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Home My WebLink About02-0682 . , Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS . Estate of Laurine Hardie also known as No 21-02.- (aB2. , Deceased Social Security No, 123 - 34-4047 William G. Hardie Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW) rn A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut or the Decedent, dated 05/14/2002 and codiciKsl dated None none named in the last Will of State relevant circumstances, e.g., renunciation, death of executor, etc. Ex:cept as follows, Decedent did not marry, was not divorced, and did not have a child born or adapted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: none o 8. Grant of Letters of Administration (c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante rninoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: I Name Relationshio Residence I (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumber land County. Pennsylvania with his/her last family '., or principal reSidence aj 11 Enck Drive. South Middleton TOtolhship, Boiling Springs, PA 17007 (list street, number, and municipality) Decedent,then~yearsofage,died 07/25/2002 at Holy Sp'irit Hospital, Harrisburg, PA (Location) Decedent at death owned property with estimated values as follows: (If domiclled 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 200,000.00 $ $ $ $ 100,000.00 situated as follows: 11 Enck Drive, Boiling Springs, PA 17007 Wherefore. Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(sl presented with this Petition and the grant of letters in the a ro riate form to the undersi ned: T ped Of Tinted name and residence William G. Hardie 310 Norwich Lane, Landenber , PA 19350 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems. Inc. n-I'1? - ~ Form RW-1 (1991) . Oath of Personal Representative Commonwealth of Pennsylvania Cc;unty of Cumberland The Petltioner(s} above-named swear{s) or affirm(s) that the statements in the foregoing Petition are true a,.,d 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 administer the est~rding to law.. '. Sworn to or affirrned and subscribed ~ 1M --x!3 ;;;;:hk William G. Hardie before me this -1..q,tlFay of JULY 2002 gistr~ No. 21 - 02.. <DB Z. Estate of Laurine Hardie Deceased Social Security No, 123.34.4047 Date of Death, 07/25/2002 AND NOW, JULY 30th 2002 ,in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters CKI Testamentary 0 Of Administration TESTAEMENTARY (c.t.a.; d.b.n.c.t.a.; pendente lite: durante absentia; durante minoritate) are hereby granted to William G. Hardie in the above estate and that the instrument(s) dated 05/14/2002 '<;,' described in the Petition be admitted to probate and filed of record as the last Wifl?df Oi!cedent. FEES Letters. $ 305.00 Short Certificat-a(s). $ 30.00 Renunciation. $ Affidavits ( $ Extra Pages ( ) $ 12.00 Codicil. $ JCP Fee. $ 5.00 Inventory. $ Other $ Attorney: Robert C. Saidis t~~ 1.0. No, 21458 Saidis, Shuff, Flower & Lindsay 2109 Market Street Address: Camp Hill, PA 17011 Telephone' 717/73 7.3405 FILED 7-30-2002 called atty 7-30-2002 TOTAL. $ 3'17 00 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPsystems,lnc. Form RW-1 (1991) .~ ~ SAlOIS SHUFF, FLOWER & LINDSAY AITORNEYS.AT-LAW 26 W. High Street Carlisle, PA II ,I LAST WILL AND TESTAMENT OF LAURINE HARDIE 21-02-682 I, LAURINE HARDIE, of South Middleton Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST I direct the payment of my just debts and expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. I direct my personal representative to bury me in the cemetery lot at Saint Patrick's New Cemetery, Lot 58D next to my husband with an existing monument for final engraving. Further, I authorize my personal representative to expend funds from my estate, in such amount as my personal representative shall consider necessary and desirable