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HomeMy WebLinkAbout02-0551PETITION FOR PROBATE & GRANT OF LETTERS Estateof_ FLORENCE~A~Y ~ No. 21-02- Jf ~ also kd6lvn as FLORENCE To: Register of Wills for the c R~ JAY deceased. County of Cumberland Soaal Security No. 185-28-9882 Commonwealth of Pennsylvania The Petition of the undersigned respectfully represents that: Your Petitioner, who is 18 years of age or older and the Executrix named in the Last Will of the above decedent dated Mav 26 1987, and codicils dated none 19_ The Executrix named none died .Renunciations for none attached hereto. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 770 South Hanover Street Carlisle Borough Decedent, then 89 years of age, died Mav 17 2002, at _ Chanel Pointe at Carlisle Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the Will offered for probate; was not the victim of a killing and was never adjudicated ~.,..,,.,,.,e~e.... Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $240.000.00 (If not domiciled in PA) Personal property in PA $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania, situated as follows: $ WHEREFORE, Petitioners respectfully requests the probate of the Last Will and Codicil(s) presented herewith and the grant of letters testamentary thereon. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss 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 representative of the above decedent, petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed a before me this 7th _day of /ly,v~ June, 2002. Priscilla J. suer C LEWIS ~ Register' 717-292-1523 No. 21-02- 55 I ~c~~R~ Estate of F~QRENCE $. TAY a/k/a FLORENCE ~ JAY ,deceased. DECREE OF PROBATE & GRANT OF LETTERS AND NOW, ~ TrtniF t 1 .2002, in consideration of the Petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated May 26 1987 described therein be admitted to probate and filed of record as the Last Will of Florence R_ Jav a/k/a Florence Ricker Jav ;and Letters Testamentary are hereby granted to Priscilla J. Lauer "TY.t~-tR.CIt~ 171 5 YY3A (~ U J'Y.fn'~+e~ d ~LIl[~(~W_ C ANTIS Register of Wills ~ Q IRWIN McKNIGHT & H HES FEES e''~!~-'V 3.C- Probate, Letters, Etc........ $ 270.00 Ro er B. I i t Es uire 06282 Short Certificates(-3- ) .... $ 9.00 ATTORN ( p. Ct. I.D. No.) Renunciation(s) ........... $ JCp . . .................. $ 5.00 60 West Pomfret SC.. Carlisle PA 17013 Other Will Pages (-1-) .... $ 3.00 ADDRESS TOTAL: .... $ 287.00 Filed ..... 6-1 1-02, , , , , , , , , , , , ,,,, 717-249-2353 called atty 6-11-02 PHONE EV )/HL t s roar v rha- ~c Ir `ormarion here given is coneal~~ copied trom an original celrificare of death duly Aled with me as I o 'd R,g;isu 1 l he ollr;urll cernficare will be faward~d n the k.lm Vital Records Office fa permanent filing. WARNING: It is illegal to duplicate this L:opy by photostat or photograph. Ic: 6,r [his ccrrificuc, $LOU __~ 8 19~~0 n L,. Local Regis[rar MAY 21 2U02 ua~e COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS '"* CERTIFICATE OF DEATH :Ni NMIE Cf CECEOENi li.rv MgE4,LUl ~ -' NE•M1L.WUpEI iK ,. F2oaenee R. Ja !EX p ScC4l5ELCVRIT'NVMpBER •GE ILan Bmq•y, UNCERIYFM UKCERIpp ~' emQ'Le ]. ISJ ~ 20 BaeaelRrN BunxRUCE rcn.w 89 YonN. , Bm x•4. I YM« u•. +NI s.l.o ro•«,co.r.h RLncE OROEaNrcnNN Own..-..~n,I,N.LO„x„e..n .N 3/29/7913 Ph.i.Qadefph~.a"a,w~ E L s RIpYyIIEry ^ soN ^ • °Oi1MiYOROlQ" aEr.edm. rnsoE OEN.N ENC[m NRYEm~414•,xl4n.aw Nr.Yw4..aN CumbertQand CartQ.~yke RYB CECENrOR `~~ ' . ChapeY Po.~n#e a# CartX.raYe ~*~ ~E.OE, ..~____. _.__.. E•. _. w^ Ne .. _ __.__ „u. CartZz k P uu v.. srm rent REYLENCF a ¢, A 17013 IBe•.wwravnr4 o~w4.EO. Curt Geortge~F'. !