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HomeMy WebLinkAbout02-0639 REV-1500 EX (6-00) 15 :f li-1!la -8 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT 20Q.! _063L__ YE./lR MJMBER QFFlClIII... USE ONI- Y COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17126-0601 FILE NUMBER 21 COUNlY CODE ~ Z W C W ~ C DECEOENrS NAME (LAST, FIRST. AND MIDDLE INITIAL) HB~FORD, ~AOLINB M DATE OF DEATH (MM..Q{}..YEAR} DA1EOF BIRTH (MM-DD-YEAR) 07/06/2002 11/1/1922 (IF APPLICABLE) SURVlVlNG SPOUSE'S NAME (LAST. FIRST. AND MIDDLE INITIAL) SOC~SECU~TYNUMBER 196-14-2986 THIS RETURN MUST BE FII-ED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER w .... )::;:$Cf.I U"''' W"U ,,00 U"''''' ..Ill .. < lXI, 04 [Xl 6. 09. o 2. Supplemental Return D 3. Remainder Return (date of death prior to 12-13-32) D 4a. Future Interest Compromise (date of death after 12-12-82) 0 5. Federal Estate Tax Retum RequirEld o 7. Decedent Maintained aUving Trust {A\\achcopy ofTNst} --.!.. 8. Total Number of Safe Deposit Boxes o 10. Spousal poverty Credit (date of death betwHn 12-31.91 ar<l1-1-95} D 11. Election to tax under Sec. 9113(A)(AUeo:hSd10} Original Return LimJled Estate Decedent Died Testate (Attach copy of Will) Utigation Proceeds Reeeived ... Z w c z o .. '" ~ 8 THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS LINDA J. LUNDBERG. ASSISTANT V. P. ~.O. BOX 308 CAMP HILL, PA 17001-0308 FIRM NAME (If Applicable) ~NC BANK, N.A. TELEPHONE NUMBER (717) 730-2265 ,. Real Estate (Schedule A) (1) 2. Stocks end Bonds (Schedule B) (2) 3. Closely Held Corporation. Partnership or Sola-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash. Bank DepOSits & Miscellaneous Personal Property (Schedule E) (5) Z 6. Jointly Owned Property (Schedule F) (6) 0 o Separate Billing Requested i= :5 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) :::l {Schedule G or l} ~ c:: 6. Total Gross Assets (total Lines 1-7) <( 0 W 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 0:: 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Oeductions (total Lines 9 & 10) 109,000.00 0.00 0.00 0.00 242,193.95 0.00 OFFClIII... USE ONLY 0.00 (8) 30,149.80 2,213.59 351,193.95 (11) (12) 32.363.39 318,830.56 0.00 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) (13) 3U,830.56 (14) 14. Net Valu. Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax 0.00 Z rate. or transfers under See. 9116 (a)(1.2) 0 ;:: 16. Amount of Une 14 taxable at lineal rale 318,830.56 < .... :> 0.00 .. 17. Amount of Une 14 taxable at sibling rate ,. 0 0,00 U 18. Amount of Une 14 taxable at collateral rate >< < 19. Tax Due .... x.OO_(15) 0.00 14,347,38 0.00 0.00 14,347. 38 x .045....-- (16) x.12 (17) x .15 (18) (19) 20. o CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ,. > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 2W46451.000 Decedent's Complete Address: SlREET ADDRESS 210 SECOND STREET Cln' I STATE I ZIP SOJIMERDALE PA l7093 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty CredIT 8. Prior Payments C. Discount (1) 14,347.38 0.00 l2,587.50 662.50 Total Credits (A + B + C) (2) l3,250.00 3. InteresUPenalty if applicable D. Interest E. Penalty 0.00 0.00 TotallnteresUPenalty (D + E) (3) 0.00 4. If Line 2 Is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) l,097.38 A. Enter the interest on the tax due, (SA) 0.00 B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) l, 097.38 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. 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? . . . . . . . . . . . . . . . . . . . . . . . . . . .. [J 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficial)l designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D [X] 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 retum, Including accompanying scheduleaartd statertlents, and \t>\hebesl of my ....ncm\edge ano belief, it \s lrue, corree\: and complete. Declaration of preparer other than the p8l'SOl'lal representative is based 00 all information of which preparer has any knO'Medge. SIGNATU E~SONRESPONSIB FORFIUN EnJRN PNC Bank, N. A. DATE BY: . Assistant Vice President AOORESS Yes No D D D D 00 00 00 00 IX] IX] CAMP HILL, PA l700l-0308 SIGNATURE OF PREPARER OTHER THAN REPRESENTA nVE DATE AQORESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% f72 P.S. ~ 9916 (a) (1.1 )(i)]. For dates of death on or after Janual')ll, 1995, the tax rate imposed on the net value of transfers to at for the use of the sUrviving spouse is 0% [72 P.S. ~ 9116 (a) (1.1) (il)] 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 tlPplicable 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~r the use of a natural parent, arl adoptive parent, or tl stepparent of the child Is 0% [72 P.S. ~ 9116(a)(1.2)1. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal bene1iciaries is 4.5%, e){cept as noted in 72 P.$. S 9116(1.2) [72 P.$. S9118(a)(1 )). The lax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. ~ 9116(a)(1.3)]. A sibling is defined. under Section 9102, as an mdividual who has at least 01'\6 parent in commoo 'Mth the decedent, whe\her by blood or adoption. 2W46461.000 REV-1502EX'" (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF HEPFORD. PAULINE M FILE NUMBER 21-2002-0639 All real property owned "Iy or.s a tenant In common must be reported at fair market value. Fair market value is defined as the price at which propertY would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or seil, both having reasonable knowledge of the relevant facts. Real property which is Jolntly-owned with right of survivorship must be disclosed on Schedule F. N0U'~R DESCRIPTION 1. HOUSE AND PROPERTY LOCATED AT 210 2ND STREET. Sl1MMBRDALI!. C1IMBERLAND COUNTY. PBNNSYLVANIA. SEE DEED ATTACHED. VALUE AT DATE OF DEATH 109.000.00 2W46952.000 TOTAL (Also enter on line 1, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 109.000.00 REV-1508 EX + (1-97) COMMONVVEAl TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF HEPFORD, PAULINE M FILE NUMBER 21-2002-0639 Include the proceeds of litigation and the date the proceeds Vv'ere received by the estate. All property jOlndy-owned with the right of 5Urvtvorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 40,000.00 1 . PNC BANK CERTIFICATE OF DEPOSIT # 2100109373 ACCRUED INTEREST 11.18 2 PNC BANK CERTIFICATE OF DEPOSIT # 2100102216 40,000.00 ACCRUED INTEREST 61.48 3 PNC BANK CERTIFICATE OF DEPOSIT # 21001022117 10,000.00 ACCRUED INTEREST 15.37 4 PNC BANK CERTIFICATE OF DEPOSIT # 31100084509 10,830.22 ACCRUED INTEREST 13.94 5 PNC BAIllt CERTIFICATE OF DEPOSIT # 31300132282 6,094.46 ACCRUED INTEREST 1.24 6 PNC BANK CHECKING ACCOUNT # 5140109676 39,454.84 ACCRUED INTEREST 9.55 7 WAYPOINT BANK CERTIFICATE OF DEPOSIT # 965303355 35,300.00 ACCRUED INTEREST 26.26 2W46AD2.000 TOTAL (Also enter on line 5 Recaoitulation' $ (If more space is needed, insert additional sheets of the same size) 60,375.41 242,193.95 Total from continuation pages4444 Estate of: HEPFOlUl, PAULINE M Schedule E -- Cash, Bank Deposits & Misc. personal Property page 2 21-2002-0639 Item No. Description Value at Date of Death 8 WAYPOINT BAlIK CERTIFICATE OF DEPOSIT # 965303361 31,000.00 ACCRUED INTEREST 23.06 9 WAYPOINT BAlIK CERTIFICATE OF DEPOSIT # 965303498 26,000.00 ACCRUED INTEREST 24.50 10 CAPITAL BLUE CROSS REFUND DUE TO CANCELLATION OF HEALTH INSUEANCE POLICY 112.45 11 DONEGAL COMPANIES REFUND DUE TO CANCELLATION OF HOMEOWNERS INSUEANCE POLICY 306.00 12 HABAND REFUND OF :tTBll.S RETURNED 49.95 13 CASH FOUND IN HOUSE 15.58 14 CONllA:tL RETIllBII.BNT PLAN PENSION JULY BENEFITS 79.87 15 MISCELLANEOUS PERSONAL PROPERTY 2,615.00 16 2002 U.S. INDIVIDUAL INCOME TAX REFUND 149.00 TOTAL. (Carry forward to main schedule) . . . . . . 