for the inscription on the marker for my grave. SECOND I give and bequeath to the persons or entities set forth the following cash bequests: a. $10,000 to the Bubbler Foundation; b. $10,000 to the Boiling Springs Civic Association; . , ~ ~ ~ j ~ SAlOIS SHUFF, FLOWER & LINDSAY ATTORNEYS-AT-LAW 26 W. High Street Carlisle, PA c. $5,000 to Domestic Violence Services of Cumberland and Perry County; d. $5,000 to Mary Ann Smith of 9 Enck Drive, Boiling Springs, pennsylvania; e. $20,000 to my brother, Borden Woytkiw; f. $10,000 to my nephew, Doug Woytkiw; g. $10,000 to my niece, Michelle (Woytkiw) LoBreau; h. $10,000 to my niece, Roberta (Woytkiw) McGowan; i. $1,000 to Erma Lininger of 90 pine Hill Road, Carlisle, Pennsylvania; and j. $10,000 to Allison United Methodist Church, 99 Mooreland Avenue, Carlisle, Pennsylvania. THIRD I give, devise and bequeath all the rest, residue and remainder of my estate to my children THOMAS L. HARDIE, WILLIAM G. HARDIE, and DARLENE HARDIE-MUNCY, per stirpes. FOURTH I direct that any and all inheritance, estate, and transfer taxes imposed upon my estate passing under this Will or otherwise shall be paid out of the principal of my residuary estate. 2 ~ SAlOIS SHUFF, FLOWER & LINDSAY ATIQRNEYS.AT-LAW 26 W. High Street Carlisle. P A Ii FIFTH In addition to the powers conferred by law, I authorize any personal representative acting under this instrument, in his absolute discretion: A. To retain in the form received, or to sell either at public or private sale any real or personal property; B. To exercise any options to subscribe for stocks, bonds, or other investments; c. To join in any plan of lease, mortgage, consolidation, exchange, reorganization or foreclosure of any corporation in which my estate or any trust may hold stocks, bonds or other securities; D. To sell, transfer, convey, mortgage, pledge, lease or exchange any property, real or personal, which at any time may form part of my estate, for the payment of debts or taxes, or for any purpose of administration or distribution, for such prices and upon such terms as my personal representative, in his sole discretion, may deem wise, and to execute and deliver deeds of conveyance or transfer thereof; E. To make settlements and compromises on such terms as my personal representative in his sole discretion may deem wise without the necessity of obtaining any court approval thereof; 3 SAlOIS SHUFF, FLOWER & LINDSAY AITORNEYS'AT-LAW 26 W. High Street Carlisle, PA II F. To make distribution hereunder either in cash or kind, as my personal representative in his discretion may deem wise. SIXTH I do hereby nominate, constitute and appoint my son, WILLIAM G. HARDIE, to act as Executor of this my Last Will and Testament. My named Executor shall be entitled to compensation for his services in administering my estate. provided, however, that if he is unwilling or unable to act as Executor, I direct the duties of Executor to be performed by THOMAS L. HARDIE. SEVENTH I direct that no personal representative, guardian, trustee or other fiduciary appointed under this instrument shall be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I, LAURINE HARDIE, have hereunto set my hand and seal to this my Last Will and Testament, consisting of four typewritten pages, the first three of which bear my 7'+ initials in the margin for identification, this ~ day of May, 2002. ~/ J/avLv 'L"AURINE HARDIE 4 Signed, sealed, published and declared by the above-named LAURINE HARDIE, Testatrix, as and for her Last Will and Testament in the presence of us, who have hereunto subscribed our names at her request as witnesses thereto, in the presence ::' ~~JZ:rix and of ::::E::heL 2 ~ ~ U';i J ~t- C~.