(iehert Epnly brt1Q,~,ic~~a .Y':' Lauert IOBOL RIlNWr ~ CmulaO R ^ OQE Cf M9PQ4rICN •mmORanTm umO Qn« MaM.0.K N«I _ ~ ,.. 5/~I /2002 Mz. DY EM««4 Yw•Mp> ~R.May 17,2002 Q RMrw ^ QnN rEY•cEYI^ ..x> ,ariri~w.n.Y«E.w (uh L#e ~'~ov2rt, PA 17315 Cem. ~~#. HoX2y Sprt.inga PA 11065 ~: BCrtema#ortyM#. HOP.2y Spatnga, PA11065 aRBE.vin --- ~ Nen.41a ^ r ^ wNQ w. ^ No ^ s4na. O coxrlNe.eN.,m.4e ^ _._._.._._........_ ................. ^ 7?~ llgNdlNtlNBMVOCERiIEYINO MY91LY..NIFTycw GrnYmncvgq.h,ygcnM ..•••... ••...••... •...••.. Ip hN4C•p«ny Ln•+I•YEn, pEEM eeevrMnW4nn.G•1•.aM yl«..•MeyE,e llnetrl•1•b mwi n~~.•EnnM LICENBENUMBF ........... ~ as MD ............. •Y[O,C.EL EY.LYMIWCOgONER N.WE.wOMOF an m•e.«•nr•..«mmm~.w«Inw.n I «.nn«ELN«w..._ ..............s«pn.ln mroolnlon.a•«n nea.rwnmulm..e«•. •,a pl.c•.Emeuelo mE e.u«IEI EIN 1 °~_'I I. ~ ............................. ~ RECSrN.NS SwxauRE moxu ............ ...... LE • K A.~e..~cQ.~. ~ 12, 101 WEFLLEUpncry v.. (] w ^ (w+1x.~ lti~ _ ~~Ir ORESIONEOIWnIyI'.b s. ~p'1 ~, ~'CO VFRlON vMOCpARETEOORUYCLCERX •~~. QfRNSWYr~ J~ ~h0 aooa ~M~ ~tII 2IIt~ ~PStctITICPlt~ I, FLORENCE RICKER JAY, of 101 Pine Road, Mount Holly Springs, Cumberland County, Pennsylvania 17065, do hereby make, publish and declare this to be my last will and testament, hereby revoking all wills heretofore made by me. 1. I direct my personal representative to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. 2. I authorize and empower my personal representative to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at either public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefor, in fee simple, as I could do if living. My representative is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said representative. 3. I give, devise and bequeath all of my estate of whatever nature and wherever situate to my children, share and share alike, the child or children of any deceased child taking the share their parent would have taken if living. 4. I nominate and appoint Priscilla L. Lauer, or if she cannot or does not serve, Daniel G. Jay, to be the personal representative of my estate, to serve without bond. 5. I suggest that my personal representative retain the services of Irwin, Irwin & McKnight, Carlisle, Pennsylvania in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 2,` ~ day of May, 1987. ~E RICKER ) Signed, sealed, published and declared by .the above-named person as and for a last will and testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as subscribing witnesses. ~~~~--C1~.i1Ls1kLl ~.s3a ~ L~i~.im~m-, CERTIFICATION OF NOTICE UNDER RULE 5 6(al Name of Decedent: FLORENCE KICKER JAY Date of Death: MAY 17 2002 Estate No.: 21-02-0551 To the Register: 1 certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on June 24. 2002 . Name Address Priscilla J. Lauer 1251 Che Orchard Road Dover PA 17315 Daniel G. Jav 2117 Suburban Greens Drive Timonium MD 21093 Martha Ann Forrestor P.O. Box 1768 Waldron AR 72958 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none . Date: 06/24/02 C~_ Signature IRWIN, MdKN.[G T & HUGHES Name Roeer B Irwin Esuuire Address 60 West Pomfret Street Carlisle PA 17013 Telephone l7l~ 249-2353 CapaCtty: Personal Representative X Counsel for Personal Representative - rI COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1]126-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 001519 IRWIN ROGER B ESQ 60 W POMFRET ST CARLISLE, PA 17013 -------- role ESTATE INFORMATION: ssrv: 1as-za-saaz FILE NUMBER: 2102-0551 DECEDENT NAME: JAY FLORENCE BICKER DATE OF PAYMENT: 08/13/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 05/17/2002 