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Home My WebLink About02-0522 PETITION FOR PROBATE and GRANT OF LETTERS ];11'" t::. t E'GJ.i((<.. Jr, No. ;U- o;}.. - 5 ~~ To: Estate of also known as Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania Deceased. Social Security No. ~O:r - 0 9 - /, ();J.. The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut Ri'f.S' in the last will of the above decedent, dated (')..t -.t<; - /f'9;' and codicil(s) dated named , 19_ (state relevant circumstances, e.g. renunciation, death of executor, etc.) pecendent was domiciled at death inC"P1~Ei!./..AN!) County, Pennsylvania,>>ith ~ .last family or principal residence at ~ 0 U). S/lA'by LAJ" EAI'4AA,.Ht. , _jT" //E.Jl./ T"".J~4f' (list street, number and muncipality) Dec ndent, then cJL/ years of age, ied - - () 1-- ~\ t:J2-; at . S ~ ,q-.J "'"LA '4-. Except as follows, dec dent did not marry, was no divorced and did not have a child born or adopted after execution of the ill offered for probate; was not the victim of a killing and was never adjudicated incompetent: oJ& 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 .1. /.. S. / AJC' sit.uated as follows: ~o v</. ~"'(;t /w... 0'" L Sf 00 () , ,... $ liD. de>.:> . ~~ . $ $ J :L;...ui-A 4 17D1.J- . WHEREFORE, petitioner(s) respectful~quest(s) robate of the last will and codicil(s) presented herewith and the grant of letters 4~n (testamentary; a ministration c.La.; administration d.b.n.c.t.a.) -I theron. , 'or u o " i13 "" "," o -00 c";:: C':l";:: 3&: "~ :;0 :< o '" Vi ./ ~ 1-#:1...::> OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I ss COUNTY OF Cumberland J The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well a truly admini~he est'!,te according to law. Sworn to or affirmed and subscribed ~ ~ '" 9f.e me this. 30th day of ~. ". , ~ 20 2 .-u... . ~ v ~ IS ~ /7-{;.'7- -3 ~o. 21-2002-522 Estate of John E. Zeigler. Jr. , Deceased DECREE OF PROBATE A~D GRA~T OF LETTERS AND NOW May 30th I~X 200;2in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated February 20th, 1993 described therein be admitted to probate and filed of record as the last will of John E. Zeigler, Jr. and Letters TeRtarTlPntnry are hereby granted to Delores Price and Sarcr Murrma FEES /~ ("'~..J '" '7 ~'" - lIt.~.,/ 1 t "I . . . .' Ci,?;! <- . ':iA~ au c<<<k'c... 7 / Register of Wills ! MARY C. LEWIS 235.00 6.00 Probate, Letters, Etc. ..,...... $ Short Certificates(2) .......... $ Renunciation .,............,. $ x-Pages (3) $ 9.00 JCP TOTAL _ $ 5.00 Filed May. .30th. .2002. . . . , . ,$. .255:00. . ATTORNEY (Sup. Ct. LD. No.) ADDRESS PHONE C-} I' l.,_ MAILED LE'ITERS AND ORDER m EXECU'IDRS ON 5/30/02 - II ~ . 21-2002-522 LAST WILL AND TESTAMENT OF JOHN E. ZEIGLER, JR. I. JOHN E. ZEIGLER, JR., Widow man, of Enola, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby mak.e. publish and declare this to be my, Last Will and Testament, hereby revoking any and all Wills and Codicils previously made by me at any time heretofore. FIRST: I hereby direct my personal representative, hereinafter named, to pay all my just debts, funeral and testamentary expenses, including Pennsylvania inheritance taxes, as soon after my demise as maybe practicable. SECOND: All the rest, residue and remainder of my estate, I hereby give. devise and bequeath. equally and per capita. among my nine (9) children. as follows: A. JOHN E. ZEIGLER. III: B. DELORES PRICE; C. NANCY LEE ZEIGLER; D. GUY J. ZEIGLER; E. MARY ELIZABETH SMITH: F. STEPHEN R. ZEIGLER; G. SARA MUMMA; H. JANET SUE SCHELL. THIRD: The fractional shares available for my sons, JOHN E. ZEIGLER, III and DAVID E. ZEIGLER, are to be held in trust as follows: A. I hereby appoint my two (2) daughters. DELORES PRICE and SARA MUMMA. as Co-Trustees to invest and manage two separate trust funds in some interest bearing accounts for each. H ~ ~ ~ U) H ~ 0 +' rn +' '" OJ 8 , "" ~ o ~~r '" ~ r B. All decisions to invest and expend such monies shall require on currence by both of my daughters. C. In the event that one daughter predeceases both JOHN E. EIGlER. III and/or DAVID E. ZEIGLER. the surviving daughter shall have the uthority to continue to serve as sole Trustee, or nominate another of my daughters s Co-Trustee. D. I specifically direct that my Trustees to use the money in each ust account to assure a decent burial and interment for JOHN and DAVID. E. My Trustees are hereby given total discretion to expend all, me or none of the remaining funds as they shall so decide. F. If one of my sons predeceases the other, whatever funds, if any, main in the deceased son's trust account. shall be transferred to the surviving other's account. G. Upon the eventual demise of the surviving son, whatever nds, if any, remain shall be distributed equally and per capita among my surviving hildren. 