-k~l.. yJ~ &?f'4--J:(-", e'. ~HJ ADDRESS c:; /3 0dd.. ~,' rc Ie: &. lisle fA I COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND We, Laurine Hardie , Rohp.rt- ("' S;, ; r1 ; << and Charles E. Clepper ,the Testatrix and witnesses, respectively whose names are signed to the foregoing or attached 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 Testament and that she signed willingly and that executed as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix signed the will as witnesses and that to the best of their knowledge the Testatrix was at the time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. J/~~ LAURINE HARDIE ~ Robert C. SaidipWitness ~~h" .~--r..f'g,h9~L.1 Charles E. C~~ltness SAlOIS SHUFF, FLOWER & LINDSAY AITORNEYS-AT.LAW 26 W. High Street Carlisle, PA Subscribed, sworn to and acknowledged before me by LAURINE HARDIE, the Testatrix, and subscribed to and sworn or affirmed to before me by Rober C. Saidis and Charles E. Cle-pper, witnesses, this day of May, NOTARIAL SEAL RENEE L MURRAY, Notary Public Carlisle Barr), Cumberland Co" PA My Commission Expires December 13, 2005 uM1 5 ;!2 N -; n ~ rJJ m ,. '" .. " r:- '" m ,.. ..... '" '" '" I:l 0; -; ~ '" ,.. :r ..... , ~ .m Ci .rJJ N \:: ~ " :r rJJ ~ .~ '" '" '" ::r: II = ~ N ~ -; 00 N 0 '" C ~ N - m ~ m "'j -; ;"l ,... >- ~ ;E 0 0 ." :;::!l ;!2 -; () N t"lQ In ,. 0; :;.:l'" " r:- " ~ ~ '" ." " Ro J: ,. ~ ::! p '" t"' - '" ~ ~ !"' m ..... ~ .~ " -; Z ~ ,., '" w .~ -; I:l ~ ~ ::; 0 '" rJJ ~ '" S m ~ - ::J I ~ if REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA CERTIFICATION OF NOTICE UNDER RULE 5.6(A) Name of Decedent: Laurine Hardie Date of Death: July 25, 2002 Will No. 21-02-0682 Admin. No. To the Register: I certify that notice of Estate Administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiary of the above- captioned estate on August l.!i!!:, 2002. Name Address Boiling Springs Civic Assoc. c/o Mary Anne Taylor, 111 Front St., Boiling Springs, P A 17007 The Bubbler Foundation c/o Dr. Patricia Sanker, Superintendent of South Middleton School District 4 Forge Road Boiling Springs, P A 17007 Allison United Methodist Church 99 Mooreland Ave., Carlisle, PA 17013 Erma Lininger 90 Pine Hill Road, Carlisle, P A 17013 Roberta McGowan 11 Pentland Cresent, Kanato, Ontario, Canada, K2KIV4 Michelle LoBreau 1424-63 Street, Edmonton, Alberta, Canada, T6LIX7 Douglas Waytkiw 1233-118A Street, Edmonton, Alberta, Canada, T6J7E9 Borden Woytkiw 319 Tory View, Edmonton, Alberta, Canada, T6R3A 7 , I Mary Ann Smith 9 Enck Drive, Boiling Springs, P A 17007 . Domestic Violence Services of Cumberland and Perry Co. Darlene Hardie-Muncy William G. Hardie Thomas L. Hardie P.O. Box 1039, Carlisle, PA 17013 2 Patrick Henry Place, Ringoes, NJ 0855 I 310 Norwick Lane, Landenberg, PAl 9350 845 Bryn Mawr Ave., Newton Square, P A 19073 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none Date: /JAAf /If 'vi Cc.J-.. . J U R ert C. Saidis, Esq ire 2109 Market Street Camp Hill, PA 1701 I (717) 737-3405 Capacity: _ Personal Representative ~ Counsel for Personal Representative J 7 - 76'''' f REV-1500 EX + (6-1"O) ( to; REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER o E C E o E N T COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) Hardie Laurine DATE OF DEATH (MM DO YEAR) COUNTY CODE SOCIAL SECURITY NUMBER ~ OFFICIAL USE ONLY 21-02-0682 YEAR NUMBER 123-34-4047 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER X 1. Original Return 2. Supplemental Return CAPB 4. Limited Estate 4a. Future Interest Compromise (date of death after 12-12-82) HpRL X 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 1 EplO CRAC (Attach copy of Will) (Attach copy of Trust) KOTK 09. 010. 0 ES litigation Proceeds Received Spousal Poverty Credit C P o 0 R N R 0 E E S N T C o M P T U A T X A T I o N (date of death between 12-31-91 and 1-1-95) laC!!'!