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ $10,210.53 REV-1182 EXI11-961 TOTAL AMOUNT PAID: REMARKS: ROGER B IRWIN ESQUIRE CHECK#18814 INITIALS: CW SEAL RECEIVED BY: 510,210.53 MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS ~. COMMONWEALTH OF PENNSYLVANIA ~ COUNTY OF CUMBERLAND I ~' Priscilla J. Lauer _ being duly sworn _. according to law, deposes and says that she is the Personal _ ___ Representative _ __ of the Estate of Florence Ricker Jay late of __the Borough of Carlisle --- - --, Cumberland County, Pa., deceased and that the within is an inventor made b Priscilla J. Lauer ., the said P y y__ _ ___ _ _ Personal Re resentative of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of deceden}'s death, Sworn and su 'bed before me, _~ ~1 ~k _ s 12t da August, 2002 Priscilla Lauer, Pe s~Onal Representative r 1251 Cherry Orchard Road U ~ Notarial S I Jacqueline L. Drawbaug , otery Public Carlisle Boro, Cumbe d County My Commission Espires Aug. 14, 20113 Member, PetmeyNania AesodegOn tff Notaries Date of Death _ 17_ Day __ _.__ Dover, PA 17315 Address OS ___ 2002 Mon}h Ysar INSTRUCTIONS I. An inventory must be filed within three mon}hs after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of addi#ional aisets. - 3. Additional sheets may be attached as to personalty or realty 4. $ee Ar}iele IV, Fiduciaries Act of 1949. - ~1 O I N 0 i N 0 Z O Z w Z ~ w z Q w o_ F, lL (] N W !_- ~ J LL LL ~ < O O Z z O o w Q d d ti a ryi V H x w U, 0 a. w. v .c a, O J -d m m d r C U v c d .O E U ~ m w w x 7 ~ x m A w 0! ~ d ` o E ~ Q 3 z ~, x K m ~ z N H O ~ JL W. H m o m l1 Inventory of the real and personal estate of FLORENCE RICKER JAY deceased 1. 6,335.501 Shares Fidelity Devonshire Trust. 70,387 42 2. 57,026 Shares Kemper Government Securities. 8,667 95 3. PNC Bank, N.A. - Checking Account 54,891 80 4. Fidelity Investments - Account IIX47-063894 Cash Reserves. 1122,019 00 TOTAL. j 255,966 f 17 REV-1S00EX +(6-00) CAPB HpRL EplO CRAC KOTK ES C P o 0 R N R D E E S N T C o M P T U A T X A T I o N REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT C'- OFFICIAL USE ONLY /7- 69-'/ FILE NUMBER D E C E D E N T COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Ja Florence Ricker DATE OF DEATH (MM-DD-YEAR) COUNTY CODE YEAR SOCIAL SECURITY NUMBER 185-78-9882 THIS RETURN MUST BE FILED IN DUPUCATE WITH THE 21-02-0551 NUMBER REGISTER OF WILLS SOCIALS C RITYNUM X ,. Original Return 4. Limited Estate X 6. Decedent Died Testate (Attach copy of Will) o 9, Litigation Proceeds Received 2. Supplemental Return 4a, Future Interest Compromise (date of death after 12-12-82) 7. Decedent MaintaIned a Living Trust (AttaCh copy of Trust) o 1 D. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) o o 3 date of death . Remainder Return prIor to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 1,. Election to tax under Sec. 9113(A) (AttaCh Sch 0) Il'_I~ NAME Ro er B. Irwin Es FIRM NAME(lf Applicable) IRWIN McKNIGHT & HUGHES TELEPHONE NUMBER 60 West Pomfret Street West Pomfret Professional Bldg. Carlisle, PA 17013 R E C A P I T U L A T I o N 9-2353 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule 8) 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) (1D) 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 Sub'ect to Tax (Line 12 minus Line 13) (1) (2) (3) None 79,055.37 None ,_~_ OFFICIAL USE ONLY (8) 255,966.17 (11) 17.123.28 (12) 238,842.89 (13) (14) 238,842.89 (15) (16) (17) (18) (19) 0.00 10,747.93 0.00 0.00 10,747.93 (4) (5) None 176,910.80 (6) None None 15,697.83 1,425.45 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 238,842 . 