60,375.41 REV-1511 EX + (1-97) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HBPFORD. PAULINE M FILE NUMBER 21-2002-0639 Debts of decedent must be renntted on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. JAMBS GINGRICH MEMORIALS 95.00 INSCRIPTION ON MEMORIAL 2 UNDBRNEATH IT ALL 48.00 CLOTHING FOR FUNERAL 3 SUMMBRDALB FIRB CO 200.00 FUNERAL LUNCHZON B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 14.042.00 Name of Personal Representattve(s) See Schedule attached Social Security Number(s) J EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees Name = CHARLBS E. PBTRIB. ESQUIRB 7.021.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 0.00 Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 0.00 5. Accountant's Fees 0.00 6. Tax Retum Preparer's Fees 0.00 7. PROBATB COST 340.00 8 LG CONNOR REAL ESTATE APPRAISBRS 275.00 FBB FOR REAL ESTATE APPRAISAL OF 210 2ND STRBET PROPBRTY 9 CLOUSER REAL ESTATB APPRAISALS 295.00 FBE FOR REAL ESTATE APPRAISAL OF 210 2ND STRBBT PROPERTY . Tota.L ~rom CODt1Duat10D pages.... .'. S~~.8U TOTAL (Also enter on line 9, Recapitulation) $ 30.149.80 2W46AG 2.000 (If mare space is needed, insert additional sheets of same size) Estate of: HEPFORD, PAULINE M Schedule H, Part B -- Administrative Costs Item No. 10 Description CLAUDE C WOLFE & ASSOCATES AMOUNT DUE FOR EXPENSES & COMMISSION ON SALE OF PERSONAL PROPERTY 11 ADMINISTRATION EXPENSES FROM MAINTAINING REAL ESTATE: D & F LAWNCARE DUTY'S LOCK AND KEY PP&L ELECTRIC PWAC WATBR S E S INSURANCE SVCS LESS REFUND SUBURBAlf PROPANE BAST PBNNSBORO TOWNSHIP WEST SHORB OIL CO 275.00 (59.00) 12 EXPENSES FROM SALB OF RBAL ESTATB: TRANSFER TAX PEST TRBATMBNT AUCTIONEBR FEE LESS REIMBURSBKBNTS: SCHOOL TAXBS CITY TAXES SBWBR/TRASH 13 CUMBERLAND LAW JOURNAL LEGAL ADVERTISING 14 THE PATRIOT NBWS LEGAL ADVERTISING $ 1,090.00 889.00 3,270.00 739.98 19.31 19.08 $ 286.20 77 .24 204.98 54.14 216.00 9.54 96.53 346.95 5,249.00 (778.37) TOTAL. (Carry forward to main schedule) . . . . . . Page 2 21-2002-0639 Amount 1,877.82 1,293.58 4,470.63 60.00 131.77 7,833.80 Estate of. HBPrORD, PAULJ:NE M Schedule H, Part B -- Personal representatives' Commissions Item No. Description 1 Name: PNC BANK, NA Social security number: Address. 4242 CARLJ:SLE PJ:KE PO BOX 308 CAMP HILL, PA 17001-0308 Year(s) commissions paid: TOTAL. (Carry forward to main schedule) . . . . . . Page 2 21-2002-0639 Amount 14,042.00 14,042.00 REV.1512 EX t (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HBPFORD, PAULINE M SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-2002-0639 Include unrelmbursed medical expenses. ITEM NUMBER 1. PAWC WATBR BILL DESCRIPTlON AMOUNT 24.30 2 PPL BLBCTRIC UTILITIBS IlLBCnrC BrLL 83.42 3 THB PATRIOT NEWS BALANCB DUB ON NEWSPAPBR SUBSCRIPTION 10.65 4 AT"T FINAL LONG DISTANCB TBLBPHONE BILL 27.36 5 WRIZON FINAL LOCAL TBLBPHONE BILL 9.97 6 ALICIA STINE, TAX COLLBCTOR SCHOOL TAXBS 1,316.87 7 BAST PBNSBORO SBWBR AND TRASH BILL 87.75 8 AT"T TBLBPHONE BILL 1.83 9 HCR/MANOR CARB Il1lRSING CARB 10.00 10 LANA BUTLER TRAWL EXPBNSB 200.00 11 CHECK NUMBBR 1795 FROM PNC ACCOUNT # 51-4010-9676 OUTSTANDrNG CHBCK AT DATE OF DBATH WRITTBN TO HBLBN SHEFFBR 200.00 12 WEST SHORB PATHOLOGY PROFESSIONAL SERVICES 23.84 13 D " F LAWNCARE LAWN MAINTENANCE 63.60 14 2002 PENNSYLVANIA INCOME TAX DUE 154.00 2W46AH2.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2,213.59 REV~1513 EX+ (9-QO) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX REnJRN RESIDENT DECEDENT ESTATE OF HBPl!'ORD PAtJL'[NB M NUMBER NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)) 1. RBAK. DONNA K 4426 PLANTATION ROAD NB APARTMENT II 5 ROANOKB. VA 24012 FILE NUMBER 21_2nn~-0~39 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not LlstTrustee{s) OF ESTATE DAUGHTBR 39.853.82 2 BUTLBR. LANA L 1245 WBITBTOP ROAD BLUFF CITY. TN 37618 DAUGHTBR 39.853.82 3 RHBAK. HARSHA A 210 READING CIRCLB STBBLTON. PA 17113 DAUGHTBR 39.853.82 4 COKBGNA. SONJA L 9 CRBSTL~NB DR~VE MANCHESTBR. PA 17345 GRANDDAUGHTBR 39.853.82 5 MATHBRS. REBBCCA 2603 PARROT SHBLL LANE RICBKOND. TX 77469 GRANDDAUGHBR 39.853.82 ENTER DOLlAR AMOUNTS FOR DISTRIBUTIONS SHOWN POOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-15DO COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL D1STRIB\IT10NS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. 2W46AI1.000 TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-150D COVER SHEET (If more space IS needed, Insert additional sheets of the same size) $ 0.00 Estate of. HEPrORD, PAULXNE M Schedule J Part 1 -- Beneficiaries xtelll No. Name and Address of Person(s) receiving property Relationship Amount or Share of Estate 5 6 BUTLER, JOHN P 1114 BRETTONWOODWOOD DRXVE TAMPA, rL 33615 GRANDSON 1 BUTLER, AXMEE A 1245 WHXTETOP ROAD BLU~r CITY, TN 31618 GRANDDAUGHTI!R 8 MIlAM, BRXDGETT 11 0 3 YVl!:RDON DRXVE APARTMENT A-4 CAMP RXLL, PA 11011 GRANDDAUGRTI!R page 2 21-2002-0639 39,853.82 39,853.82 39,853.82 ...... ..,...... Q)...... ~ IIQ Q) \'"" ..-I \-I...... \I< ~~~oO:'" i ,;\ p. ('t'l P.\!:\ '" .0 ~ ro III ~...... ~ .00: ,Cl 0\ I . IIQllD\-I...... ':E \>'.... ::l \0 ~ l/l~\-I,Cl1l'\ ~~~.~,... ~ o CO \-I \'"" ro<"\-I...... rolntll\'"" iiil OoO:('t'l:t.--- Qo -' -- .- ..... - --, LAST WILL AND TESTAMENT I, PAULINE M. HEPFORD, of 210 Second Street, Summerdale, County of Cumberland, Pennsylvania, do hereby make, publish, and declare this to be my LAST WILL AND TESTAMENT, revoking any and all prior wills and codicils, in manner following, that is to say, FIRST, that I direct that my Personal Representative shall pay all of my lust debts and funeral expenses as soon as this shall be practicable. SECOND, that upon my death, I give and bequeath my tangible personal property to be divided in an equal a manner as possible among my children, DONNA M. REAM, LANA L. BUTLER, and MARSHA A. RHEAM. THIRD, that I direct that the rest, residue and remainder of my Estate shall be reduced to cash and the proceeds are to be divided into eight (08) equal shares. I give and bequeath one (01) share to each of my children, and I give and bequeath one (01) share to each of my grandchildren: SONJA L. COMEGNA, REBECCA A. BUTLER, JOHN P. BUTLER, AIMEE A. BUTLER, and BRIDGET A. RHEAM. FOURTH, that I direct that the share of any beneficiary who has not yet attained the age of eighteen (18) years shall be held in trust for him or her until his or her eighteenth (18th) birthday. I hereby appoint PNC Bank as the Trustee. I waive any requirement to post bond. FIFTH, that I hereby appoint PNC Bank as the Executor of my estate. I direct that my Personal Representative shall not be required to post bond in this or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this eighth day of March, 1995. ? c '. 7 I -;/1. / / '-('t.,.A1. ~ / /)' ,VC PAULINE M. HEPFORD [> ~ Z A;:6;.. WITNESS ~~ WITNES ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN I, PAULINE M. HEPFORD, testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I have signed and executed the instrument as my Last Will and Testament; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by PAULINE M. HEPFORD, the testatrix, this eighth day of March, 1995. :Jd<'L~~ -'YJ/ ').kJ'!fk~ PAULINE M. HEPFOR~ d). ri /'~ NOTARY P#IC /)~ i ,>' L-'-','." " "i NOTARIAL SEAL KELLY R. PETRIE, Notary Public Paxtang Boro. Douphin County Mv Commission E.VD:res .Jan. 27, 1997 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN WE, CHARLES E. PETRIE and DEAN G. MANTIS, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw testatrix sign and execute the instrument as her LAST WILL AND TESTAMENT; that PAULINE M. HEPFORD signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our knowledge the testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed before me by CHARLES E. PETRIE and DEAN G. MANTIS, witnesses, this eighth day of March, 1995. ~E.P~ WITNESS ~'~' (J NO "LIC ' . "NEW p;;;Z f7 i t~(/ NOTARIAL SEAL KELLY R. PETRIE. Notary Public Paxtang Bora. Dauphin County Mv Comm:sslon Exctres ,Join. 27. 