<>N 1Itl;!IlT IiIE COMPLllTIiD. ALL CORRESPONDENCE & CONFIDENTIAL TiIX IN NAME COMPLETE MAILING ADDRESS Robert C. Saidis FIRM NAME (If Applicable) Saidis, Shuff, Flower & Lindsa TELEPHONE NUMBER 2109 Market Street Camp Hill, PA 17011 R E C A P I T U L A T I o N 3 -3405 Real Estate (Schedule A) Stocks and Bonds (Schedule B) Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule 0) S. Cash, Bank Deposits & Miscellaneous Personal Property ISchedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) ISchedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions Itotal Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11 ) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (1) (2) (3) 149,000.00 232,604.44 None (4) (5) None 19,798.67 (6) 18,368.96 162,820.01 32,726.65 8,868.23 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. X 449,997.20 20,000.00 36,000.00 x X X X .0 0 o 45 .12 .15 3. date of death . Remainder Return prior to 12-13-82) S. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (AttaCh Sch 0) R"~TION JllflijllJ,.l)iilJi:iQ ''JiI), OFFICIAL USE ONLY (8) 582,592.08 (11) 41. 594.88 (12) 540,997.20 (13) 35,000.00 (14) 505,997.20 (15) (16) (17) (18) (19) 0.00 20,249.87 2,400.00 5,400.00 28,049.87 Copyright (c) 2000 form software only The Lackner Group. Inc. Form REV-1500 EX (Rev. 6-00) 'Decedent's Complete Address: . STREFT ADDRESS . . 11 Enck DrIve CITY I STATE I ZIP Boilin~ Snrings PA 17007 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 28,049.87 0.00 32,500.00 1,402.49 Total Credits ( A + B + C) (2) 33,902.49 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( 0 + E) (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. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + 5A This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 5,852.62 0.00 0.00 0.00 ptEAsgll~~~Wlg~.I+I~gm~18tt8w~~~III~Ggl~+1181~'~I:.~~.:~t~21:~G..AN "X" 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? . 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 4. Did decedent own an Individual Retirement Account annuity, or other non-probate property which contains a beneficiary designation? IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. "j"::::::::,:::..:.::.:..::::;"::,:,::::::::,::::):::::::::::::::::::::::::jji::jjii:wn:::H::: '",,',0'."","':,,','..,.,.,.""""""""""'"""""""""""""""""''''0.'<""",,, IN THE APPROPRIATE BLOCKS Yes No ~~ o []] o o []J []J Under penalties of perjury, I declare that I have examined this return. including accompanying schedules and statements, and to the best of my knowledge and belief, it is true. . Declaration of preparer other than the personal representative is based on all informatIon of which preparer has any knowledge. URN William G. Hardie 310 Norwich Lane ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Landenber , PA 19350 Saidis, Shuff, Flower & Lindsay 2109 Market Street DATE 2/;!~3 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 9t 16 (a) (1.1) (i)l 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) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (al (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 P.S. 9116(a)(tll 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(a)(1.3)). 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-150E EX t (1-97) ( COMMlllrlWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Laurine Hardie SS# 123-34-4047 07/25/2002 21-02-0682 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller. neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts, Real property which is jointly-owned with riQht of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE DESCRIPTION NUMBER OF DEATH 1 11 Enck Drive, Boiling Springs, South Middleton Township, 149,000.00 Cumberland County, PA (based on sale price - see settlement sheet attached) SCHEDULE A REAL ESTATE TOTAL (Also enter on line 1. Recapitulation) $ 149,000.00 (If more space is needed. insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1502 EX (Rev. 1-97) REV-1S03 EX + (1-97) ..cOMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER Laurine Hardie SSfl 123-34-4047 07/25/2002 21-02-0682 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 2 3 DESCRIPTION Vanguard Group, Acct. #9896819969 273.049 units International Growth Fd @12.54 58.718 units Vanguard 500 Index Fd @ 77.51 Scudder Investments Acct. #996679134111-5 200 shares Senetek PLC at .53 per share 4 Paine Webber, "TOD" investment acct. JNOOl7766 (children are beneficiaries - see attached) 5 Prudential Securities, "TOD" acct. 02703511259 (Paige Muncy beneficiary) Prudential Securities, "TOD" acct. 02703511255 (Erica Muncy beneficiary) 6 UNIT VALUE VALUE AT DATE OF DEATH 7,975.26 15,563.91 106.00 205,824.49 1,567.39 1,567.39 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. TOTAL (Also enter on line 2, Recapitulation) Form REV-1503 EX (Rev. 1-97) 232,604.44 REV-1508 EX +(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Laurine Hardie SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY SSfI 123-34-4047 FILE NUMBER 21-02-0682 07/25/2002 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 10 11 12 13 VALUE AT DATE OF DEATH DESCRIPTION New York State Teachers' Retirement System, pension payment received after date of death 1,738.10 2 cash 49.50 3 United Healthcare Insurance Co., medical expense reimbursement 124.42 4 Home Instead Senior Care, refund 1,199.50 5 Continental Casualty Co., medical reimbursement 616.00 6 Continental Casualty Co., refund of unearned premium 656.08 7 Ford Taurus, value based on purchase price 9,500.00 8 Household Furnishings, value based on purchase price 2,772.25 9 State Farm Insurance, refund of premium 267.56 Medical insurance refund payments 843.96 Verizon, refund 39.81 AAUW Investment Club 1,829.49 Amityvi11e Union Free School Dist., refund of medicare premium 162.00 TOTAL (Also enteron line 5, Recapitulation) $ 19,798.67 (If more space is needed, insert additional sheets of the same size) CopyrIght (c) 1996 form software only CPSystems, Inc. Form REV-15G8 EX (Rev. 1-97) REV-1509 EX + (1-97) , COMMONWEALTH OF PENNSYLVANIA INHERITANCETJoj( RETURN RESIDENT DECEDENT ESTATE OF Laurine Hardie SCHEDULE F JOINTL V-OWNED PROPERTY SSlf 123-34-4047 07/25/2002 FILE NUMBER 21-02-0682 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. A. SURVIVING JOINT TENANT(S) NAME William G. Hardie ADDRESS RELATIONSHIP TO DECEDENT 310 Norwich Lane Landenberg, PA 19350 son B. c. JOINTLY-OWNED PROPERTY, LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank DATE OF DEATH DECO'S VALUE OF account number or similar identifying number. NUMBER TENANT JOINT Attach deed for jointly-held real estate VALUE OF ASSET INTEREST DECEDENT'S INTERES 1 A F & M Bank, money market 10,015.06 50.00% 5,007.53 1170-41837 2 A F & M Bank, checking acct. 26,722.85 50.00% 13,361.43 1133 -15827 TOTAL (Also enter on line 6, Recapitulation) $ 18,368.96 T (If more space is needed insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems.lnc. Form REV-1509 EX (Rev. 1-97) AEV-1SV)EX +(1~97) . COMMONt.vEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Laurine Hardie SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY SSiI 123-34-4047 07/25/2002 FILE NUMBER 21-02-0682 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. ITEM NUMBER 1 DESCRIPTION OF PROPERTY RELA~~8~~gl~ ~Wb~~5~~r~WJ~~~1fftEE6F ~~~~RSFER. ATTACH ACOPYOF THE DEED FOR REAL ESTATE. Paine Webber IRA acct. ilJN00086 (children are beneficiaries) DATE OF DEATH VALUE OF ASSET 72,518.68 % OF DECD'S INTEREST 100.001. EXCLUSION (IF APPLICABLE) TAXABLE VALUE 72,518.68 2 Charles Schwab, educ at i anal IRA 1,200.54 100.00% 1,200.54 (Paige Muncy beneficary) 3 Charles Schwab, educational IRA 1,200.54 100.00% 1,200.54 (Erica Muncy beneficiary) 4 Union Central Life Insurance 87,900.25 100.00% 87,900.25 Annuity accounts 3060648-30607 (see form 2791 attached) (decedent's children benef.) TOTAL (Also