89 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. x X X X .0 0 .045 .12 .15 Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 770 South Hanover Street CITY I STATE I ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 10,747.93 0.00 537.40 Total Credos ( A + B + C) (2) 537.40 3. InterestIPenaJty if applicable D. Interest E. Penalty TolallnleresVPenalty ( D + E I (3) 4. If line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (s) A. Enter the interest on the tax due. (SA) B. Enter the lolal of Line S + SA This is the BALANCE DUE. (5B) Make Check Payable 10: REGISTER OF WILLS, AGENT 0.00 0.00 10,210.53 0.00 10,210.53 ;'~~~~ii!'~~~WER THE:~~~Lo~IN~' Q~E~TI~NS8Y'~LACI:~G!~N' 1. !!i:iii:::; ,c."".., "X" !i~!i!~~i~!~~~;~:~~!~ij~~~:i~~~~!~i::;;:" Yes No ~~ Did decedent make a transfer and: a. retain the use or income of the property transferred; b. retain the right to designate who shall use the property transferred or its income; . c. retain a reversionary interest; or . d. receive the promise for life of either payments, benefits or care? . 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 fo( 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. o o o IT] IT] IT] Under penalties of perjury, r declare that I have examined this return, including accompanying schedules and statements. and to the best of my knowledge and belief, il is true, correct and complete. Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FlUNG RETURN <J rt.0J SIGNATURE OF PREPA Priscilla J. Lauer _ _ }:??~_ _~I:".r:r:Y_ _c>r:?!'_":r:<1_. _ _. _ _ _ _ _ _ _ _ _ _ _ _.. _ _ _ _ _ _ __ Dover, PA 17315 IRWIN McKNIGHT & HUGHES 60 West Pomfret Street - - C~~ ii ~i;'-,- - PA- - - i i6i3 - - - - - - - - - - - - - - - - - - - - - - - - - -- DATE !l'(t'-/c1L DATE For dates of after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving [72 P.S, 9116 (a) (1.1) (il), 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) Oi)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1. 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, 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 noted in 72 P.S. 9116{ 1.2) [72 PS 9116(0)(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(aX1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Copyright (c) 2000 form software only The Lackner Group, Inc. Form 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 Florence Ricker Jay SSII 185-78-9882 05/17/2002 21-02-0551 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION VALUE AT DATE NUMBER UNIT VALUE OF DEATH 1 6,335.501 shares Fidelity Devonshire Trust 11.11 70,387.42 2 57,026 shares Kemper Government Securities .152 8,667.95 TOTAL (Also enter on line 2, Recapitulation) 79,055.37 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1503 EX (Re,. 1-97) REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Florence Ricker Jay SS# 185-78-9882 05/17/2002 21-02-0551 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 SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY DESCRIPTION PNC Bank NA - checking account VALUE AT DATE OF DEATH 54,891. 80 2 Fidelity Investments - account #X47-063894 cash reserves 122,019.00 TOTAL (Also enler on line 5, Recapitulation) $ 176,910.80 (If more space is needed, insert additional sheets of the same size) Copyrlght(c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97) REV-1511 EX +(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCETPIX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Florence Ricker Jay SSIf 185-78-9882 05/17/2002 FILE NUMBER 21-02-0551 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1 FUNERAL EXPENSES, Hollinger Funeral Home 6,017.00 B. ADMINISTRATIVE COSTS, 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) I E1N Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. 