'I ~ FOURTH: I hereby nominate, constitute and appoint my two daughters. ELORES PRICE and SARA MUMMA as Co-Executrixs of this my, Last Will and estament FIFTH: The above named persons shall not be required to post bond r surety in this or any other jurisdiction for faithful compliance of the office Executrix or ustee. IN WITNESS WHEREOF, I hereunto set my hand and seal to this and two (2) ther typewritten pages, identified by my signature, to this my, Last Will and estament, dated on this the 'L(J day of 71-<>-lj 11 .' ,ft~~ Z~~G '"::;:I .19 '() he preceding instrument, consisting of this and two (2 ) other typewritten page, i entified by the signature oftheTestator, JOHN E. ZEIGLER, JR., as and for s Last Will and Testament. who at his request. in his presence and in the presence each other have subscribed our names as WITNESSES hereto. / ,~'-;/ 2} I N pQ:t-LdxJ RESIDINGAT,;i;f ~}{/YL/ ;",rJ:l/' ~~ U!t~ ~ RESIDING AT ~( jJ~ . II ~ , COMMONWEALTH OF PENNSYLVANIA) ) COUNTY OF CUMBERLAND CltAA 4 ~L~ .{ /WITNESS WE'd~ ~i~DiC -J~~j-\K\~S) ,AND . ,\, the Testator. and the witnesses, respectively, whose names are signed to the attached and foregoing instrument. being first duly sworn. do hereby declare to the undersigned authority that the Testator, JOHN E, ZEIGLER, JR., signed and executed the instrument as his last Will, and that he signed and executed it willingly, and that he executed it as hiS free and voluntary act for the purposes therein expressed, that each of the Witnesses, in the presence and hearing of the Testator signed the Will as Witnesses, and that to the best of our knowledge and sight, JOHN E. ZEIGLER, JR. was atthetime eighteen (18) or more years of age, of sound and disposmg mmd. memory and under no constraint or undue influence. !;OHN E/~IG I / ~k~ ITNESS Subscribed, sworn to and acknowledged before me by JOHN E. ZEIGLER, JR. the Testator, who personally appeared before me, the undersigned officer, and subscribed ~ntobytheWITNESSE;S.. ~" j' .... '- 6/L.:''5" and ~. JlU_> ,0nthisG;' the ,..-9c\ day of Ec;:rs , 19-.:L3 ~~J /) t-~ '..L.. 1 I ___'_ .I f J ,-,_ CLeJA,t,J l NOTARY PUBLIC , , Eo" :f;F:;: i/ . Co " j L MYc'>I],J";,;..oi:J,:____',""",,., ",: .,"f,r' o . ':-.- - . .-"', -', ~",1.I . . Member, PennsylvarJiil~n of No..... = to> S @I . ~ IQ - l:l = t:l Ii >: '" --' ... '1' 5 OJ "' <= " o <) N LO QlLOLO .~N(y) ~a ' Cl.....N ~......~ .~ - >.0:..... .ll..... - ..... :E:ro-- LOoQi 0<=<= ....wo -'" ll. cJ IN RE: : BEFORE THE REGISTER OF WILLS ESTATE OF JOHN E. ZEIGLER,: CUMBERLAND COUNTY, PENNSYLVANIA JR. : NO. 2002-00522 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: JOHN E. ZEIGLER, JR. ~ '.... r- ..0 Date of Death: May 27, 2002 Will No. 2002-00522 Admin No. To the Register: I certifY that the Notice of Estate Administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate of John E. Zeigler, Jr. on June 10, 2002. Name Address Delores A. Price 400 West Shady Lane Enola, P A 17025 Nancy L. Zeigler 1019 North Avenue 52 Los Angeles, CA 90042 Greg Joseph Zeigler 36 Carolyn Street Harrisburg, PA 17112 Mary Elizabeth Smith 105 Commonwealth Avenue Lincolton, NC 28092 Sara J. Mumma 17202 North 131"' Drive Sun City West, AZ 85375 Janet S. Schell 119 Sumner Lane Enola, PA 17025 . . Notice has now been given to all persons entitled thereto under RUle 5.6(a) except: NONE Dated: June 10, 2002 Nora . Blair Counsel to Personal Representative Supreme Court ID #4551a 5440 Jonestown Road P.O. Box 6216 Harrisburg, PA 17112-0216 (717) 541-1428 1lEI/._EX+...-J '* REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT . COMMONI'EALTH Of PEN<lSYLVANlA [8>ARTMENT OF REVEN..E DEPT. 280601 ________.__~~,PA11128-ll601 0- " .. a .. u i!l -- DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAl) Zeigler, Jr., John E. DATE OF DEATH (MM-Do.:vEAR) - -----, DATE-OF BIRTH(MM-DO-YEAR} OS/27/2002 09/28/1907 (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) ....------- ------ It!lI 1. Original Return 04. DC' 6. o Limited Estate o o o o 48. FlJbJre Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a living Trust (Attach copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95 o 3. -RemafriderRetlJm(d8te"ofdeathpriorto--1-i~13~i)- o 5. Federal Estate Tax Return Required o 6. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Allach Sch 0) 2. Supplemental Return .. 0- ,,-c.. uE" "1';8 ~::a: !1l Decedent Died Testate (Attach copy of Witt) 9. litigation Proceeds Received '0- 00" .... "a pj" u2 LEPHONE NUMBER 717/541-1428 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, PartnefShip or Sole-Proprietorship 4. Mortgages & Netas Receivable (Schedule 0) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) ~ 0 Separate Billing Requested ~ 7. Inter-VIVOS Transfers & Miscellaneous Nero-Probate Properly i'! (Schedule G or L) ~ 8. Total Gross Assets (total Lines 1-7) u ::! 