGS ( ) CHECKING ( ) TRUST ()() TIME CERTIFICATE 06-21-2000 X 7,943.33 0.500 3,971.67 .00 3,971.67 .15 595.75 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due x TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-19-2003 CDo02201 .00 595.75 TOTAL TAX CREDIT 595.75 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER THIS DATE. 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 DUE A REFUND. ~~~ nl""'t.II""'DIt"r'" roT"'" "... ...11'1"'" .............. --- ........--..----..- .. /?"R6-~ ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIYISIDN 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 REV-1547 EX AFP 111-031 EDMUND G MYERS JOHNSON ETAL PO BOX 109 LEMOYNE DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-07-2003 JONES 08-19-2002 21 02-0803 CUMBERLAND 101 HELEN M Allount Rellitted PA 17043 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=isirj-E3Ci;:'p--("OY:03Y-NOTicE--OF-YtiHEifiTAirCE-TAi-jrpPRAisEifENT~--iLl-owAircE-iri----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF JONES HELEN M FILE NO. 21 02-0803 ACN 101 DATE 04-07-2003 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) 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) (5) (6) (7) .00 1, 131. 84 .00 .00 131,396.69 22.967.65 .00 (8) NOTE: To insure proper credit to your account. subnit the upper portion of this forll with your tax paYllent. 155.496.18 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. Charitab1e/Govern.enta1 Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 9.420.45 11. 073.25 (11) (12) (13) (14) 20.493 70 135.002.48 .00 135.002.48 NOTE: I~ an assessment was issued previously, lines re~lect ~igures that include the total o~ ALL 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. A.ount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CR TS: 14, lS and/or 16, 17, 18 and 19 will returns assessed to date. .OOX 00 = .00 X 045 = .00 X 12 = 135.002.48 X 15 = (19)= .00 .00 .00 20.250.37 20.250.37 DATE 02-19-2003 NUMBER CD002198 + INTEREST/PEN PAID (-) .00 AMOUNT PAID 20.250.37 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 20.250.37 .00 .00 .00 . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR rNSTRUCTTnN~ 1 1?-J?6W ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* JAMIE MANNIX 3022 PENN ESTS E STROUDSBURG INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN REV-l60~ EX AFP 101-031 L_ 04-02-2003 JONES 08-19-2002 21 02-0803 CUMBERLAND 201-18-5723 02146588 Allount Rellitted HELEN M PA 18301-0000 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1604 EX AFP (01-03) __ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS -- DATE 04-02-2003 ESTATE OF JONES HELEN M DATE OF DEATH 08-19-2002 COUNTY CUMBERLAND FILE NO. 21 02-0803 ADJUSTMENT BASED ON: S.S/D.C. NO. 201-18-5723 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 02146588 FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT NO. 2183720 TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST (X) TIME CERTIFICATE DATE ESTABLISHED 06-21-2000 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.500 .00 .00 .00 .15 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-19-2003 CD002201 .00 595.75 TOTAL TAX CREDIT 595.75 BALANCE OF TAX DUE 595.75CR INTEREST AND PEN. .00 TOTAL DUE 1i91i.75CR . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $I, 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.) JAMIE MANNIX 3022 PENN ESTS E STROUDSBURG COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSNI'DC ACN '* BUREAU. OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 REV-UD~ EX AFP I Dl-D31 04-02-2003 JONES 08-19-2002 21 02-0803 CUMBERLAND 201-18-5723 02146592 Allount Rellitted HELEN M PA 18301-0000 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1604 EX AFP (01-03) __ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS -- DATE 04-02-2003 ESTATE OF JONES HELEN M DATE OF DEATH 08-19-2002 COUNTY CUMBERLAND FILE NO. 21 02-0803 ADJUSTMENT BASED ON: S.S/D.C. NO. 201-18-5723 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT NO. 2183715 ACN 02146592 TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST (X) TIME CERTIFICATE DATE ESTABLISHED 06-15-2000 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.500 .00 .00 .00 .15 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-19-2003 CD002201 .00 751.29 TOTAL TAX CREDIT 751. 29 BALANCE OF TAX DUE 751.29CR INTEREST AND PEN. .00 TOTAL DUE 71i1 ?Qr:R . IF PAID AFTER THIS DATE. 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 DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) REV.'470 EX (6-88) '* INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME HELEN M. JONES FILE NUMBER REVIEWED BY Phyllis Hoch ACN 2102-0803 02146588,02146592 ITEM SCHEDULE NO. EXPLANATION OF CHANGES ADJUSTED ABOVE ACN'S TO ZERO. REPORTED ON PROBATE RETURN. ROW Paqe 1 \ 17.. ,j'6. 