3. Attorney's Fees IRWIN McKNIGHT & HUGHES Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address 9,200.00 City Relationship of Claimant to Decedent State Zip 4. Probate Fees Register of Wills 287.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs Cumberland Law Journal - estate notice publication 75.00 2 Register of Wills - filing fee 25.00 3 The Sentinel - Legal - estate notice publication 93.83 TOTAL (Also enter on line 9, Recapitulation) S 15,697.83 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97) REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCETAX RETURN RESIDENT DECEDENT ESTATE OF Florence Ricker Jay SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SS{I 185-78-9882 05/17/2002 FILE NUMBER 21-02-0551 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Chapel Pointe at Carlisle AMOUNT 1,425.45 TOTAL (Also enter on line 10, Recapitulation) S 1,425.45 (If more space is needed, insert additional sheets of the same sjze) CopyrIght (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rell. t-91) REV-1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Florence Ricker Jay SSff 185-78-9882 05/17/2002 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS [Include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] 1 Martha Ann Forrester P.O. Box 1768 Waldron, AR 72958 2 Daniel G. Jay 2117 Suburban Timonium, MD Greens Drive 21093 3 Priscilla J. Lauer 1251 Cherry Orchard Road Dover, PA 17315 RELATIONSHIP TO DEC~QENT Do Not List Trust.e(s) Daughter Son Daughter FILE NUMBER 21-02-0551 AMOUNT OR ~HARE OF ESTATE 1/3 remainder 1/3 Remainder 1/3 remainder ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 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 (c) 2000 form software only The Lackner Group, Inc. 0.00 Form REV-1513 EX (Rev. 9-00) last Jiil! aub ~~$lantrn! I, FLORENCE RICKER JAY, of 101 Pine Road, Mount Springs, Cumberland County, Pennsylvania 17065, do hereby publish and declare this to be my last will and testament, revoking all wills heretofore made by me. 1. I direct my personal representative to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. Holly make, hereby 2. I authorize and empower my personal representative to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at either public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefor, in fee simple, as I could do if living. My representative is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said representative. 3. I give, devise and bequeath all of my nature and wherever situate to my children, alike, the child or children of any deceased share their parent would have taken if living. 4. I nominate and appoint Priscilla L. Lauer, cannot or does not serve, Dan i e 1 G. Jay, to be the representative of my estate, to serve without bond. estate share child of whatever and share taking the or if she personal 5. I suggest that my personal services of Irwin, Irwin & McKnight, the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal th i s 2' r!! day of May, 1987. representative retain the Carlisle, Pennsylvania in ''1.; /;-'. .~I :;c, fj1.i/)'/.-<-L i~~< h> ft~[ ) FLORENCE RICKER JA: U Signed, sealed, published and declared by the above-named person as and for a last will and testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as subscribing witnesses. ~j'I/';'Jc" (;r!x:f.J~/)/?~ ACKNOWLEDGEMENT .~ AffIDAVIT WE, FLORENCE RICKER JAY, BETZI A. MORRISON and SHARON L. SCHWALM, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in their presence and hearing of the testatrix, signed the Will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. ]-:it?