9. Funeral Expenses & Administratiw Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabililies, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) OFFICIAL IJSE ONL y FILE NUMBER 21 02 __ G.PUNTYCODE y~_ --~-sOCiAi-SECURtTY-NUM~ 205-09-1602 0522 JiUMBER._ THtS RETURN MUST BE FILED IN OUPUCATE 'NITH THE _~(3IS!ER OF WILLS SOCIAL SECURITY NUMBER 5440 Jonestown Road PO Box 6216 Harrisburg, P A 17112 (1) 40,000.00 OFFICIAL USE ONLY (2) None. -. (3) None (4) None (5) 93,227.97 (6) None (7) None (8) 133,227.97 (9) 19,748.76 (10) 4,470.00 (11) (12) 24,218.76 109,009,21 13. Charitable and GO\I9l1lmental 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) (13) (14) 109,009.21 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under See. 9116(a)(1.2) ~ 16. Amount of Line 14 taxable at lineal rate 109,009.21 x .045 (16) ~ " L 17. Amount of Line 14 taxable at sibling rate x .12 (17) ill u ~ 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 4,905.41 4,905.41 '<is);)';>',,.i:'; ""';>ji "'cr':':;i"';.' ",30i';' CHECK HERE IF YOU ARE REQUESTI',G A REFU\D OF A[\J OVERPA{"E~JT 'LO:'i")::it'ji 20. 0 "'{.{:':l!i~iJl'.~.lali.,!Ii',.,..1 .( Copyright 2000 form software only The Lackner Group, Inc. }., Fonn REV-1500 EX (Rev. 6-00) .Decedent's Complete Address: STREET ADDRESS 400 West Shady Lane ----- CITY --- FTATE PA Enola Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2 CreditslPayments A. Spousal Poverty Cred~ B. Prior Payments C. Discoont Total Credits (A + B + C) 3. InteresUPenalty W applicable D. Interest E. Penalty TotallnteresUPenalty (0 + E) 4. If Line 2 is greaterlhan Line 1 + Line 3. enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2. enter the difference, This is the TAX DUE. A. Enter the interest 00 the tax due. B, Enter the total of Line 5 + SA This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT ! ZIP-;;;;;5 (1) __ 4,905.41 (2) 0.00 (3) 0.00 (4) -- (5) 4,905.41 (SA) (5B) 4,905.41 --- 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 incOl'Oe of the property transferred; ______.......... .,............................. n 15<:1 ;: =ht=:~~:E:~::::p::t:n::7~~i~~~;.........:.:,::::::... B ~ 2. ~~ :':e ".:.=00~1~...~~:.~~cIecfJdef1t~~P~.~thinone~r..~..d~~..\YilI1()(J) 0 181 3. Did decedent own an "in tNst for" or payable upoo death bank 8CCOOnt or S8CUrity al his or her death? 0 181 4. ~:~=:~I::v:=~i"""""tJl.cc<>J~: ~~~~...~~h~n~~p~VJhi~h 0 181 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, induding accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete DeclaratiOfl O!!?~parer other ~,n,t~~personal re~rEl~Elrl_!ative is based o_r! <I,lIinfonnati~~!_.....~icf.1_preparer ha~ arlX~Owledg_13: ___ SIGNATURE OF PERSON SPONSIBlE FOR FlUNG RETURN ADDRESS DATE Sara Mumma ~ 17202 North 131 st Drive "I{""'" ./ _ Sun City West, f\? 85375 _ -X-,,{2... ~ SIGNATURE OF RS6'li(RESPON - EFOR FIL G RETURN ADDRESS ------- -- DAre Delores Price 0.--,) /1 - /J /)./;) ... ~ Jt7-,,-~~__ V^- ~ J~~I~Flsr~g~}ane ADDRESS 5440 Jonestown Road PO Box 6216 Harrisburg, PAl 7112 DATE )-31-03 I-,b -0-:" For dates of death 00 or after July 1. 1994 and before Janull/)' 1. 1995. the lax rate imposed 00 the net value of transfers to or for the use of the survMng spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)]. For dales of death 00 or after January 1, 1995, the lax rate imposed 00 the net value of transfers to or for the use of the survMng spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemDl 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 dales of death 00 or after July 1. 2000: The tax rate imposed 00 the net value of transfers from a _ child twenty-one years of age or younger al death to or for the use of a nalural parent. an adoptr.e parent. or a stepparent of the child is 0% [72 P.S. ~9116 <a) (1.2)]. The lax rate imposed 00 the net value of transfers to or for the use of the decedent.s Iineai benefICiaries is 4.5%. except as noled in 72 P.S. ~9116 1,2) [72 P,S. ~9'16 (a) (1)]. The lax rate imposed 00 the net value of transfers to or for the use of the_ent's siblings is 12% [72 P,S, ~9116 (a) (1.3)]. A sibling is defined, under Sectioo 9102. as an individual who has alleast one parent in common with the decedent. whether by blood or adoptioo. . SCHEDULE A REAL ESTATE I COMMONNEALTHOFPEttiSYlVANlA ~ Ir+ERlTANCE TAX RETLRN RESIDENT DECEDEN1' ----- ESTATE OF . ZeIgler, Jr., John E. 'I FILE NUMBER 21 - 02 - 0522 ----- --.----- ----- ----- - --------... ...