enter on line 7, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems.lnc. 162,820.01 Form REV-1510 EX (Rev. 1-97) REV-1S1"'EX +{1-97} \ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Laurine Hardie SSjt 123-34-4047 07/25/2002 FILE NUMBER 21-02-0682 Debts of decedent must be reported on Schedule t ITEM NUMBER DESCRIPTiON AMOUNT A. FUNERAL EXPENSES, Ewing Bros. Funeral Home 9,885.30 funeral luncheon 219.81 Carlisle Memorial Service, Inc. 369.00 B. ADMINISTRATIVE COSTS, 1. Personal Representative's Commissions Name of Personal Representative(sJ Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip - Year(s) Commission Paid: 2. Attorney's Fees Saidis, Shuff, Flower & Lindsay 11,560.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip - Relationship of Claimant to Decedent 4. Probate Fees Register of Wills 352.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs Cumberland Law Journal, estate notice 75.00 The Patriot News, estate notice 131.47 filing fee and additional short certificates 30.00 Fleischer Lawn Care 148.40 Costs incurred in sale of real estate 9,464.54 commission 8,940.00 transfer tax 1,490.00 radon 350.00 water and sewer bill 82.50 (credit for taxes paid 1,397.96) Executor's expenses (postage, copying, fax, travel) 63.38 Trash removal and repairs to house 427.75 TOTAL (Also enter on line 9, Recapitulation) $ 32,726.65 (If more space is needed, insert additional sheets of the same size) Copyright (el 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97) REV-151ZEX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Laurine Hardie SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SSfj 123-34-4047 07/25/2002 Include unreimbursed medical expenses. ITEM NUMBER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 DESCRIPTION United Church of Christ Homes, nursing home bill Sprint, phone bill Central Medical Equipment Masland Assoc., Inc., medical expense Verizon, phone bill Ford motor credit, loan (see attached) Yellow Breeches EMS Andrews & Patel Assoc. PC Comcast Citi Cards, credit card balance Belvedere Medical Group Carlisle Pathology Carlisle Imaging Assoc. Masland Assoc. I medical expense Carlisle Digestive Disease Assoc., Ltd. Sprint Moffitt Heart & Vascular Group, medical expense West Shore Pathology Dr. David Hosizaki The city of Edmonton, Alberta, Canada, emergency response dept. Moffitt Heart and Vascular PA GI Consultants, PC PNC Bank, check charges Central Penn Medical Group University of Alberta Hospital Quantum Imaging FILE NUMBER 21-02-0682 AMOUNT 304.50 46.82 24.15 115.51 65.43 3,908.43 48.75 658.77 37.54 1,972.18 402.23 74.20 49.37 21.58 88.15 52.65 52.99 15.68 300.00 266.42 53.06 60.88 55.20 28.02 160.88 4.84 TOTAL (Also enter on line 10, Recapitulation) $ 8,868.23 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) REV-1S13 'EX + (9-00) SCHEDULE J BENEFICIARIES , COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Laurine Hardie SSil 123-34-4047 07/25/2002 NUMBER I. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [Include outright spousal distributions. and transfers under Sec. 9116(a)(1.Z}] 1 Mary Ann Smith 9 Enck Drive Boiling Springs, PA 17007 2 Borden Woytkiw 319 Tory View Edmonton, Alberta, Canada T6R3A7 3 Doug Woytkiw 1233-118A Street Edmonton, Alberta, Canada T6J7E9 4 Michelle LoBreau 1424-63 Street Edmonton, Alberta, Canada T6LIX7 5 Roberta McGowan 11 Pentland Cresent Kanato, Ontario, Canada K2K1V4 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) friend brother nephew niece niece FILE NUMBER 21-02-0682 AMOUNT OR SHARE OF ESTATE 5,000.00 20,000.00 10,000.00 10,000.00 10,000.00 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 1 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Bubbler Foundation c/o Patricia Sanker 4 Forge Rd. Boiling Springs, PA 17007 2 Boiling Springs Civic Assoc. c/o Mary Anne Taylor 111 Front Street Boiling