1997 v I,: 1':.,";1 '11'1.1':_T~","'\~"l'ill't.> 'flu, 'rrlnll&:l~ I"rf'~". W4ts 3Jnbrnturr. tlttbr tqr l,l::th. flay ot October in the year Qf our Lord Oue Thousand Nine Hundred ami r'orty ~even. iljrtmrrll E. M. Horner, widower, of SutrtmercRle ~ Cumberland Gounty, Pennsrlvaniu, party of the first pArt, "Jl.ND" Charles S. Hepford and Pauline l.:. rlep1'ord, his wife, of the snme place, parties of the ~el"l)lld part, mit"r!l5rt~ That the said part y of the 6rst part, for and in consider- atioll oj the ~11111 of ;)even Hundred (.~':'0700.00) Dollars i~nlawiul money of the United States of America, well and truly paid by the said pa.rties of the gee-ond part to the said part y of the first part, at and before the S<<!aling and delivery of these presents, the n':<:eipt whereof is hereby acknowledged, has granted. bargained, sold. aliened, enfeoffed. released. c:ollveyefl, and confirmed and by these presents does grant, bargain, ~!I. alien, enftoff. relt'll.se, convey and confirm \1nto the said part ie S of the second part their heirs and ass'gns, 1\11 those th~ee certain lots or pa~cels of land situate in Summerdale, t..:nml1f">\'l(\nd County, Pennsylvania, bound.ed and described as fal-lows, to wit:- - ~', } IlilHliG at a point in the southeas t corner of the intersection of Second and jjater ~treets; thence south~nrdly along the eastern 1 ine ot .)econa street one hundrerl t.,,'.'enty five and e i,:;:ht-tenths (125.8) f~~t tn tne northern line of Lot No. ;~O, ,;ectif>ln II}'.", rm the herein- nt't~:' "~ntioned Plan of Lots; thence e8~ t".-:-rrrlly Glan,,: the northern Line (~l I,~')t i:o. ;30, S~ction 11,", one ~L1ndr'Gri !"ib:ty (ISO) feet to the /,?:::t.- .'n Line at' n Sixte0n \ J:'3) re~t :;1de ,11e:; th8nce north~nrdly "J.onrr I;'l,; ;.H:.c~tcrn line of ",air' ,ji:x.teen (IS) fe::t ":ide 1\11ey fifteen ['n(~ ,:,i"~l'.;:l"'ei-ht-)na h~mdredth5 (J~.86) fept to the southGrn line of ".'Iter' ot.re0t; t.hence north'.v0stw8rlil;.r alon,=,: t.be southern line 01' ,'later ~;t,r0,rot, '~~e !llln0rec1 ela'hty eir.-ht And sixty six-one hundredths (188.6&) fei;;t. to f\. point, the place of' !~;~'::J!'''IT'S-. I::LI1U Lots tio. :Sl, 32 find 33, ~ection "AII, in the flan of ::;ummerdale, Pa., as re(",ordect in t'he llffice of the ~lecoI'der of .ueeds in and for Cumberland County 1n Plan ?ook t:o. 1, PElge 44. (hevised Plan, book 2, P~Be 109). B~IHG part of the same trnct or piece of land which J. ;,11. ..etzel and wife, by their indenture J:1p.de the 15th. tiay of March, 1909, wugrtl,rr with all and singular, the tenement!>, hereditaments and 3.ppdrtenances to the same bel()n~ing, or In anywise appert3inin~, and the revergion and re\'ersions. remainder and ~ rents, i~~t1t>g and prol1tg thereof; fInd AlflO ;1.11 the estate, right, tide, i.nterest, propttty. daim :lIlt! lierllrlnd \\'hatscle\'er, both in Jaw and equity of th~ ~nid part;t ,)f the tirst part, of, in, to or outo[ the <;tid premi~e~. anrl every part and parcel thereof WO l~nltr tUtu to 1ijuli'l the said premises, with all and singulaT the appurtenances. 1UIto 1M said par! i e s of the second part, the i r heirs and assigns. to and for the only proper use and hehoof of the said part les of the second p:lrttheirneirs and assi~l1s fore\'er, Frovided, however, that the said parties of the second pDrt, their heirs, executors, ad- l~:inistrators or assigns shall at no time hereafter, construct or build any building or buildings of any kind nearer than ten rest from the in- side pavement line of said lot or lots. ho~s cannot be kept on this gr_ ~i\i\,~?g sc~\)not be sold or leased to Italian or colored people. I A party of the first part, for himself, his heirs. executors and administrators, do e s said part les of the ser:ond part their hy these presents, co\-enant, grant and agree to and with the heirs and assigns, that he the said party or the fir8t part, h1~ heirs all arid ginguJar the heredilllents and !Jrelllises hereinabove uescribed and granted or mentionrd. and illtended 50 to be, with the :>""\\rtenances, unto the said part 1e S of the second part. their heirs and ~lSSi~m, against the said part _ y. of the first part and his hein~ and against all and every Olbtt penoa "I' persons wholll~oe\'er, law full v claiming or to daim the l'><1mc or any part thereof. .1'.111 :llld will, by these pregents, W.-\RRANT AND FOREVf.,R DEFEi\I1, JJu llllitul'!Hl Whereof. \nn\1 :lJll\ seal ~l1e 11.1;- and y<,ar the said pan y first above written, (ll the lirst pan ha s hereunto set his " , 26.21[.~EAL) Signed. Sealed and Delivered in the Presence of .. ..._~.__._. SEAL} ____I SEAL} )~LJ."\~ mm. ..._..._ISEAL} (SEAL) ....__ISEAL) ._._, SEAL) ___,_{SEAL) ...__'SEAL\ ','B;""""k~;"l'. \., 0;;,...... . , , " , '0 . _ -,~! , ,-- ~ --~ ._.___1 SEAL) ___(SEAL) 1 SEAL} S'fATE OF PENNSYLVANIA tJl\UrHI11 COUNTY. t SS, I Un the 15th. day oi October in the year One Thuu~alld Nine Hundred aud i"arty ..:.>even, lJeiore me. the ':'>ullsni.her , a Uotary Y'ublic, in and for said ~tate and County, jll'rsnn;dh ~';lll1t' Illi.' above-named H. :,;. Horner, v:idower, and he ackIHJ\vkd~e the ahovc indenture to be his ,'h,t and Dc.-ed.anrl dl'~ire(\ the _~;\ll1e l11i~ht he recordl"d as snch. Witness my hand and I:otariil ~eaL ).\., 0... U -J ~ I',iy Conunission expires:-- !.QM. :..I'\'\-,\ 1 Herehy Ccrtiiy that tIll: PrCloise 1{~,;idt'l1ce oi the (;ralllec. in Ihe within Deed is .summerdale, 1-'a. .\ttorney ior _..._.Jir.an.t.e..If;..s...~ ......___.___.~_, ~ 26.~~ ~ ... + ..-< . " '0 ~: ,0 ." " ,,, t " ~ """ ),. .~ '0 " _o~_' '0-'1 " .... '-< t- " " ..:\t~ i:r 1- 0 . '~ '0 '-<'0 ;)'1 01 '-< ~ O. '-< .... '" ~ - ." <'/ '-< m 0 ~g " :J::"--4 '" ~ ~ 0.. en .... "- . " .... '0 01 . '-' ~ 0 U}~ 0 ," 0 '-< .0 .--. 0 ., '" ~ 0 r- Z <1>'=; .0 '" ;:: '" ~ .... 0 '-< ~ +' '" .~ " " " +' " E "' -'1"-< 0 0 0 ~ " 0.... "' .." " { .1 J~hi; ~ '" ., ~ ';;; " ~ is " " 2 p. " ~ 0 ~ :l ~ ,n u COMMONWE.....LTH UF PE~~SYLVA.NI.--\ w""t-{ . CUUNTY ~ SS fKl'COrlll'll In the Office for Recording of Deeds, in and for the County of 'f-LJ""r in Deed Book 1< Vol. I ~ ' Pa~e )(Jl, l1IIIUltl'!Ill My hand and seal of office, this /l)"tl.. day of. nn ~ qu"j,,, Anno Domini, ]91<-1, ;t fl., i"~,,, .. , Erica L Schlegel ~ ~.:;-....-.. 07/17/200210:18 AM To: Judith M Haftl/PNCAdvisors/SCP/PNC@PNC cc: Subject: Date of death balances Estate of Pauline M Hepford (Deceased) SS# 196-14-2986 00007-06-2002 ACCOUNT NUMBER 'DATE OF DEATH BALANCE + ACCRUED INTEREST CDS #21001019373 $40,000.00 + $11.18 CDS #21001022116 $40,000.00 + $61 .48 CDS #21001022117 $10,000.00 + $15.37 CDS #31100084509 $10,830.22 + $13.94 CDS #31300132282 $6,094.46 + $1.24 DDA #5140109676 $39,454.84 + $9.55 Safe deposit box #316 located at the Enola Branch. If you selected the balances to be sent to the "Branch" they will only be sent to the requestor by Lotus Notes. Have a great day!!! :-) I U 07/23/2002 PNC ADVISORS POBOX 308 CAMP HILL PA 17011 ~l Way~qi!lKt LOOK FOR US. WE'LL GET YOU THERE. F'--:-;;:"".i.lK r-:'-.--:i\, 'J \J!L~_o ._~2 1(.1, '( ".