- -- ------- All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be excMnged between a willing buyer and a willin.Q seller, nerther being compelled to buy or sell, both having reasonable ~nowledge of the relevant facts. Real property Which is joinUy-owned with righf of survivorship must be disclosed on schedule F. ITEM NUMBER I DESCRIPTION VALUE AT DATE OF DEATH 40,000.00 House at 400 Shady Lane, Enola, Pennsylvania in need of repair. Sold for $40,000.00. See attached settlement sheet TOTAL (Also enter on Line 1, Recapitulation) 40,000.00 ARTHUR M FELD E8Q 7177700SB9 02/26/09 01.29pm P. 001 A Settlment statement U,S. Department of Housmg and Urban Developmf!nt OMe No. 2502-0256 B. Tv.... of Loan 1. FHA 2. FMHA 3. Conv. Unlns 6. File Number 7. Loan Number: 4. VA 5. Con...... Ins. 1028-02 Mortgage InsUf8nce Case Number: C Note: this form is furnished to give you a statement of actual settlement costs, Amounts paid to and by the settlement agent are shown. Items mar1l:ed "(p.a.c.)" were paid outside the dosing; they are shown here for information DurDOSes and are not included in !he totals_ D. Name/Address of Borrower: DELORES A. PRICE 400 WEST SHADY LANE ENOLA PA 17025 E. Name/Address of Seller: THE ESTATE OF JOHN E. ZEIGLER 400 WEST SHADY LANE ENOLAPA 17025 F. Name/Address of Lender: FIRST NATrONALBANK OF MARYSVILLE 101 LINCOLN STREET MARYSVILLE, PA 17053 G. Property Location: 400 WEST SHADY LANE ENOLA PA 17025 Settlement Agent Arthur M. Feld, Esquire 1309 Bridge St, NewCumberland, PA 17070 TIN: 23-258276 Date of Settlement FEBRUARY ,2003 SUMMARY OF SELLER'S T~SACTION 400. GROSS AMOUNT DUE TO SELLER 40,000.00 401. Contr!c:t Sales Price 402. Personal P e 1619.50403.00 40 000.00 J. SUMMARY OF BORROWER'S TRANSACTION 1 DO. GROSS AMOUNT DUE FROM BORROWER 101. Contract Sales Price 102. Personal Property 103. Settlement cha e to borrower line 1400 104,00 404.00 105.00 405.00 AdlUstments for items aid b seller in advance stments for items id b sellef in advance 106. C' /town taxes 406. C' /tOwn taxes 107 Cou Taxes NlA 407. Coun taxes 108 School Taxes 2/26/03-06130103 278.13408. School Taxes 2126J03-06/3 3 109. Refuse 409. Refuse 110. Water 410. Water 111. Sewer 411. Sewer 112. Se& tines. 4061408 412 120. GROSS AMOUNT DUE FROM BORROWER 41,897.63 420. GROSS AMOUNT DUE TO SELLER 200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SEllER NIA 278.13 40,278.13 201. DeDosit or earnest mone 202_ Princi al amount of new loan s) 01. Excess osit(see Instructions 62,000.00 502. Settlement cha 8$ to seller line 1400 503. EXisting loan s)taken sub.ectto 504. Pa ff of 1st Mort e LD2In 505. Pa off of 2nd ort e Loan 506.00 507.00 ADJUSTMENTS FOR ITEMS UNPAID BY SELLER 510. Ci !town taxes 511, CountVta>les 512. Assessments 513. School Taxes 514, Refuse 515 Water 516. Sewer 517.00 518.00 519.00 62,000.00 520. TOTAL REDUCTIONS IN AMOUNT DUE SELLER 300. CASH AT SETTlEMENT FROMfTO BORROWER 600. CASH AT SETIlEMENT TOIFROM SELLER 301. Gross l'lmountdue from borrower 41,897.636 1. ross amount due to seller ine line 120 420 302. Less amounts id b /for borrower 62,000.00 602. Less reductions In amount due line 220\ seller line 520 303. CASH From T X Borrower 20102.37 603. CASH )FROM TO X ELLER 33,873,13 SUBSTITUTE FORM 1099 SElLER STATEMENT: The information contained herein is important tax infonnatjon and is being furnished to the Intemal Revenue SetVtce. If you are required to file a return, a negligence penalty or other sanchon will be imposed on you if this item is required to be reported and the IRS determines that it has not been reported. The Contract Sales price destfibed on line 401 above constitutes the Gross Proceeds of this transaction. SELLER INSTRUCTIONS: If this. real estate was your principal residence. file Form 2119, Sale or E)(change of Principal Residence, for any gain, with your income tax return; for other transactions, complete the applicable parts of Form 4797, Form 6252 and/or Schedule 0 (Form 1040) You are required by law to prolo'ide Arthur M. Feld, Esquire with your correct taxpayer i<lentification number. If you do not provide your correct taxpayer identification number, you may be subject to cMI or criminal penalties imposed by law, and Under penalties of perjury. I certif that the number sl'town on the additional documents signed at settlement is my correct taxpayer identification number. 6,405.00 203. Existin loan(5 taken subject to 204.00 205.00 206.00 207.00 ADJUSTMENTS FOR ITEMS UNPAID BY SELLER 210.Cit /town taxes 211. Coun taxes 212. Assessments 213. School Taxes 214. Ruse 215. Water 216. SEMIet 217.00 218.00 219.00 220. TOTAL PAID BYfFOR BORROWER 6,405,00 4 ,278.13 6,405.00 Seller #1 Buyer #1 Seller #2 Buyer if2 ARTHLR M FELD ESQ 71 77~388 ~2/Z6/~3 ~l'Z9pm P. ~0Z L SETTLEMENT CHARGES 700< TOTAL SAlESlBROKER'S COMMISSION BASED ON PRICE $ PAID FRON PAID FROM AT ,,~ BORROWER' SELLER'S Di....ision of Commission (line 700) as follows" FUNDS AT FUNDS AT 701.