-i/H~<- /2;;ctla1.. . ..~ckf- FLORENCE RICKER ~ () L " .. ./-., Z . MD S N , ~/Z 4 / " Mt"~ '( 'f~'Q1(Mifl/~ COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND 55. Subscribed, sworn to and acknowledged before me by FLORENCE RICKER JAY, the testatrix, and subscribed and sworn to before me by BETZI A. MORRISON and SHARON L. SCHWALM, witnesses, th i s 2 (, ~day of May, 1987. /'1. I? iCe .' (S. c;;i:!:Li-,- i'ROGtJ::N. NOTAl' PUI~C . . CARUSLE IORG, CUIISERlAND COUNTY MY COMMISS:OIl ExmES ocr. 3. 1988 .Fideli;' ~ Investments' June 26, 2002 ~~~~UW[~ JUL 0 1 2002 IRWIN MCKNIGHT & HUGHES ATTN: ROGER B IRWIN 60 WEST POMFRET STREET CARLISLE PA 17013-3222 IRWIN, McKNIGHT & HUGHES Dear Roger B Irwin: I am responding to your request for information regarding Florence Jay's Fidelity accounts. Registered Owner: Florence R Jay Account Number: X47-063894 Registration: Florence R Jay-Individual Value on 05/ 17/2002: See attached valuation report:X2025I All information in the enclosed valuation report(s) is based on assets in the above-listed Fidelity account(s) as of the date indicated on the report(s). Valuation information for these accounts is provided through Evaluation Services Inc., a third party valuation service provider. Fidelity does not warranty the accuracy of this information for any particular purpose. In addition, Fidelity does not provide legal or tax advice. Consult with an attorney or tax professional regarding any specific legal or tax situation. I hope this information is helpful. For questions concerning account holdings or instructions on how to transfer the ownership of the accounts, please call one of the representatives at our Inheritor Services Group at 800-544-0003 between 9:00 A.M. and 7:00 P.M. Eastern time Monday through Friday or visit our website at www.fidelitv.com. Sincerely, (lAM r {\C~4! D 1 . \ &JQ/,,&--Y~ Marshall Pulliam Account Re-Registration Services Our file: W06077-07JUN02 :-"ideliw ~i1~:rnb.r -"':~,.;,.i Ln,js dl::,rrii..:ljt8,j ;'''3d',y D,~;l!!b;,'('(s Customer Service Group p-o. 80'< 650276 Dallas, TX 7S265-()276 ~ '" ... '" ~ I; .. I 0 I 0 u ~ ~ u it .. 01 U 0 01 ~ " '" '" ... H .. ... .. '" ~ "I; 0 ... '" .. '" '" .. ~ r:lH ... 15> I UH "" " . ... '" .. ... ... .. '" ... '" ... . " .. ... ... .. '" '" -- I::r:l .. '" ... ... ... . ~ '" '" '" ... B~ .; ,; ..; .; ... '" ... ... 0 0 ~ ., ... ... ... '" " g 0 0 . " '0 0 . .... 0 ... . a~ ... '" .... ... ... > ... 0 ... " 0 0 0 ~ " 0 ... ....., ... '" ... " ..u ... ... 0 0. -I;! 0 ... ~.. ... 0 ... ~~ 0 ... - !;! 0 .., ... ... ~ H ...., - ~'" ... "' .; ... 0 ~i '" 01 .. ::!., E U ::! H _U ~ ...... ~O ~ "", ... 01 ...... 0 " .." .. 0 H" '" ... ~ e ;; .... - " ., ... ... ... H .. <J ., ... ... 0 ~ .,,, .... ~ - - - " . g: "' "' "' 0 ~ " ; 0 0 0 0 ~:l U ... > .. [;! ..... 01 ... 0 ~ 0 >- . .. ... !l~ . I 0 0 0 -- .; " ~ ... "' 01 '" - "0 .. ... 5 ... 0 0 1l [;! '" - .. . ... .. "' '8 .... H 0 '" ... .. .. " !:! 0 . " .. " U .. - '" . .... .z" 01 01 ... .... > 15 0.. " .. 0 > h '" ~ - .... 01 '" ~If)~ "' '" " !'J 0 H 0 g"g 1l ~ .. !;! .... .. "'~o ..0 . .. H H :a ~ .., 01 .. " 01 " Id h . .. " " . .. ~!; " .. "H . lJ " 0 0 '" ... 0 "- g 0 .. "' ... '" .l! -r:l . "' '" .. e " ~~ ~ ... ... ~ 0 '" 0 '" .,; ,:: ..; .\! . " "'::! "' N . ... . 0. .. " . ... " 0. 0. ... ... . "' ... .. ... . ~ ... ill 0 '" 0 0. 0 ... "' ... . "- N .. ~ ... ... 0 " .. .. ... 