- ";;:,\ The information which you requested on the account(s) of PAULINE HEPFORD (Social Security Number 196-14-2986) is/are as follows: Account Number Class of Accounr Date Opened Principal Balance Accrued Interest 965303355 CERTIFICATE 02110/97 35300.00 26.26 35326.26 Balance at Date of Death Account Ownership SOLE Name of Joint Owner, if any Date Ownership Was Established Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established 965303361 CERTIFICATE 02114/97 31000.00 23.06 31023.06 SOLE PLEASE COMPLETE W-9 Additional Information Requested 965303498 CERTIFICATE 06/05/97 26000.00 24.50 26024.50 SOLE tcerel~ !:lr/YOuNG SENIOR SERVICES REP. P.O. Box 1711. HARRISBURG. PeNNSYtlfANIA 17105-1711 .. _ _^ -.._ 1#""11_ Ar"""""" _ ..._._~...._..__;_......""'".... ,.._.... REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA PETITION FOR GRANT OF LETTERS Estate of PAULINE M. HEPFORD No. 21-02-639 also known as , Deceased Social Security No. 196142986 Petitioner(s), who is/are 18 years of age or older, apply)ies) fOf' (COMPLETE "A" OR "B" BELOW:) [i] A Probate and Grant of letters and aver that Petitioner(s) is/are the execut or Decedent, dated 3/8/95 and codicil(s) dated N/A named in the last Will of the 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 the victim of a killing and was never adjudicated incapacitated: o B. Grant of letters of Administration (c_t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: I Name Relationship Residence I (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 210 Second Street, East Pennsboro Township, PA (list street, number and municipality) Decedent, then 79 years of age, died July 6 , 2002 , at HCR Manor Care, Camp Hill, PA (Location) Decedent 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. Total. 200,000.00 $ $ $ $ $ 114,000.00 314,000.00 Real Estate situated as follows: 210 Second Street, East Pennsboro Township Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: I ---v '- '1\. '-/ lib.. 6-- Type~) or printed name and residence PNC BANK, BY~ LINDA J. lUNDBERG, ASST. VICE-PRESIDENT P.O. BOX 308 CAMP Hill, PA 17001-0308 I Signature F)- 70 P Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and 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(s) of the Decedent, Petitioner(s) will well and truly administerrt(ie_estate accgrding,-~o law. Sworn to and affirmed and subscribed PNC BANK LINDA J. LU ERG, ASST. VICE-PRESIDENT before me this 16th day of Jul 2002 _ DECREE OF REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of PAULINE M. HEPFORD Deceased No. 21-02-639 also known as Social Security No: 196142986 Date of Death: 7/6/02 AND NOW, JULY 16th 2002 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters Q Testamentary ^ of Administration ((c.t.a., d.b.n.c.t.; pendente life; durante absentia; durante minoriate) are hereby granted to PNC BANK in the above estate and that the instrument(s), if any, dated 03/08/1995 described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. FEES Letters .......................... .......... $ 305.00 Short Certificates(s) ..... .......... $ 21.00 Renunciation ................ .......... $ Extra Pages ( ) ...... ......... $ 9.00 .T.R ............................... ........ $ JCP Fee ........................ ......... $ 5.00 Inventory Other ..... TOTAL Register Wills ' L Signature Attorney: CHARLES E. PETRIE $ I.D. No: 29029 $ Address: 3528 BRISBAN STREET $ 340.00 HARRISBURG PA 17111 Telephone: 561-1939 DATE FILED: 7/16/02 This IS to certify that the information here given is uHrccdy copied frorn an original cC_I~riflc~1te of death duly: filed with Locd Registrar. The original certificate will he forwarded to the SLl1\: Viul Records Office for permanent hllIlg, me as WARNING: It is illegal to duplicate this copy by photostat or photograph. No. {I~if~\"~'Qffl;~~~_ I.\\'_~/ ",/JIn--:. d~/ .v~-:. /i~! !jf.~\~\ If::ei ~~ \~% i5:, }/l'.h~ t!,,~ '"Z~ ;*1 ~~"'.i' ~~~ '.~,l "'- '1,f" i!..'f.",- ----- 1"'EN' 1 ~,~ ",,' ....,'",,,'''/,,,,'''PIJ..!!.y t2/ftAr/ /.:r? <;f;.?:;~l._"t.~'/<"-'P'f .._ j/ I' !ocd Registrar ....; h:c for this certificate, $2.00 P 8385631 JUL 1 0 2002 Dare 21-02-639 ~3A8. 2187 COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF HEALTH - VITAL RECORDS CERTIFICATE OF DEATH .. Pauline M. Hepford UNDER 1 YEAR UNDER 1 DAY MontIl. D.y. Hour. Minut.. D.4TEOF 81RTH ,Mon,n.IJaV"eell srAIE ",l~ ~U"'eEfI - -----,--,. :~::-~~--~rC;-~'S:CU-R: NU~~R--=-;~ 8 6 BlRTHPL,o,CE rC~~-';';;;- PLJoCE OF D-EATI-i 10,,..-.. ""1 ,,,'e .,., ."'!lud""'. nn 'J1"~' ""'ill ',ta,.", ~c'~'9nlounl'YI HOSPlV,L - Humme 1 s town Pa. In~I"'--1 rJ EPJOu!p.au.nt U , k, FACILmNAME,lto04"""'''''"''''_<J'vEsu"",,,nU'wnll<l'' DATEOFOe.4rH,;;;;';;;,lJal. !&.<II NAMEOFOECEOENTtf';'IM'lJd"'~---------- ]7093 ", RACE. Am.""an Indi.n, 8l&c~, """'~.. .t, (Spec",,) White ". MARtT.4L ST.4TUS. M.U>e<! SURVIVING SPOUSE N..., Ma"'8~, Wldc_ ;11 "'~~, J'.....ma.,"" nMnel D..",ct>d(Sj)<!(:'r,.) I.. Widowed l1c.KJ V..,*_nt~vedin EaRt Pennsboro .-July 6, 2002 .4GE'laSlB"lMav) . COUNTI'OFDE.IJ'H 79 ,,, . ] ]/]/]922 CITY, BORe, TWf' OF DE.4TH =,ty) 0 Ito. Cumberland DECEDENT'S USUAL OCCUP,(['ION ((l.vekondol work <lone OO/.ng mosr olwor~ongl't.;dDnoIu"'.I"ed) 11.. Houseduties l1b. DECEDENT'S MAlllNG .4D~ESS (Su...., C'f>/fTo,o.in. Slat.. L,,,C"'I~I Ie. Cam Hi 11 KINO Of BUSINESS/INDUSTRY ~. HCR Manor Care w..o.S DECEDENT EVER IN us, ARMEDFORCES? v..O /01010 2]0 2nd St. Summerdale, Pa. ", DECEDENT'S .4CTU.4l RESIDENCE IS.....n..'uc''''''. ""otn~, '""8) 17._Sl.t. Pa. o. _. IMoon. townah;p1 ... FRHER'S NAME (F~S/. M.oal., LaS/) John D. Behrens 17b.Coumy Cumberland 17d.D :;,~=r:::aJ ,~.... ", INFORMANT'S N.4ME (T~p&'Pnml 20.. Dean G. Mantis METI-iOOOF DISPOSITION 8un-1 01 Cr.m~ion 0 on"'r(Spoc.....\ R.m""..tramSl.t.O DArEQFDISPOSITION (Mo<1lh,l)a~, '!'eat! o ]0, MOTHER'S NAME ,F,,'" I>l'lJdIe. M~,~..\Su.n_.a) Ill. Mary E. Seibert (NFORMMH'S M.4ILlNG .400RESS 151'_. C,r,.f1Own, SIal.. Z;p Codel 2Ob_ 33 S. 18th St. Carn Hill Pa. 17011 PLACE OF DISPOSITION - Nam. ot C.m~le"" C,.malor; LOCATION _ C'f>/rTown, 51.t., lipCocM ",OIl"'rPl~c. ICENSEE OR PERSON "CTIIiG.45 SUC 2002 2~.t Paul's Lutheran Church 2101. Silver Springs Twp. Pa. LICENSE NUMBER 22b, FD 012774-1. N.4ME ANOADQRESS OF FACILITY 22cRichardson F.H. 29S.Enola Dr. Enola Pa. 17025 LICENSE NUMBER DATE SIGNED ~ IMonlh~fearl\ dvl.J " ~J1l"" TO lNl>Nl Y knowledge. death o<:cu"e~~11h.l""". d~l' ~n~ pl.c. stal." (S'\lnalu TdNoI 21<0. 'fC,~....... he r- tot, A :J'^-C--u0-s TIME OF DE.4m I] G(, A PART II: Oln",;gn'fk:.nccondiloonsoontrbJt!nglOd"Ih,l>ut nOl""Uh"'llonlNUn<>><lyIngcaUHlI'Wn",PlI.RTI 10100.0 OUE1O(ORASACQNSEOUENCE OF) " Ye.O MANNER OF DEATH ~ U l.J DATE OF INJURY IM"',~, Ilay, feat! , ,~ TIME OF INJUAY INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED , WERE AUTOPSY FINDINGS -"""1LA81.EPRlOAlO COMPLETION OF CAUSE OFOEATH7 Natu.st Hem",,,,,, [J IJ LJ ~~CiOFINJUAY Al--;;O;;;;-;;;;~~'nl.ja~1",y.uf"O:. M. bU'lljin\l..lc,Sproc"vl ". Y.. [] NoD AcCldenl P.<l<l.n\Jln......"ya'.on _0 ,,0 500:;<101 Coul~nol t>a11.1.'m'n~~ .,-"r,~j~'~<J 'j~"" .!Jl .~ lid ;<;1''''''. ColVIT""",. Sta'~l 2... 21b. CERTIFIEAIC~tcI<OOv"""l . CEI'lTlf'VI"fG PHYSICIAN <Phy5IC..... c@".y.n'lcau;a ." ,'~~". wh",,' ~"(.II'~, ul\.,,,- "" I\~'I"''''O'''',;''''' "~ril~ i,n" Tolhe....tol...,.""'..IecI\I..d...Iloc<:u..edd....otll.uUM(.I.ndm.nn.'a..l.lo-d.. " " REGI5TR-?" SIGN.4TUAE~~M~IO~'~-" !:~~~t!"d(../ " "( ./ ';Z..<.Z..c.t,.;.,:";>, n_.... hllq( v'tJ '" ________ {;j,w1lI..