$ to SeTILEMENT SETTLEMENT 702. S to 703. Commission paid at Settlement (Money retained by broker applied to commission ($ ) 600. ITEMS PAYABLE IN CONNECTION WITH lOAN 801. Loan Ortglnatlon Fee % First National Bank of Marysville 620.00 802. Loan Discount " 803. Appraisal Fee $250,00 to First National Bank of Marysville POC 804. Credit Report to 805. Broker Fee to BOB. Tax Service Fee to 807. Processing Fee to 808. Courier Fee 10 609. Flood Cart To 810. Yield Spread to Broker 811. Admin Fee to 812. AppliCatlon Fee $125.00 10 Fim National Bank of Marysville PDC 813.00 814.00 900. ITEMS REQUIRED BY lENDER TO BE PAID IN ADVANCE 901, Interest from to @$ Jday 902.00 003.00 1000. RE:SfRVES DEPOSITED WITH lENDER 1001. Hazard insurance months @ $ pe' ..- 1002. Mortgage insurance months@ $ pe, ..- 1003. City property taxes months@$ per month 1004. County property taxes months@$ per month 1005. School taxes months@$ pe< ..- 1100 TITLE CHARGES 1101. Settlement Fee 1102. Title Examination to 1103. Document Preparation to 1104. Notary Fees ""h 4.00 400 1105. Attorney's Fees to Arthur N. Feld 510.00 1106 Title Insurance 1107. Endorsements 100I30OI8.1 to 1108 Lender's Coverage $ 1109. Qwne(sCoverage $ 1110. SettlementXolfice to 1111. Extra Copies to 1112 Recording to 1113 Closing Service letter fee to 1200. GoVERNMENT RECOA.DING ANO TRANSFER CHARGES 1201. Recording Fees: Deed $41.00 , Mortgage $-44.50 ; Release $ 85.50 1202. 6tV/county taxfstamps Deed $ 400,00 Mortgage $ 400.00 1203. State Tax Stamps: Deed $ -400,00 MortgageS 400.00 1204.00 1300. ADDITIONAL SETTI.EMENT CHARGES 1301. Survey to 1302. Pest Inspecl:ion 10 1303. Overnight Fee 1304. pay-off to 1305, ATIORNEY NORA BlAIR INHERITANCE TAX ESTATE OF JOHN E ZEIGLER 6,000.00 1306 ALICIA 0 STINE TREASURER- TAX BILL 100 1307.00 1308.00 1309.00 1400. TOTAl SETTlEMENT CHARGES (enter on lines 103 al'lll502) 1.619.50 8,405.00 I have carefully reviewed the HUO.1 Settlement S1atement and to the best of my knoWledge and belief, it is a true and accurate statement of all receipts and disbursements mEtde on my aCWJnt in this transaction lfurtt\ercertify that I have received a copy of tile HUD-1 Settlement Statement Borrower #1 Borrowef"lf.2 Seller#1 Seller #2 To the best orrrry knowledge, th& HUD_1 Settlement Statement which I have prepared is. a true and acx:urate acoount of the funds which were recetved and have been or will be disbursed by the undersiglle<l as part Of the settlement of this transaction. ArthurM. FeId Settlement Agent *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY , ul__ COMMOMNEAlTH OF PEtflSYLVANA I~TAN:E TAX RETLRN RESIDENT OECEOENT ESTATE OF . ZeIgler, Jr., John E. I FILE NUMBER 21 - 02 - 0522 Include the proceeds of Ittigation and the date the proceeds were received by the estate. All properly JolnUy-owned with the right of survivorshIp must be disclosed on schedule F. ITEM NUMBER I - Personal property sold at auction VALUE AT DATE OF DEATH 766.50 DESCRIPTION 2 Payment from Delores Price for commission on her items sold at auction 130.50 3 1st National Bank of Marysville bank accounts 92,330.97 4 TOTAL (Also enter on Line 5, Recapitulation) 93,227.97 . SCI-EDlJLE H FUNERAl.. EXPENSfS& AD'tftSTRAT1\IE COSTS COMMONI\EALTHOf f>E/fl$YLVANlA lI+ER1TNoICETAXREl1..RN RESIDENT DECEDENT ESTATE OF Zeigler, Jr., John E. Debts of decedent must be reported on Schedule I. ----------------- ITEM I DESCRIPTION ~~'-1~ER I ~~~r:~n~::~~~~~~me-- I I 2 I Gingrich Memorials (800.00 + 554.00 + 95.00) B. ADMINISTRATIVE COSTS: Personal RepresentatiYB's Commissions Sara Mumma Social Security Number(s) / EIN Number ct Personal RepresentaIiw(s): StreeIAddress 17202 North 131stDrive City Sun City West State AZ Year(s) Commission paid 2003 1. Zip 85375 2. Attorney's Fees Blair Law Office -- NoraF. Blair 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Delores Price St_Address 400 West Shady Lane City Enola Relationship of Claimant to Decedent Stale P A Spouse Zip 4. Probate Fees Cumberland County Register of Wills .Paxton Herald -- estate notice Cumberland County Law Journal --- estate notice Accountant.s Fees 5. 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs Sara Mumma Executor's expenses (travel, telephone calls, copies postage) 2 Delores Price Executor's expenses (mileage, copies, telephone calls, postage) Total of Continuation Schedule(s) uuJ__ J:ILE N~~_B~~ 0522 ... 17025 TOTAL (Also enter on line 9, Recapitulation) -I "","" I ! 5,800.00 1,449.00 3,164.56 2,000.00 3,500.00 255.00 35.50 75.00 1,287.00 142.60 2,040.10 19,748.76 . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Zeigler, Jr., John E. 3 ScIIllCUe H FlI1IlrllIIExpelI!S& Am..M.lIiveCoslscorDu!d Alicia D. Stein, Treasurer -- 2002-2003 school real estate taxes 4 PPL (42.25 + 41.66 + 41.59 + 36.44) 5 East Pennsboro Township Sewage 6 Sodler Oil 7 Auctioneer's expenses I FILE NUMBER -,----21 - 02-=~522 Page 2 of Schedule H 799.45 161.94 80.10 98.61 900.00 . OOM~~OF~W~A ItH:RITAN::ETAX FlETLRN RESlDENf oeceoeNT ESTATE OF . ZeIgler, Jr., John E. SCHEDULE I DEBTS OF DECEDENT. MORTGAGE LIABILITIES, & LIENS Include unrelmbureed medical expenses. ITEM NUMBER \ 2 3 4 5 6 7 8 9 10 \\ Central Medical Equipment DESCRIPTION Graham Medical Clinic East Penn Ambulance Service (37.7\ + 25.00 + 41.78) Forest Park Health Center West Shore Ambulance Apria Healthcare PPL Verizon East Pennsboro Sewage Dr. Nipple Central Medical Equipment I 1____ I FILE NUMBER- 2\ - 02 - 0522 AMOUNT 21.19 \ 04.49 21.46 3,966.75 51.00 ]8.\9 48.3\ 47.51 80.\0 56.77 54.23 TOTAL (Also enteron Line 10, Recapitulation) 4,470.00 REV-1513 EX+ (9-00) . SCHEDULE J BENEFICIARIES I COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETIJRN RESIDENT DECEDENT - .rLE N~I~~~~ 05:- --t'RELATIONSHIP-TO~. ~UNTORS~~ DECEDENT OF ESTATE _ _ nnNnfl....T......~} I Daughter One-Sixth ESTATE OF Zeigler, Jr., John E. NUMBER NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distnbutions) I Delores Price 400 West Shady Lane Enola, P A ] 7025 2 Nancy Lee Zeigler 1019 North Avenue 52 i Los Angeles, CA 90042 Daughter One-Sixth 3 Guy J. Zeigler 36 Carolyn Street Harrisburg, P A 17112 Son One-Sixth 4 i Mary Elizabeth Smith 105 Commonwealth Avenue Lincolton, NC 28092 Daughter One-Sixth See Continuation Schedule(s) attached I Enter dollar anounts for distributions ShONO _ on lines 15lhroogh 18, as appropnate, on Rev 1500 COIIef s~ II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAl DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE , ! B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ESTATE OF NUMBER I I. *' SCHEDULE J BENEFICIARIES continued COMMONWEALlH OF PENNSYLVANIA INHERITANCE TAX RETIJRN RESIDENT DECEDENT Zeigler, Jr., John E. NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY -- - -- [include outright spousal distributions, and transfers under Sec.9116(a)(1.2)J 5 [TAXABLE DISTRIBUTIONS Sara Mumma 17202 North 131stDrive Sun City West, AZ 85375 6 Janet Sue Schell 19 Summer Lane Enola, P A 17025 7 John E. Zeigler, III DECEASED 8 Stephen R. Zeigler DECEASED 9 David E. Zeigler DECEASED L_______ i ___I - --rI.E N~I~~~~ 05:- I-'~. ~60.E~~~~TO-I~UN~OR. S~E--- ___ Do Not LialTnatwe(s) r_<?~EST~~__ ! Daughter One-Sixth Daughter One-Sixth Son -0- Son -0- Son -0- Page 2 of Schedule J 21-2002-522 LAST WILL AND TESTAMENT OF JOHN E. ZEIGLER, JR. I. JOHN E. ZEIGLER. JR., Widow man, of Enola, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be my, Last Will and Testament, hereby revoking any and all Wills and Codicils previously made by me at any time heretofore. . FIRST: I hereby direct my personal representative, hereinafter named, to pay all my just debts, funeral and testamentary expenses, including Pennsylvania inheritance taxes, as soon after my demise as maybe practicable. SECOND: All the rest, residue and remainder of my estate, 1 hereby give, devise and bequeath, equally and per capita, among my nine (9) chilcren, as follows: A. JOHN E. ZEIGLER,III; B. DELORES PRICE; C. NANCY LEE ZEIGLER; D. GUY J. ZEIGLER; E. MARY ELIZABETH SMITH; F. STEPHEN R. ZEIGLER: G. SARA MUMMA; H. JANET SUE SCHELL THIRD: The fractional shares available for my sons, JOHN E. ZEIGLER, III and DAVID E. ZEIGLER, are to be held in trust as follows: A. 1 hereby appoint my two (2) daughters. DELORES PRICE and SARA MUMMA. as Co-Trustees to invest and manage two separate trust funds in some interest bearing accounts for each. 1, '- ",_t.~':'J,.io;!rr~'---'-', ...:l <>: l'1~ oJ " ~ 0 .p <Xl .p " '" E-i -- -",-,,<-.- f.'':<l:,~,'~::-'"1cT''''',",1\':''.,,,,,,,;_:.!r-:!~''''''~''' I , B. All decisions to invest and expend such monies shall require ncurrence by both of my daughters. C. In the event that one daughter predeceases both JOHN E. EI~LER. III and/or DAVID E. ZEI GLER. the surviving daughter shall have the hority to continue to serve as sole Trustee, or nominate another of my daughters s Co-Trustee. D. I specifically direct that my Trustees to use the money in each ust account to assure a de~ent burial and interment for JOHN and DAVID. E. My Trustees are hereby given total disaetion to expend all, me or none of the remaining funds as they shall so decide. F. If one of my sons predeceases the other. whatever funds, if any, main in the deceased son's trust account. shall be transferred to the surviving other's account. G. Upon the eventual demise of the surviving son, whatever nds, if any. remain shall be distributed equally and per capita among my surviving Heren. _n._..__.. .... ~ . ._._,~ ---'.- --,-- ., ,.., "'"_'..~_n' ~ :::.~'0..-::::~.::::..-\.'k;:~~:.;.C2..;.~;-:co.::~;-::;!;:?.:.~.:.-'~~~~-:':'.,:.:::.o.~~'''_ _""_ .~~.::iilffr-.-- ~]T"""w. ........