'J? ~ BUREAU OF INDIVIDUAL TAXES ~~HERITANCE TAX DIVISION OEPT. z8ii601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* MEREDITH MANNIX 1550 A LOVELL CT PATUXENT RIVER MD 20670-0000 INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN RU-1"~ EX AfP 'D1-D3) 04-02-2003 JONES 08-19-2002 21 02-0803 CUMBERLAND 201-18-5723 02146591 Allount Rellitted HElEN M MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1604 EX AFP (01-03) __ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS -- DATE 04-02-2003 ESTATE OF JONES HElEN M DATE OF DEATH 08-19-2002 COUNTY CUMBERLAND FILE NO. 21 02-0803 ADJUSTMENT BASED ON: S.S/D.C. NO. 201-18-5723 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 02146591 FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT NO. 2183719 TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST (X) TIME CERTIFICATE DATE ESTABLISHED 06-19-2000 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.500 .00 .00 .00 .15 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-12-2003 CD002169 .00 751.14 TOTAL TAX CREDIT 751.14 BALANCE OF TAX DUE 751. 14CR INTEREST AND PEN. .00 TOTAL DUE 71;1 1 ti~R . IF PAID AFTER THIS DATE, 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.) REV-1470 EX <-J '* INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME FILE NUMBER HELEN M. JONES 2102-0803 REVIEWED BY ACN Phyllis Hoch 02146591 ITEM SCHEDULE NO. EXPLANATION OF CHANGES ADJUSTED ABOVE ACN'S TO ZERO. REPORTED ON PROBATE RETURN. ROW Paae 1 /-?-Pt:-R \. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z8D6Dl HARRISBURG, PA 171Z8-D6Dl COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REY-IU1 EX AFP (01-051 '03 JUN 20 All :41 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-19-2003 JONES 08-19-2002 21 02-0803 CUMBERLAND 02146588 HelEN M JAMIE MANNIX 3022 PENN ESTS E STROUDSBURG P~~~~l~~ Allount Rellitted 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 ~ REv=i&Cf;-EX-AFP--roY=03Y------...-iNHERITANc'E--TAX-SY]rfEHfNT-cfF-ACCoUi,rf--...---------------- ----- ESTATE OF JONES HelEN M FILE NO.21 02-0803 ACN 02146588 DATE 05-19-2003 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: 04-01-2003 PR I NC I PAL TAX DUE: ................................................................................................................................................................................ .......................................... .00 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-19-2003 CD002201 .00 595.75 04-28-2003 REFUND .00 595.75- TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 lli 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?-P6'- P BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z8D6Dl HARRISBURG, PA 171Z8-D6Dl COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REY-IU1 EX AFP (01-051 Reccl(c:. of DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-19-2003 JONES 08-19-2002 21 02-0803 CUMBERLAND 02146592 HelEN M Ref JAMIE MANNIX 3022 PENN ESTS E STROUDSBURG .03 JUN 20 All :41 Allount Rellitted P A(..:J.8S;,OI CumbEk 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 ~ REV :i&cf;-E3f-AFP--roY:03'r------...-iNHERITANCE--TAX-SYA-fEHftiT-crF-ACCoui,rf--...---------------- ----- ESTATE OF JONES HelEN M FILE NO. 21 02-0803 ACN 02146592 DATE 05-19-2003 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: 04-01-2003 PR I NCI P AL TAX DUE: ................................................................................................................................................................................ .........................-..... .00 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-19-2003 CD002201 .00 751.29 04-28-2003 REFUND .00 751. 29- TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 lli 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. ) /?-c?6'" 2? BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE J:NHERJ:TANCE TAX STATEMENT OF ACCOUNT '* REV-IU7 EX AFP 101-051 Recore :. Re~j:~ .', ,..f L'j DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-19-2003 JONES 08-19-2002 21 02-0803 CUMBERLAND 02146591 AlIOunt R_i tt.d HELEN M MEREDITH MANNIX 1550 A LOVELL CT PATUXENT RIVER .03 JUN 20 All :41 MD ~lO Cumb6ik", . .... Pi" 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 forI! with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REv=i6"ifj-i:x-"Fii-foY:oiY------...-iNirERITANc'f-TAx-sTAyEM'E-tiT-CrF'-ACCOUNy--...------------------ --- ESTATE OF JONES HELEN M FILE NO. 21 02-0803 ACN 02146591 DATE 05-19-2003 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: 04-01-2003 PR I NC I PAL TAX DUE: ................................................................-....-.......................................................................................................... .............................. .00 PAYMENTS (TAX CREDITS): PAVMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-12-2003 CD002169 .00 751.14 04-28-2003 REFUND .00 751.14- TOTAL TAX CREDIT .00 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. ) STATUS REPORT UNDER RULE 6.12 G;/t/ or...... Name of Decedent: HELEN M. JONES Date of Death: AUGUST 19,2002 Will No. 0803-2002 Admin No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rule, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the Estate is complete: Yes X No 2~ If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's Account is: c. parties of interest? Did the personal representative state an account informally to the Yes No X Executor was Sole Beneficiary 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: June 30, 2003 ~:~~ ...... I -..l ::::! J t..,~~ EDMUND G. MYERS Name JOHNSON, DUFFIE, STEWART & WEIDNER 301 Market Street P.O. Box 109 Lemoyne, P A 17043 (717) 761-4540 Capacity: Personal Representative (x) Counsel for Personal Representative N ....... . . ;;:( ~ ....... E: ,...,"<r "'-' p w _ .0 '.. >= J) :::: 3u