~'\D ~ltMEL _ d- '~-]q3 _l:SK>_~E_D':u~~~_I~:-=:~____ N1",J~m AOORESS Of PlHSON Wll0COMPtETW CAUs,: Of Oe.411-i _'~ ~:_"'i11f~~~J';J)-N 7013 OA1[f'LE:\lM""'Jri'~ _~"./O<Ot:J L 'PAO"IOUNCING AND CERTIFYING PHYSICIAN ,Ph"",...," 1."1' "";-'''1 """,r. _)0'.' ce'loIV'~'l'u' '"".,e u' 'l@.,h\ To lh.....' 01 m, ~no..ltdl;l., duthQ<:c,mK alII,. Urn.. o.t_. .nd pl~c.. ~tl<l dU.l"lh. ca~.~(.).nd "'.,,"e,.. .1~I.d 'MEDICAl EXAMINER/CORONER On tM b..I. 01 ....",in.llon .ndlor inv..hgallon, In"'y op;n,on, de.lh o<:cu"ed at the 11m., d~le, .nd place. and du. to the ",."sels) .nd 11..m.nn.....st.ted............. .......... . .... ... ..,........ .. .... ...... ... .. ..., .... . l(j- . , 21-02-639 LAST WILL AND TESTAMENT I, PAULINE M. HEPFORD, of 210 Second Street, Summerdale, County of Cumberland, Pennsylvania, do hereby make, publish, and declare this to be my LAST WILL AND TESTAMENT, revoking any and all prior wills and codicils, in manner following, that is to say, FIRST, that I direct that my Personal Representative shall pay all of my just debts and funeral expenses as soon as this shall be practicable. SECOND, that upon my death, I give and bequeath my tangible personal property to be divided in an equal a manner as possible among my children, DONNA M. REAM, LANA L. BUTLER, and MARSHA A. RHEAM. THIRD, that I direct that the rest, residue and remainder of my Estate shall be reduced to cash and the proceeds are to be divided into eight (08) equal shares. I give and bequeath one (01) share to each of my children, and I give and bequeath one (01) share to each of my grandchildren: SONJA L. COMEGNA, REBECCA A. BUTLER, JOHN P. BUTLER, AIMEE A. BUTLER, and BRIDGET A. RHEAM. FOURTH, that I direct that the share of any beneficiary who has not yet attained the age of eighteen (18) years shall be held in trust for him or her until his or her eighteenth (18th) birthday. I hereby appoint PNC Bank as the Trustee. I waive any requirement to post bend. .' FIFTH, that I hereby appoint PNC Bank as the Executor of my estate. I direct that my Personal Representative shall not be required to post bond in this or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this eighth day of March, 1995. I> . .J I ~!14' ./ ,: - ('( ( cC ,....<.~ " /)' ,/ .7'1.fl/. PAULINE M. HEPFORDj.' J (~/~ WITNESS ~ ~ ..,~~/.., WITNESS ' . . . ~ ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN I, PAULINE M. HEPFORD, testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I have signed and executed the instrument as my Last Will and Testament; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by PAULINE M. HEPFORD, the testatrix, this eighth day of March, 1995. ,'J)' , /1:t<d,~~....e PAULINE M. /.J) / -;7),'4":;' ._~/ HEPFORB' .,~, (( </ NOTARY PUljiIC " //~) ,"") -7 ! 6.". . . l~- '1..-- NOTARIAL SEAL KELLY R. PETRIE. NotJry Public Paxt3ng HJro. Dauphin Coullty M Commi~~~~~0.-I:Sl:~:~::.L~~?~.-u!.97 . AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN WE, CHARLES E. PETRIE and DEAN G. MANTIS, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw testatrix sign and execute the instrument as her LAST WILL AND TESTM-IENT; that P""ULIHE M. HEPFORD signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our knowledge the testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed before me by CHARLES E. PETRIE and DEAN G. MANTIS, witnesses, this eighth day of March, 1995. c/rJ/,P~ WITNESS ~~ WITNE' . / NO~~'~LIj;; /) . :'."/'11 NOTARIAL SEAL KELLY R. PETRIE. Notary Public Paxt3ng Boro. Dauphin County M Cornrn's';"~~2...~:"':.2i.!:~2-.)~997 6 CERTIFICATE OF NOTICE UNDER RULE 5.6W NAME OF DECEDENT: PAULINE M. HEPFORD DATE OF DEATH: July 6, 2002 WILL NO.: ADMIN NO.: 2002-00639 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 July 22, 2002. NAME ADDRESS Donna Ream Lana Butler Marsha Rheam Sonia Comegna Rebecca Mathers John Butler Aimee Butler Bridgett Rheam 4426 Plantation Rd., NE #5, Roanoke, VA 24012 1245 Whitetop Rd., Bluff City, TN 37618 210 Reading Circle, Steelton, PA 17113 9 Crestline Drive, Manchester, PA 17345 106 Second Street, SugarLand, TX 77478 7714 Bretwood Drive, Tampa, FL 33615 1245 Whitetop Road, Bluff City, TN 37618 1103 Yverdon Drive, Camp Hill, PA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: NONE DATE: July 22, 2002 /' ~..Lf ~ SIGNATURE NAME CHARLES E. PETRIE , , ADDRESS 3528 Brisban Street Harrisburg, FA 17111 TELEPHONE (717) 561-1939 CAPACITY: Personal Representative X Counsel for Personal Representative o PNCAuVlSORS PO Box 308 Camp Hill PA 17011 Tel: 717730-2265 October 3, 2002 Register of Wills Cumberland County South Hanover Street Carlisle, PA 17013 Re: Pauline Hepford Estate Date of Death 7/6/2002 File No #21-02-0639 Dear Register of Wills: On behalf of the Corporate Executor of the above-referenced Estate, I enclose a check in the amount of $12,587.50 for payment on account of Pennsylvania Inheritance Tax. This payment will yield a 5% discount in the amount of $662.50 for a total credit towards the Pennsylvania Inheritance Tax in the amount of $13,250.00. Please send us the usual customary receipt at your earliest convenience. Sincerely, ~~ Linda J. Lundberg Estate Administrator Assistant Vice President Enclosure: LJUjmh A. member of lhe PNC Financial Services Group 4242 CcHlisle Pike Camp Hill Pennsylvania 17011 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17i2B-060' REV-1162 EX{11-96} RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT PNC BANK PO BOX 308 CAMP Hill, PA 17001-0308 n_uF_ fold ESTATE INFORMATION: SSN: 196-14-2986 FILE NUMBER: 2102-0639 DECEDENT NAME: HEPFORD PAULINE M DATE OF PAYMENT: 10/04/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 07/06/2002 NO. CD 001691 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $12,587.50 I I I I I I I I TOTAL AMOUNT PAID: $12,587.50 REMARKS: PNC BANK CHECK# 11706048 SEAL INITIALS: DO RECEIVED BY: REGISTER OF WILLS MARY C. lEWIS REGISTER OF WillS , \J o PNCBAN< ESTATE OF PAULINE M HEPFORD DECEASED (DIED 1/6/02) LATE OF THE TOWNSHIP OF EAST PENNSBORO CUMBERLAND COUNTY PA WILL NO 21-02-0639 INVENTORY COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND LINDA J LUNDBERG ASSISTANT VICE PRESIDENT OF PNC BANK. NATIONAL ASSOCIATION EXECUTOR OF THE ESTATE OF PAULINE M HEPFORD DECEASED HAVING BEEN DULY AFFIRMED ACCORDING TO LAW DID DEPOSE AND SAY THAT THE ITEMS APPEARING IN THE FOLLOWING INVENTORY ARE PERSONAL ASSETS WHEREVER SITUATE AND REAL ESTATE IF ANY 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 THE DECEDENT OWNED NO REAL ESTATE OUTSIDE THE COMMONWEALTH OF PENNSYLVANIA EXCEPT THAT WHICH APPEARS IN A MEMORANDUM AT THE END OF THIS INVENTORY AFFIRMED AND SUBSCRIBED BEFORE ME THIS ,.;.~ ~ DAY OF 1LD003 ~~~.. ~ ( v: "'\~! '--. ~!-..~~,"",!",,,,~-;,...~""""~',1 N:)r~ ~;tl\1 . .' ~ DEN1:?E C. ; ~'):?\ f ~- ut,W: ~ ~ HamprJcr. "flV) , CW:~.ISI' ~r,j (;(/~n:Y M __, "'W, "'flrlfo My Ccmm\S..~ t 1 \ t:^p.r~S \"av. ~l, ~"-FV~ "'~,....--""'"',.".,.,.,...,.~~,,-"'"'-=> .-.-",-,""",,'~' - 1 - TRSNOlIIO/O<'1 PNC ADVISORS PAULINE M HEPFORD REAL ESTATE 210 2ND STREET EAST PENNSBORO TWP SUMMERDALE PA CERTIFICATES 10,830.22 PAR PNC BANK NATIONAL ASSOCIATION SAVING CTF ACCOUNT 131100084509 INTEREST TO 7/06/02 10,000 PAR PNC BANK NATIONAL ASSOCIATION SAVING CTF ACCOUNT 121001022117 INTEREST TO 7/06/02 40,000 PAR PNC BANK NATIONAL ASSOCIATION SAVING CTF ACCOUNT 1210011022116 INTEREST TO 7/06/02 40,000 PAR PNC BANK NATIONAL ASSOCIATION SAVING CTF ACCOUNT 121001019373 INTEREST TO 7/06/02 35,300 PAR WAYPOINT BANK SAVING CTF ACCOUNT 1965303355 INTEREST TO 7/06/02 31,000 PAR WAYPOINT BANK SAVING CTF ACCOUNT 1965303361 INTEREST TO 7/06/02 26,000 PAR WAYPOINT BANK SAVING CTF ACCOUNT 1965303498 INTEREST TO 7/06/02 6,094.46 PAR PNC BANK NATIONAL ASSOCIATION SAVING CTF ACCOUNT 131300132282 INTEREST TO 7/06/02 CASH HABAND REFUND RE RETURNED ITEMS CAPITAL BLUE CROSS REFUND RE CANCELLATION SECURITY 65 MEDICAL INSURANCE DONEGAL COMPANIES REFUND RE HOMEOWNERS POLICY CANCELLATION PNC BANK, NATIONAL ASSOCIATION CHECKING ACCOUNT 15140109676 DATE OF OEATH BALANCE 39,454.84 INTEREST TO 7/6/02 9.55 - 2 - o PNCBAN< 771239 109,000.00 10,830.22 13.94 10,000.00 15.37 40,000.00 61. 