~. .... - , FOURTH: I hereby nominate, constitute and appoint my two daughters, ELORES PRICE and SARA MUMMA as Co-Executrixs of this my, Last Will and estament. FIFTH: The above named persons shall not be required to post bond surety in this or any other jurisdiction for faithful compliance of the office Executrix or ustee. IN WITNESS WHEREOF, I hereunto set my hand and seal to this and two (2) her typewritten pages, ieentified by my signature, to this my, Last Will and estament, , dated on this the "Ll1 dayof Jt~. ,19 '13 he preceding instrument, consisting of this and two (2 ) other typewritten page, i entified by the signature ofthe Testator, JOHN E. ZEIGLER, JR., as and for s Last Will and Testament, who at his request, in his presence and in the presence each other have subscribed our names as WITNESSES hereto. l! L.xf RESIDINGAT,J0f 1Jp'1)/'t/1rW ~ Ut~~ RESIDINGAT ~( I#C-- , , ~...-....-,~~.~-.o__"___ _~,"'~-."","",'n."'__ ~. _._.,...-....~.~_ """".,. COMMONWEALTH OF PENNSYLVANIA) ) COUNTY OF CUMBERLAND ) ~4:/L ITNESS ... WE.&~ ~~ uu~j~l1.e:SS .AND . , the Testator. and the witnesses. respectively, fhose names are signed to the attached and foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator, JOHN E, ZEIGLER. JR., signed and executed the instrument as his last Will. and that he signed and executed it willingly. and that he executed it as his free and voluntary act for the purposes therein expressed. that each of the Witnesses, in the presence and hearing of the Testator signed the Will as Witnesses. and that to the best of our knowledge and sight, JOHN E. ZEIGLER, JR. was at the time eighteen (18) or more years of age, of sound and disposing mind, memory and under no constraint or undue influence. g~ ?~~J~~ I~" JOHrlG R.JR estator) i~ _.... I~SS Subscribed, sworn to and acknowledged before me by JOHN E. ZEIGLER. JR. the Testator, who personally appeared~b.efore me, the undersigned officer,and subscribed t~orn t.9 by the WITNESSE..s.-, . I, . ( . ~ 0.IL<.lS_"> and UI ~ .onthls~? the r9cl day of , 19--1...".> - ~ \)CklJJ3 a NOTARY PUBLIC N t<iriJi S~o31 Donald B. C-;""" p,.I-,I'c East Penn:::;t;:Jr,? T-...J;.)" CL :;~:"C>':XJ;Y fAy CofTln1i33JOn bl)!;-'~" f\!:J\.'. 24, 1996 . . Member, PennsylvaniaAseodalion of NolaiiQo NORA F. BLAIR Attorney at Law 5440 Jonestown Road NFBLA W (alpaonl ine.com TO:CUMI,ft?I.''/NI"> (.1 l1..,u; hf GJZ:I...t:-~ Post Office Box 6216 Harrisburg, Pa 17112-0216 FAX (717) 541-1429 (717) 541-1428 DATE: .;1/,;n/D.3 CLIENT: "2 f' r C " ~ d' , ENCLOSED PLEASE FIND THE FOLLOWING DOCUMENT (S) : Deed 4. Inventory K Inheritance Tax Return Matrix Quit Claim Deed __ Chaprer7Petition __ Mortgage __ Status Report Chapter 13 Petition Satisfaction Piece Answer Bankruptcy Schedules Petition Motion __ Filing Fee Application and Order __ Objection to Plan Other: (JL;;:' ~(C r-tA/LI-l. -rQ;': -pA-J'f-- MArLrAl"":: ]},4 -r p / :;2- :2. '7. 03) 4< 7J.1~ () /1 '7 ,,,t1 A' ~ I f . ALSO ENCLOSED: __ Self-addressed Stamped Envelope for Return of Order/decree __ Self-addressed Stamped Envelope for Return of Copies and Order/decree X Self-addressed Stamped Envelope for Return of Copies Self-addressed Stamped Envelope .-4 Stamped Envelope Addressed to Cr~,I:tt.~) S-?t1.4 ~ /Lt'1'^';? I Co /y k Stamped Envelope Addressed to Qebtv.(", .l)t: t..,o/z..l-~ y:>/Z.-&C {. t L 17 /'J t c.. 0 .-'::J Check for additional probate fees ){ Check for inheritance tax Amount $ Check for tiling fees Amount $'-f,yj)S-. t.f I Amount $ ,:<.11 tI (/ Other: )( PLF:ASE TIME STAMP AND RETUHN THE COI'II':;'; [I \ MY OFFICE. PW:A;';r: HF:TIIHN SICNF:D ()HlJr:H!IlF:C'ln~E T' 1\1','! WVIC'E YOlm ASSISTANO~ IS Crn:ATLY APPltECIATl<1 ) IF 'I'll ":I{/<; IS A PROBLEM. PLEASE CAI.I. I'vH: i\T :>4] -I42H OIt I H772:l:l.~J540. I I . ~ Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Zeigler, Jr., John E. , Deceased No. 21 - 02 - 0522 Date of Death 5/27/2002 Social Security No. 205-09-1602 also known as Sara Mumma Delores Price The Personal Representative(s) of the above Estate, deceased, verify that the ~ems appearing in the following Inventory include all of the personal assets wherever s~uate and all of the real estate located in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed oppos~e each item of said Inventory represents ~s fair value as of the date of the Decedent's death, and that the Decedent owned no real estate outside of the Commonweatth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penatties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to author~ies. perso;i:ln::;~esentat~_0. ~~~. / Sara Mum)l}-a, . 'iJI-. {j Signature: .--------Yr::i2Jlo__'"'!