0 '" . . " .... ... '" 0 " -- 0 '" '" .. '" 0 " ~ ~ e ... .. ... .. .. ~ ... ~ " '8 ... ~ . . ~ ... ... ~ . " -- " 0 t: .... " .. JUN-26-2002 12:18 PNCBRNK ClF DEPRRTMENT 412 705 0057 P.01/01 o PNCBAN< June 25, 2002 Roger B. Irwin West Pomfret Professional Building 60 West Pomfret Street Carlisle, PA 17013-3222 RE: Estate of Florence R. Jay, deceased SSN: 185-28-9882 DOD: 5/17/2002 Dear Mr. hwin: In response to your request for Date of Death balances for the customer noted above, our records show the following: Checking Account Account #5140186276 Established 06/01/1970 FLORENCE RlCKER JAY DOD balance: $54,875.11 + $16.69 accrued interest Interest Paid 1/1/2002 - 5/17/2002 - $51.54 Please note that this office only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please call1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, ~~~ Rachelle Wells 1-800-762-1775 P7-PFSC-04-F 500 first Ave. Pittsburgh PAl 5219 Member FDIC TOTRL P.01 ~~-~~ y ( BUREAU OF INDIVIBUAL TAXES \'b. INHERITANCE TA% BIVISION DEPT. 280681 HARRISBURG, PA 17128-0601 r ROGER B IRWIN ESp IRWIN ETAL 60 W POMFRET ST CARLISLE PA 17013 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENi, ALLOWANCE OR DISALLDNANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REY-156) EX XFP (O1-APl DATE 09-30-2002 ESTATE OF JAY FLORENCE R DATE OF DEATH OS-17-2002 FILE NUMBER 21 02-0551 COUNTY CUMBERLAND ACN 101 Anount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION_ FOR YOUR RECORDS -~ REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR ----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF JAY FLORENCE R FILE NO. 21 02-0551 ACN 101 DATE 09-30-2002 TAX RETURN WAS: f X) ACCEPTED AS FILED ( ) CHANGED AISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly ONned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment, 255,966.17 9. Funeral Expanses/Adm. Costs/Misc. Expanses (Schedule H) (9) 15,697 .83 10. Debts/Mortgage Liabilities/Liens (Schedule IJ (30) 1.425 4F 11. Total Deductions 12 (11) 17.1 ~ H . Net Value of Tax Return [12) 238,842.89 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13] .00 14. Nst Value of Estate Subject to Tax [lyJ 238,842.89 NOTE: If an assessment was issued previousiy, lines reflect figures that incl d 14, 15 andior 16, 17, 18 and 19 will u e the total Of ASSESSMENT OF TAX: ALL returns assessed to date. 15. Anount of Line 14 at Spousal rata (15) .00 00 _ 00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 238,842.89 X X 045- . 10,747 93 17. Amount of Line 14 at Sibling rate (17) .00 X 12 - . 00 18 Anount f Li . . o ne 14 taxable at Collateral/Class B rate (18) .00 X 15 - 00 19. Principal Tax Due . TA C E ITS• (19)= 10,747.93 DATE 08-13-2002 NUMBER CD001519 INTEREST/PEN PAID (-J AMOUNT PAID 537.40 10,210.53 TOTAL TAX CREDIT 10,747.93 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .DO [1J .DO [2J 79.055.37 [3J .00 (4J .00 (5J 176.910.80 (6J .00 m .00 [B) ~ IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. ZF TOTAL DUE IS REFLECTED AS A ••CREDIT•• (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIDNS.) RESERVATION: Estates pf decedents tlv ing on or before Decanber 12, 1982 -- if any future interest in the estate is transferred in possession or enjmynenY tm Cle ss B (collateral) beneficiaries of the tlecetlent after the expiration o4 env estate for life mr for yea rs, the Cmmmonwealth hereby expre ssly reserves the right to appraise and assess transfer Inheritance Tezes et the lawful Class B (collateral) rata on any such future interest. PURPOSE OF NOTICE: To fulfill the raqu irements o4 Sec[ion 2140 of the Inheritance and Estate Tax Ac k, Act 23 of 2000. (72 P. . Section 9140). PAYMENT: Detach the tap portion pf this NeYiee antl submit with Your payment Ym the Register of Nills printed on the reverse sitle. --Make check pr money order payable to: REGISTER OF NILLS, AGENT REFUND (LR): A refund of a taz credit, which was not requested on the Tax Return, may be requested by couple ting an ^App lice tipn fmr Refund of Pennsylvania Inhe ritanee antl Este Ye Taz^ (REV-1313). Applications are available aY the Office of the Register of Nills, env of the 23 Revenue District Offices, pr by calling the spacial 24-hour answering service for forms ordering: 1-800-362-20507 sarv ices for taxpayers with special hearing and / pr speaking needs: 1-800-447-3020 (TT pn lv)• OBJECTIONS: AnY party in interest not satisf ietl xith the apprai semant, allowance, or tli sallowance of deductions, or assessment of tax (inclutlin9 tliscount or interest) as shown on this Nc Yice oust object within sixty (60) tlavs of receipt of this Notice by: --written pretest to the PA Department p4 Revenue, 8certl of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal kp the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be atldre ssetl in writing to: PA Oepar Re^17128-0601ue, 8ureeu o4 Intl ividual Taxes, ATTN: Post Assessment Rav iew Unit, Oep t. 280601, Harrisburg, Phone (717) 787-6505. Sae page 5 of the booklet ^In struc tians for Inheritance Tez Return 4mr a Resident Decadent" (REV-1501) for an explanation of administrative lv carrec Table errors. DISCOUNT: If env tax tlue is paid within three [3] calendar months after the decedent's tleeth, a Five percent (5%) tliscount of the tax paid is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax antl interest assessed, antl not paid before Jenua ry 18, 1996, the first day after the antl of the tax amnesty period. This non-participation penalty is appealable in the same manner antl in the the same time periptl es you woultl appeal the tez and interest Shat has been esse ssed as intlicated an this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months antl one (1) day from the date o4 death, to the tlate of payment. Taxes which became delinquent before Januerv 1, 1982 bear interest et the rate o4 six [6%] percent par annum calculatetl et a daily rate o4 .000164. All taxes which became delinquent on antl after January 1, 1982 will bear interest aY a rata which will very frow calendar year to calendar veer with Yhat rate announcetl by the PA Oapartment of Revenue. The applicable iota re s4 rates far 1982 through 2002 are: Year Interest Rate Daily Interest Factor Y=ar Interest Rate Daily Interest Factor .000548 1992 9% .00024] 1982 20% .000192 1983 16% .000438 1993-1994 7% .000301 1995-1998 9% .000247 1984 13% 1999 7% .000192 1985 13% .000356 ,000219 1986 30% .0002]4 2000 8% .000247 2001 9% .000247 198] 9% 2002 6% .000164 1988-1991 11% .000301 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Ant Na tice issued after the tax becomes tlelinquenk will reflect an interest calculation tc fifteen (15] days beyond the date of the assessment. If payment is matle after the in Merest compute ticn date shown an the Notice, adtlitional interest musk be <alcula ietl. STATUS REPORT UNDER RULE 612 Name of Decedent: FLORENCE KICKER JAY Date of Death: MAY 17 2002 No. 21-02-0551 L~ C~ 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: X Yes No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes X No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? X Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts maybe filed with the Clerk of Orphan's Court and maybe attached to this report. Date: 1/13/03 Capacity: Signature ~- IRWIN, McKNIGHT & HUGHES Rorer B. Irwin Esquire Name (please type or print) 60 West Pomfret Street Address Carlisle. PA 17013 City, State, Zip _(717) 249-2353 Telephone Number Personal Representative X Counsel for Personal Representative