48 40,000.00 11.18 35,300.00 26.26 31,000.00 23.06 26,000.00 24.50 6,094.46 1.24 49.95 112.45 306.00 39,464.39 TR!iN02110/021 PAULINE M HEPFORD CONTINUED: CASH PNC ADVISORS o PNCBAN< CONRAIL RETIREMENT PLAN PENSION PAYMENT CASH FOUND IN DECEDENT'S HOUSE PROCEEDS RE SALE OF PERSONAL PROPERTY TOTAL INVENTORY - 3 - 771239 79.87 15.58 2,615.00 351, 044.95 ------------ ------------ TRSNOI'IIO'02J 0.PNCAuVlSORS PO Box 308 Camp Hill Pa 17001-0308 (717) 730-2265 March 27, 2003 Register Of Wills Cumberland County Courthouse South Hanover St Carlisle, PA 17013 Re: Pauline M. Hepford Estate Date of Death 7/6/02 File #: 21-02-0639 Dear Register Of Wills: On behalf of the Corporate Executor of the above-referenced Estate, I enclose a check in the 'amount of $1 ,097.38 balance due on account of Pennsylvania Inheritance Tax along with two original completed copies of the tax return. I have also enclosed the final inventory along with a check in the amount of $31.00 for filing fees. Thank you for your assistance. Sincerely, ~U~b~ Estate Administrator Assistant Vice President Enclosures: LJLljmh A member of The PNC Financial Services Group 4242 Carlisle Pike Camp Hill Pennsylvania 17011 www.pncadvisors.com COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRlSSURG, PA i 7128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT PNC BANK ATTENTION: LINDA J lUNDBERG PO BOX 308 CAMP Hill, PA 17001-0308 __nun lold ESTATE INFORMATION: SSN: 196-14-2986 FILE NUMBER: 2102-0639 DECEDENT NAME: HEPFORD PAULINE M DATE OF PAYMENT: 04/02/2003 POSTMARK DATE: 0010010000 COUNTY: CUMBERLAND DATE OF DEATH: 07/06/2002 NO. CD 002377 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,097.38 I I I I I I , I TOTAL AMOUNT PAID: $1,097.38 REMARKS: PNC BANK ATTN: LINDA J lUNDBERG CHECK# 422657 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS DONNA M. OTTO DEPUTY REGISTER OF WillS \ 1"}-?5"-- 8' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX JI REII-\!\41 EXAFP (Dl-03) DATE ESTATE OF DATE OF DEATH FI LE NUMBER COUNTY ACN 05-12-2003 HEPFORD 07-06-2002 21 02-0639 CUMBERLAND 101 M '03 ~1AY 16 AlO :46 LINDA J LUNDBERG PNC BANK NA PO BOX 308 CAMP HILL CiJ~(i'; PAC~!f~tglf; ;'.. i,>..".' PAULI NE 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 ~ ilE-V"':-is'47-Ex--AFP--CO-(':-o3Y-NiiYfcE--o,,-YliiiEiffTAN-cE-YA"X-A-PPRAySEMENT-,--ALL-OWAirCE-O-im------m----- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF HEPFORD PAULINE M FILE NO. 21 02-0639 ACN 101 DATE 05-12-2003 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 BJ 3. Closely Held Stock/Partnership Interest (Schedule CJ 4. Mortgages/Notes Receivable (Schedule OJ 5. Cash/Bank Deposits/Misc. Personal Property (Schedule EJ 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 1l. 12. 13. 14. Total Deductions Net Value of Tax Return Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) Net Value of Estate Subject to Tax 0) (2) (3) (4) (5) (6) (7) 109.000.00 NOTE: To insure proper .00 credit to your account. .00 submit the upper portion .00 of this form with your 242,,193.95 tax payment. .00 .00 (8) 351,193.95 (9) (10) 30.149.80 2.213.59 (11) (12) (13-) (14) :ti.?363 ~9 318,830.56 .00 318,830.56 NOTE: If an assessment was issued previouslY, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of All returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due (15) .00 X 00 .00 (16) 318,830.56 X 045 = 14,347.38 (17) .00 X 12 .00 (18) .00 X 15 .00 (19)= 14,347.38 TAX CRI'DITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 10-04-2002 CDOO1691 662.50 12,587.50 04-02-2003 CD002377 .00 1,097.38 TOTAL TAX CREDIT 14,347.38 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.) RESERVATION: Estates of decedents dying on or before December 12, 198Z .- if any fut~re interest in the estate is transferred in possession or enjoY~ent to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Co~monwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: To fulfill the reauirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 91liO). PAYMENT: Detach the top portion of this Notice and submit with Your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGIStER OF MILLS} AGENT REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be req\lested by cOllpleting an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices. or by calling the speCial 24-hour answering service for forms ordering: 1-800-362~2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-5020 (TT only). OBJECTIONS: Any party in interest not satisfied with the appraisement. allowance, or disallowance of deductions, or assessment of tax (inclUding discount or interest) as shown on this Notice must object within sixty (60J days of receipt of this Notice by: --written protest to the PA Department of Revenue. Board of Appeals, Dept. 281021. Harrisburg. PA 17128-1021, OR --election to have the lIatter detennined at audit of the account of the personal representative. OR uappeal to the Orohans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit. Dept. 280601, Harrisburg, PA 17128~0601 Phone OIl) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for' an e~plan<!ltion of adlllinistratively correctable errors. DISCOUNT: [f any tax due is paid within three (3) calendar ~onths after the decedent's death, a five per-cent (Sr.) discount of the tax paid is allowed. PENALTY: The ISr. tax amnesty non-participation penalty is cONPuted on the total of the tax and interest assessed, and not paid before January 18. 1996. the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same ~anner and in the the same time period as YOU would appeal the ta~ and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of pay~ent. Taxes which became delinquent before January 1. 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes Which beca~e delinquent on and after January I, 1982 will bear interest at a rate Which will vary from calender year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are: Interest Daily Interest Daily Interest Rate ~ Year ~ ~ Year ~ Daily Factor Year 1982 2Dr, .000548 1987 9% .000247 1999 1% .000192 1983 16% .000438 1988-1991 11% .000301 2000 .% .000219 1984 11% .000301 1992 or. .000247 2001 9% .0002li7 1985 13r. .000356 199:;-1994 77. .(}DDI92 2DD2 '" .000164 1986 10% .00027li 1995-1998 9% .000247 2003 5% .000137 --Interest is calculated as follows: INTEREST = 8ALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --AnY Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assess~ent. If paY~ent is ~ade after the interest computation date shown on the Notice, additional interest must be calculated. . , \)~.' 