~_~~~______ ("/i../'~~ _ Delores Price Attorney: NoraF.Blair 1.0. No.: 45513 Signature: Address: 5440 Jonestown Road PO Box 6216 Harrisburg, PA 17112 Telephone: 717/541-1428 Address: 17202 North 131st Drive Sun City West, AZ 85375 Telephone: Dated: ( -:, I - C';> _..._--~_.._-_. ..,..;>-- Personal Property Personal property sold at auction 766.50 Payment from Delores Price for commission on her items sold at auction 130.50 1st National Bank ofMarysville bank accounts 92,330.97 Total Personal Property $93,227.97 (Attach add~ional sheets if necessary) Total Personal Property and Real Estate $133,227.97 Register of Wills of Cumberland County, Pennsylvania INVENTORY continued Estate of ~eigler, Jr., John E. also known as , Deceased No. 21 - 02 - 0522 Date of Death 5/27/2002 Social Security No. 205-09-1602 Real Estate House at 400 Shady Lane, Enola, Pennsylvania in need of repair. Sold for $40,000.00. See attached settlement sheet 40,000.00 Total Real Estate $40,000.00 2 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128.0601 REV-1162 EX(ll-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BLAIR NOR F ESQUIRE 5440 JONESTOWN ROAD HARRISBURG, PA 17112-0216 ~-- fold ESTATE INFORMATION: SSN: 205-09-1602 FILE NUMBER: 2102-0522 DECEDENT NAME: ZEIGLER JOHN E JR DATE OF PAYMENT: 02/28/2003 POSTMARK DATE: 02/27/2003 COUNTY: CUMBERLAND DATE OF DEATH: OS/27/2002 NO. CD 002235 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $4,905.41 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: NORA F BLAIR ESQUIRE CHECK# 4415 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS $4,905.41 DONNA M. OTTO DEPUTY REGISTER OF WILLS Ie \ \: ~. '-, -"':..j '" (c. "~.. '\~ ;0 .( \",-. " \--. ~' '~lIi0 First Class Mail c2/-();)- 5~~ -- - N ora Ft. Blair A Horney At Law 544v Jonesto\'m Road P03t Office Box G21t1 Harri1::burg, PA 17112"u216 ..,...'"-----~..._,---~..~~"'---" CUMHEELAlHJ CGUNT~{ HEGTSTER OF -"lILIJ8 One (~<;l1rtl:ouse Square Carlisle, PA 17013 . /"}-67-..3 'v BUREAU OF INOIVIOUAL 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 NORA F BLAIR BLAIR LAW OFFICE PO BOX 6216 HARRISBURG DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-14-2003 ZEIGLER JR 05-27-2002 21 02-0522 CUMBERLAND 101 * REY-I!i47EKlFP!Ol-05) JOHN E Allount Rellitted PA 17112 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-,,=is4TEx--AFP--foFiiirNoricE--oF-i-NHEifiTANcrrAx-il-ppiiA"isEi.iiNi":--Aii-oWAifcroR"-------n-------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF ZEIGLER JR JOHN E FILE NO. 21 02-0522 ACN 101 DATE 04-14-2003 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 OJ 5. Cash/Bank Deposits/Misc. Personal Property (Schedule EJ 6. Jointly Owned Property (Schedule fJ 7. Transfers (Schedule GJ 8. Total Assets U) (2) (3) (4) (5) (6) (7) 40.000.00 .00 .00 .00 93.227.97 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule HJ 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/GovernMental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) UO) 19,748.76 4.470.00 (11) (2) (3) (4) I~ an assessment was issued previOUSly, lines re~lect ~igures that include the total o~ ALL ASSESSMENT OF TAX: 15. AMount of Line 14 at Spousal rate 16. AMount of Line 14 taxable at 17. Amount of Line 14 at Sibling 18. Amount of Line 14 taxable at 19. Principal Tax Due TAX CREDITS: NOTE: NOTE: To insure proper credit to your account, subMit the upper portion of this form with your tax payment. 133,227.97 74.718 76 109,009.21 .00 109,009.21 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. Lineal/Class A rate rate Collateral/Class B rate US) (6) U7J (8) .00 X 00 = .00 109,009.21 X 045 = 4,905.41 .00 X 12 = .00 .00 X 15 = .00 (19)= 4,905.41 \+, AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-27 2003 CD002235 .00 4,905.41 TOTAL TAX CREDIT 4,905.41 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .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 INSTRUCTIONS.) C/~K Register of Wills of Cumberland County STATUS REPORT BY PERSONAL REPRESENTATIVE UNDER RULE 6.12 Name of Decedent: JOHN E. ZEIGLER, JR. Social Security Number: 205-09-1602 Date of Death: May 27,2002 Estate No. 2002-00522 Administration No. 21-02-0522 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above- captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is "No", state when the personal representative reasonably believes that the administration will be complete: 3. If the answer in No.1 is "Yes", state the following: A. Did the personal representative file a final account with the Court? Yes No X B. The separate Orphans' Court No. (If any) for the personal representative's account is : C. Did the personal representative state an account informally to the parties in interest? Yes No_X 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. .::::r ~~...... ... / --", .. - ) '''--'' -'- /~ j Nora . Blair, Esquire Counsel for Personal Representative Supreme Court ID 45513 5440 Jonestown Road Post Office Box 6216 Harrisburg, PA 17112-0216 (717) 541-1428 Date: September 3, 2003 "~ I