0PNCBAN< COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PA ORPHANS' COURT DIVISION NO._ ESTATE OF PAULINE M HEPFORO DECEASED LATE OF THE TOWNSHIP OF EAST PENNSBORO FIRST AND FINAL ACCOUNT OF PNC BANK, NATIONAL ASSOCIATION EXECUTOR AND PROPOSED SCHEDULE OF DISTRIBUTION DATE OF DEATH JULY 6 2002 WILL NO. 21-02-0639 LETTERS GRANTED JULV 16 2002 FIRST COMPLETE ADVERTISEMENT OF GRANT OF LETTERS MARCH 21 2003 ACCOUNTING JULY 16 2002 TO AUGUST 25 2003 PURPOSE OF ACCOUNT: THE EXECUTOR OFFERS THIS ACCOUNT TO ACQUAINT INTERESTED PARTIES WITH THE TRANSACTIONS THAT HAVE OCCURRED DURING ITS ADMINISTRATION OF THE ESTATE. IT IS IMPORTANT THAT THE ACCOUNT BE CAREFULLY EXAMINED. REQUESTS FOR ADDITIONAL INFORMATION OR QUESTIONS OR OBJECTIONS CAN BE DISCUSSED WITH: PNC BANK, NATIONAL ASSOCIATION CIO LINDA J LUNDBERG ASSISTANT VICE PRESIDENT POBOX 30B CAMP HILL, PA 17001-030B TELEPHONE (717) 730-2265 CHARLES E PETRIE ESQUIRE 352B BRISBANE STREET HARRISBURG, PA 17111 TELEPHONE (717) 561-1939 - 1 - TRSNOI (\OIO~1 PAULINE M HEPFORD PRINCIPAL RECEIPTS NET GAIN/LOSS ON CONVERSIONS ADJUSTED BALANCE LESS DISBURSEMENTS DEBTS OF DECEDENT FUNERAL EXPENSES ADMINISTRATIVE EXPENSES FEDERAL AND STATE TAXES FEES AND COMMISSIONS FAMILY EXEMPTION TOTAL PRINCIPAL DISBURSEMENTS BALANCE BEFORE DISTRIBUTIONS DISTRIBUTIONS TO BENEFICIARIES PRINCIPAL BALANCE ON HAND INVESTMENTS MADE CHANGES IN INVESTMENT HOLDINGS INCOME RECEIPTS LESS DISBURSEMENTS BALANCE BEFORE DISTRIBUTIONS DISTRIBUTIONS TO BENEFICIARIES INCOME BALANCE ON HAND COMBINED BALANCES REMAINING 0PNCBAN< 771239 SUMMARY AND INDEX fAID 3 - 3 351,193.95 4 - 5 .00 351.193.95 6 - 6 6 - 6 6 - 8 8 - 8 8 - 8 6 - 8 2,486.59- 95.00- 9,289.80- 13,684.88- 21,063.00- .00 46,619.27- 304,574.68 .00 9 - 9 304,574.68 10 - 12 10,212.83 13 - 13 612.77- 9,600.06 .00 14 - 14 9,600.06 314,174.74 - 2 - 1I\SKQ\<\(lH\;>\ PAULINE M HEPFORD 7/01102 PNC ADVISORS RECEIPTS OF PRINCIPAL INVENTORY FILED ON 4/02/03 PER COpy ATTACHED ASSET NOT INVENTORIED INTERNAL REVENUE SERVICE REFUND 2002 INDIVIDUAL INCOME TAX TOTAL PRINCIPAL RECEIPTS - 3 - o PNCBAN< 771239 351,044.95 149.00 351,193.95 ======::===== TRSN02tl0102l PNC ADVISORS Q}PNCBAN< PAULINE M HEPFORD 10/02102 12113/02 3/14/03 3/14/03 6/25/03 6/25/03 6/25/03 6/26/03 6/26/03 GAINS AND LOSSES ON SALES AND OTHER DISPOSITIONS GAIN 6,094.46 PAR PNC BANK NATIONAL ASSOCIATION SAVING CTF ACCOUNT 831300132282 PROCEEDS: ACQUISITION VALUE: 6,094.46 6.094.46 .00 210 2ND STREET EAST PENNSBORO TWP SUMMERDALE PA PROCEEDS, 109,000.00 ACQUISITION VALUE: 109.000.00 35,300 PAR WAVPOINT BANK SAVING CTF ACCOUNT 8965303355 PROCEEDS: 35,300.00 ACQUISITION VALUE: 35.300.00 31,000 PAR WAVPOINT BANK SAVING CTF ACCOUNT 8965303361 PROCEEDS: 31,000.00 ACQUISITION VALUE, 31.000.00 10,830.22 PAR PNC BANK NATIONAL ASSOCIATION SAVING CTF ACCOUNT 831100084509 .00 .00 .00 PROCEEDS: ACQUISITION VALUE: 10,830.22 10.830.22 .00 40,000 PAR PNC BANK NATIONAL ASSOCIATION SAVING CTF ACCOUNT 821001019373 PROCEEDS, ACQUISITION VALUE: 40,000.00 40.000.00 .00 26,000 PAR WAVPOINT BANK SAVING CTF ACCOUNT 8965303498 PROCEEDS: 26,000.00 ACQUISITION VALUE, 26.000.00 10,000 PAR PNC BANK NATIONAL ASSOCIATION SAVING CTF ACCOUNT 821001022117 .00 PROCEEDS: ACQUISITION VALUE: 10,000.00 10.000.00 .00 40,000 PAR PNC BANK NATIONAL ASSOCIATIDN SAVING CTF ACCOUNT 8210011022116 PROCEEDS, ACQUISITION VALUE: 40,000.00 40.000.00 .00 - 4 - 771239 LOSS TI\SNQZll(1fQZ) PAULINE M HEPFORD PNC ADVISORS o PNCBAN< GAINS AND LOSSES ON SALES AND OTHER DISPOSITIONS GAIN TOTAL GAINS AND LOSSES LESS LOSS NET GAIN .00 .00 .00 ---------- ---------- - 5 - 771239 LOSS .00 TRSN02(IIJIIJ2) PAULINE M HEPFORO 7/17/02 7/23/02 7/29/02 7/29/02 8/06/02 8/06/02 10/21/02 1/21/03 4/08/03 8/12102 7/18/02 7/31/02 8/28/02 8/29/02 PNC ADVISORS DISBURSEMENTS OF PRINCIPAL DEBTS OF DECEDENT D & F LAWNCARE LAWN MAINTENANCE PAWC UTILITV SERVICE PPL ELECTRIC UTILITIES SERVICE THE PATRIOT NEWS BALANCE NEWSPAPER SUBSCRIPTION AT & T SERVICE VERIZON SERVICE PNC BANK, NATIONAL ASSOCIATION CHECKING ACCOUNT 15140109676 CHECKS ISSUED PRIOR TO DEATH HONORED SUBSEQUENT THERETO WEST SHORE PATHOLOGV MEDICAL SERVICES PENNA DEPARTMENT OF REVENUE BALANCE 2002 INDIVIDUAL INCOME TAX TOTAL DEBTS OF DECEDENT FUNERAL EXPENSES JAMES GINGRICH MEMORIALS INSCRIPTION ON MEMORIAL TOTAL FUNERAL EXPENSES ADMINISTRATIVE EXPENSES CHARLES E PETRIE ESQUIRE REIMBURSEMENT FOR PROBATE COSTS DUTVS LOCK AND KEV LOCKS CHANGED ON OUTSIDE DOORS lG CONNOR REAL ESTATE APPRAISERS APPRAISAL FEE RE REAL ESTATE CLOUSER REAL ESTATE APPRAISALS APPRAISAL FEE RE REAL ESTATE - 6 - 0PNCBAN< 171239 63.60- 24.30- 83.42- 10.65- 27.36- 9.97- 2,089.45- 23.84- 154.00- 2,486.59- 95.00- 95.00- 340.00- 17 . 24- 275.00- 295.00- lRSNP2l101021 PAULINE M HEPFORD 9/05/02 10/03/02 10/28/02 10/28/02 11/20/02 11/20/02 11/27/02 12113/02 1/02103 3/26/03 3/26/03 4/14/03 PNC ADVISORS DISBURSEMENTS OF PRINCIPAL D II F LAWN CARE LAWN MAINTENANCE S E S INSURANCE SERVICES INC INSURANCE PREMIUM 275.00 LESS REFUND 1/07/03 59.00 D II F LAWNCARE LAWN MAINTENANCE CLAUDE C WOLFE II ASSOCIATES EXPENSES II COMMISSIONS RE SALE OF PERSONAL PROPERTY SUBURBAN PROPANE SEMI-ANNUAL RENT ON PROPANE TANK EAST PENNSBORO TOWNSHIP SEWER/TRASH SERVICE WEST SHORE OIL CO FUEL OIL DELIVERY EXPENSES RE SALE OF REAL ESTATE 210 2ND STREET EAST PENNSBORO TWP SUMMERDALE PA TRANSFER TAX PEST TREATMENT AUCTIONEER FEE 1,090.00 889.00 3,270.00 5,249.00 LESS ADJUSTMENTS CITY TAXES SCHOOL TAXES SEWER/TRASH 19.31 739.98 19.08 WEST SHORE OIL CO INC FUEL OIL DELIVERY REGISTER OF WILLS FILING FEE RE PENNA INHERITANCE TAX RETURN REGISTER OF WILLS FILING FEE RE INVENTORY CHARLES E PETRIE ESQUIRE REIMBURSEMENT FOR LEGAL ADVERTISING - 7 - o PNCBAN< 771239 95.40- 216.00- 190.80- 1,877.82- 9.54- 96.53- 221.54- 4,470.63- 125.41- 15.00- 16.00- 206.77- T~SN0'2\lf.1l\"J2) PAULINE M HEPFoRo 8/25/03 10/03/02 3/26/03 8/25/03 8/25/03 PNC ADVISORS DISBURSEMENTS OF PRINCIPAL PPL ELECTRIC UTILITIES MONTHLY ELECTRIC SERVICE 8/23/02 9/26/02 10/28/02 11/25/02 1/06/03 79.54- 51. 41- 37.24- 20.97- 15.82- PENNSYLVANIA SERVICE 8/23/02 9/20/02 10/21/02 11/25/02 12/23/02 RESERVE FOR FILING FIRST AND FINAL ACCOUNT AMERICAN WATER CD 10.56- 11.10- 11.14- 12.20- 11.14- TOTAL ADMINISTRATIVE EXPENSES FEDERAL AND STATE TAXES REGISTER OF WILLS PENNA INHERITANCE TAX LESS 5% DISCOUNT 13,250.00 662.50 REGISTER OF WILLS BALANCE PENNA INHERITANCE TAX TOTAL FEDERAL AND STATE TAXES FEES AND COMMISSIONS CHARLES E PETRIE ESQUIRE ATTORNEYS COMPENSATION PNC BANK, NATIONAL ASSOCIATION EXECToRS COMPENSATION TOTAL FEES AND COMMISSIONS TOTAL PRINCIPAL DISBURSEMENTS - 8 - o PNCBAN< 771239 204.98- 56.14- 500.00- 9,289.80- 12,587.50- 1, 097 . 38- 13,684.88- 7, 021. 00- 14,042.00- 21,063.00- 46,619.27- ------------ ------------ TRSN02(IOI02l PAULINE M HEPFORD PNC ADVISORS PRINCIPAL BALANCE ON HAND INVESTED CASH TOTAL PRINCIPAL - 9 - GPNCBAN< 771239 ACQUISITION VALUE 304,574.68 304,574.68 ------------ ------------ TRSN02110102l PAULINE M HEPFORD 10/21/02 PNC ADVISORS RECEIPTS OF INCOME INTEREST PNC BANK, NATIONAL ASSOCIATION CHECKING ACCOUNT #5140109676 INTEREST TO CLOSING PNC BANK NATIONAL ASSOCIATION SAVING CTF ACCOUNT #31100084509 8/18/02 30.88 9/17/02 22.85 10/18/02 22.12 11/18/02 22.77 1/18/03 22.76 2/18/03 22.76 3/18/03 20.55 4/18/03 22.76 5/16/03 22.02 6/17/03 22.76 6/25/03 4.40 PNC BANK NATIONAL ASSOCIATION SAVING CTF ACCOUNT #21001022117 8/05/02 26.54 8/26/02 43.32 9/26/02 43.31 10/26/02 41.92 11/26/02 43.32 12/18/02 22.02 12/26/02 41.91 1/26/03 43.32 2/26/03 43.31 3/26/03 39.13 4/26/03 43.31 5/26/03 41.92 6/25/03 40.52 PNC BANK NATIONAL ASSOCIATION SAVING CTF ACCOUNT #210011022116 8/05/02 106.19 8/26/02 173.26 9/26/02 173.26 10/26/02 167.67 11/26/02 173.26 12/26/02 167.67 1/26/03 173.26 2/26/03 173.26 3/26/03 156.50 4/26/03 173.26 5/26/03 167.67 6/25/03 162.08 PNC BANK NATIONAL ASSOCIATION SAVING CTF ACCOUNT #21001019373 8/20/02 162.08 9/03/02 173.26 10/05/02 167.67 11/05/02 173.26 - 10 - o PNCBAN< 771239 5.89 236.63 513.85 1,967.34 TR5N02l101021 PNC ADVISORS PAULINE M HEPFORD RECEIPTS OF INCOME CONTINUED: PNC BANK NATIONAL ASSOCIATION 12/05/02 1/05/03 2/05/03 3/05/03 4/05/03 5/05/03 6/05/03 6/25/03 WAYPOINT BANK SAVING CTF ACCOUNT 8/06/02 9/03/02 9/30/02 10/31/02 11/30/02 12/31/02 1/31/03 2/28/03 3/10/03 3/14/03 WAYPOINT BANK SAVING CTF ACCOUNT 8/02/02 9/03/02 9/30/02 10/31/02 11/30/02 12/31/02 1/31/03 2/28/03 3/14/03 WAYPOINT BANK SAVING CTF ACCOUNT 8/02/02 9/03/02 9/30/02 10/31/02 11/30/02 12/31/02 1/31/03 2/28/03 3/31/03 4/30/03 6/02/03 6/25/03 167.67 173.26 173.26 156.50 173.26 167.67 173.26 106.19 11965303355 136.53 162.79 157.54 162.79 157.55 162.79 162.80 147.04 52.51 6.93 11965303361 119.90 142.96 138.35 142.96 138.36 142.96 142.97 129.13 64.56 11965303498 127.42 151.92 147.02 151.92 147.03 151.92 151.93 137.22 151.93 147.02 151.93 122.52 PNC BANK NATIONAL ASSOCIATION SAVING CTF ACCOUNT 1131300132282 9/03/02 6.48 10/02/02 14.94 - 11 - o PNCBAN< 771239 1,967.34 1,309.27 1,162.15 1, 739.78 21. 42 TRSN021101021 I . PAULINE M HEPFORD PNC ADVISORS RECEIPTS OF INCOME OTHER INCOME BLACK ROCK US TREASURY MM INSTITUTIONAL CLASS FD #02 8/01/02 9/03/02 9/03/02 10/01/02 10/01/02 11/01/02 11/01/02 12/02/02 12/02/02 1/02/03 1/02/03 2/03/03 2/03/03 3/03/03 3/03/03 4/01/03 4/01/03 5/02/03 5/02./03 6/02/03 6/02/03 7/01/03 7/01/03 8/01/03 8/01/03 TOTAL INCOME - 12 - 16.53 .67 38.41 1. 73 39.94 2.70 39.42 2.92 37.85 3.44 83.73 3.92 107.72 4.10 94.65 5.22 127.87 5.35 145.41 6.04 150.64 6.07 151.04 5.94 207.85 .0PNCBAN< 771239 1,289.16 10,212.83 ------------ ------------ TRSN021101021 r . PAULINE M HEPFORO PNC ADVISORS DISBURSEMENTS OF INCOME PNC BANK NATIONAL ASSOCIATION INCOME COMPENSATION 8/23/02 9/10/02 10/10/02 11/08/02 12110/02 1/10/03 2/1 0/03 3/10/03 4/10/03 5/09/03 6/10/03 7/10/03 8/08/03 TOTAL INCOME DISBURSEMENTS - 13 - 41.71- 53.58- 54.40- 56.49- 53.44- 56.98- 58.92- 54.48- 47.91- 42.29- 42.81- 36.93- 12.83- o PNCBAN< 771239 612.77- 612.77- ---------- ---------- TRSN021!O/!l21 PAULINE M HEPFORD PNC ADVISORS BALANCE OF INCOME ON HAND INVESTED CASH TOTAL INCOME - 14 - 0PNCBAN< 771239 ACQUISITION VALUE 9,600.06 9,600.06 ------------ ------------ TRSN02(IO/02J PNC ADVISORS 0PNCBAN< 0771239 ESTATE OF PAULINE M HEPFORD DECEASED (DIED 716/02) PNC BANK, NATIONAL ASSOCIATION : B~~; EXECUTOR l"1\StHl2\10102l - 15 - PNC ADVISORS o PNCBAN< COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS LINDA J LUNDBERG BEING DULY AFFIRMED ACCORDING TO LAW DEPOSES AND SAYS THAT SHE IS AN ASSISTANT VICE PRESIDENT OF PNC BANK, NATIONAL ASSOCIATION, THE ACCOUNTANT NAMED IN THE FOREGOING ACCOUNT AND THAT THE SAID ACCOUNT IS JUST AND TRUE TO THE BEST OF HER KNOWLEDGE AND BELIEF AND THE GRANT OF LETTERS AND THE FIRST COMPLETE ADVERTISEMENT THEREOF OCCURRED MORE THAN FOUR MONTHS BEFORE FILING OF THE ACCOUNT AND THE DECEDENT WAS NOT ADJUDICATED INCOMPETENT AFFIRMED AND SUBSCRIBED TO BE~E THIS~~ DAY ~'-f/h<!, 2003 I HEREBY CERTIFY THAT I AM NOT A DIRECTOR OR OFFICER OF PNC BANK, NATIONAL ASSOCIATION ~~~ G- NOTARIAL SEAL DENISE C. SULLENBERGER. Notary Public Hampden Twp., Cumberland County My Commission Expires Nov. 22. 2004 H\St462\1\l/l)2) - 16 - :/" , 0PNCBAN< ESTATE OF PAULINE M HEPFORD DECEASED (DIED 7/6/02) LATE OF THE TOWNSHIP OF EAST PENNSBORO CUMBERLAND COUNTY PA WILL NO 21-02-0639 INVENTORY COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND LINDA J LUNDBERG ASSISTANT VICE PRESIDENT OF PNC BANK, NATIONAL ASSOCIATION EXECUTOR OF THE ESTATE OF PAULINE M HEPFORD DECEASED HAVING BEEN DULY AFFIRMED ACCORDING TO LAW DID DEPOSE AND SAY THAT THE ITEMS APPEARING IN THE FOLLOWING INVENTORY ARE PERSONAL ASSETS WHEREVER SITUATE AND REAL ESTATE IF ANY 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 THE DECEDENT OWNED NO REAL ESTATE OUTSIDE THE COMMONWEALTH OF PENNSYLVANIA EXCEPT THAT WHICH APPEARS IN A MEMORANDUM AT THE END OF THIS INVENTORY ~~ (--'S- "'/1, NOTARIAL SEAL -"JlSE C. SULLENBERGER. Notarf Public '-lampden Twp., Cumberland Couniy , Commission Expires Nov. 22. 2004 - 1 - TRSNOlt10/021 I PNC ADVISORS PAULINE M HEPFORD REAL ESTATE 210 2ND STREET EAST PENNSBORO TWP SUMMERDALE PA CERTIFICATES 10,830.22 PAR PNC BANK NATIONAL ASSOCIATION SAVING CTF ACCOUNT #31100084509 INTEREST TO 7/06/02 10,000 PAR PNC BANK NATIONAL ASSOCIATION SAVING CTF ACCOUNT #21001022117 INTEREST TO 7/06/02 40,000 PAR PNC BANK NATIONAL ASSOCIATION SAVING CTF ACCOUNT 1210011022116 INTEREST TO 7/06/02 40,000 PAR PNC BANK NATIONAL ASSOCIATION SAVING CTF ACCOUNT #21001019373 INTEREST TO 7/06/02 35,300 PAR WAYPOINT BANK SAVING CTF ACCOUNT 1965303355 INTEREST TO 7/06/02 31,000 PAR WAYPOINT BANK SAVING CTF ACCOUNT 1965303361 INTEREST TO 7/06/02 26,000 PAR WAYPOINT BANK SAVING CTF ACCOUNT 1965303498 INTEREST TO 7/06/02 6,094.46 PAR PNC BANK NATIONAL ASSOCIATION SAVING CTF ACCOUNT #31300132282 INTEREST TO 7/06/02 CASH HABAND REFUND RE RETURNED ITEMS CAPITAL BLUE CROSS REFUND RE CANCELLATION SECURITY 65 MEDICAL INSURANCE DONEGAL COMPANIES REFUND RE HOMEOWNERS POLICY CANCEllATION PNC BANK, NATIONAL ASSOCIATION CHECKING ACCOUNT #5140109676 DATE OF DEATH BALANCE 39,454.84 INTEREST TO 7/6/02 9.55 - 2 - 0PNCBAN< 771239 109,000.00 10,830.22 13.94 10,000.00 15.37 40,000.00 61. 48 40,000.00 11.18 35,300.00 26.26 31, 000.00 23.06 26,000.00 24.50 6,094.46 1.24 49.95 112.45 306.00 39,464.39 TRSN021101l)21 " PAULINE M HEPFORD CONTINUED: CASH PNC ADVISORS 0PNCBAN< CONRAIL RETIREMENT PLAN PENSION PAYMENT CASH FOUND IN DECEDENT'S HOUSE PROCEEDS RE SALE OF PERSONAL PROPERTY TOTAL INVENTORY - 3 - 171239 19.81 15.58 2,615.00 351,044.95 ------------ ------------ TRSN02lTO/OZl ( PROPOSED SCHEDULE OF DISTRIBUTION PAULINE M. HEPFORD ESTATE Balance Remaining per First and Final Account $ 314.174.74 The Executor proposes to distribute the balance according to decedent's Last Will and Testament in the following manner: In Satisfaction ofItem SECOND: To: Donna M. Ream One-third net proceeds from sale of personal property Cash $ 245.73 To: Lana 1. Butler One-third net proceeds from sale of personal property Cash $ 245.73 To: Marsha A. Rheam One-third net proceeds from sale of personal property Cash $ 245.72 In Satisfaction of Item THIRD: To: Donna M. Ream - 118 Residue Cash $ 39,179.69 To: Lana 1. Butler - 118 Residue Cash $ 39,179.69 To: Marsha A. Rheam - 118 Residue Cash $ 39,179.70 To: Sonja 1. Comegna - 118 Residue Cash $ 39,179.69 , PROPOSED SCHEDULE OF DISTRIBUTION PAULINE M. HEPFORD ESTATE - CONTINUED To: Rebecca A. Butler - 1/8 Residue Cash $ 39,179.69 To: John P. Butler - 1/8 Residue Cash $ 39,179.70 To: Aimee A. Butler - 1/8 Residue Cash $ 39,179.70 To: Bridget A. Rheam - 1/8 Residue Cash $ 39.179.70 TOTAL $314.174.74 2 (Y/ PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF (j.. THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION Name of Decedent: Date of Death: Estate No.: STATUS REPORT UNDER RULE 6.12 Pauline M. Hepford July 6, 2002 21-02-0639 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: I. 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: (date) 3. If the answer to No. I is yes, state the following: Date: \.D \ ~ 1'1) ~ (MAH:rmtlAM3) R.W.-58 A. Did the personal representative file a final account with the court? Yes x No The separate Orphans' Court No. (if any) for the personal representative's account is: (Not Applicable in Dauphin County) Did the personal representative state an account informally to the parties in interest? Yes No 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. PNC BANK, !'!A BY~~.~ Signat\.ireA. . ,,__ ' l~.,_ d ~J_,;,-"h B. c. D. Linda J. Lundberg Name (Please type or print) po Box 308, Camp Hill PA 17001-0308 Address 717-730-2265 Telephone No. Capacity: x Personal Representative Counsel for Personal Representative