Springs, PA 17007 Total of Continuation Schedule(s) 10,000.00 10,000.00 15,000.00 35,000.00 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET S (If more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lackner Group. Inc Form REV-1513 EX (Rev. 9-00) Estate of: Laurine Hardie Sac Sec #: 123-34-4047 Date of Death: 07/25/2002 Item If Continuation of Schedule J, Part I (Taxable Bequests) Name and Address of Beneficiary Relationship Amount or Share of Estate 6 friend Erma Lininger 90 Pine Hill Road Carlisle, PA 17013 7 William G. Hardie 310 Norwich Lane Landenberg, PA 19350 son 8 Thomas L. Hardie 845 Bryn Mawr Ave. Newton Square, PA 19073 son 9 Darlene Hardie-Muncy 2 Patrick Henry Place Ringoes, NJ 08551 daughter 1,000.00 1/3 of residue 1/3 of residue 1/3 of residue Estate of: Laurine Hardie Soc Sec #: 123-34-4047 Date of Death: 07/25/2002 Continuation of Schedule J, Part II-B (Charitable and Governmental Bequests) Item # Description Amount or Share of Estate 3 Domestic Violence Services of Cumberland and Perry County P.O. Box 1039 Carlisle, PA 17013 5,000.00 4 Allison United Methodist Church 99 Mooreland Ave. Carlisle, PA 17013 10,000.00 15,000.00 FROM : S~IDIS.SHUFF,FLOWER+LINr~qy F~X NO. 2436510 Ju 1. 26 2002 10: 5S~M PI " To. ""' ;'.<. \6'1 ~:! . ->!\ ~'II ~ ~' YlI\ ~'i\ ;11 "" ~I ~il I ;( SAIDIS lUFF. FLOWER & LINDSAY ~_"T~W !'6 W. HI~ $tt~t C.ulJilc. PA '.- ,- I I, , LAST WILL AND TESTAMENT 01' LAURINE HARD J:E _. LAURINE HARDIE, of South M::.ddlecon Townsh,,-?, Cumberland I I! county I II I \ , Pennsylvania, be~ng of sound and disposi~g nind, memo~/ publisb. and declare this as and understanding, do hereby make, a~d ~O~ my Last Will and Testament, he~eby revoki~g all o~her Wills a~d Codicils he=etofore made by me. FIRST : di!:"ect t.he payine~t. of my ::;ust:. debts a::d experlses or my last l:lness a~c :~~e~al ~rom my estate as soan after ~y death as conveniently may be done. 1 di~ec~ ~y personal ~eprese~tative to bu~y me i~ che cemetery lot ac Sa~~~ ?ac=icK'S New Ceme~erf, ~oc saD ~exc co my h~soanc with a~ existi~g mOQU~enL to~ final e~g~avins. F"'..l~';:.~e=, I a:J.thc~:.ze my gersor:a:.. repr;~s2:1t.at.i.ve :0 expe::.d I '! Eunds E~om my est-at.e, ir. s1.:cn arr.oun:: as l1Y peyso:-:a2. represe0~acive shall co~s~de~ necessa~y a~d deslrable fo= ~he il 'I i( ,. i~sc~~p~~o~ on the marker for ~y grave. SECOND : g~ve a~d bequeath to the perso~s or ent~~ies set for~h ~~e fol~owing cash beq~es~s: a. SlO,OOO co the Bubble~ Foundation; b. Slo,ooe Co the BOlling Sp=ings Civic Assor:~d.ti.on; FROM: SA1DIS,SHUFF,FLOWER+LINDcqy 'i I, ~ 'I ii, I , .;); ~"I ! ''-..! , '\ Ii . I , .i i -sl .~~II . '->. \ , " I ! ! SAIDIS lUFF. FLOWER g" LINDSAY .....~~ I.:r-A:T~L\w .6 W, Htt;h Street CJrlfsl~. PA FAX NO. 2436510 Jul. 26 2002 10:56AM P2 C. $5,000 co Domescic V"olence Serv~ces of Cumberland and ii I ; , i , 2e::'~y COI..lr:~y; d. $5,000 co Mary ~~n Sm~~h of 9 EncK Drive, Soiling Sp~i~gs, Pennsylvanla; e. $20,000 t.o my bracher, Sorden Woy~kiw; E. $10,000 to my rtephslN' . Doug Woytkiw; g. $10,00C to my niece, Micr.elle (....oyt.kiw) i...oBr2au; h. $10,000 to my c:.ece, Rober1:.a (Woyt:kiw) McGowan; i. $1, 000 to Er7na Linir.ger of 90 Pine Hill Road, Ca::clisle, Pennsylvar.ia; and J' $:0,000 tc Allison Un~ced Methodisc Churctr 99 Moore :a.I:c! Aven~el Ca~lis:e, Pe~~9ylva~~a. THIRJ:1. I give, dev~se and be~~eath all the rest, residue and rema~~de~ 0: ~y esta~e to my child~e~ THOMAS L. HARDIE, WILLIAM G. HARDIE, and DARLENE HARDIE-MUNCY, per st~~pes FOURTH I Ii I _ d~~ect c~a: a~y a~d al: ~~he~:ta~ce, esta~~, a~d c~ans:e~ , \ caxes imposed upo~ my escate pass~~g under this W~ll Q~ I II \ otherw~se s~all be paid cut of the p~incipal cr my residuary I estate. 2 SRIDIS,SHUFF,FLDWER+LINDSRY I I FROM \ \ II ,I I I I " ~i\ '~ 11 ~l ~I '-.I. I \ ~\ I I I I i I SAIDIS UFF, FLOWER ? LINDSAY H ~i\T.LA\I( I5W. Hig.h.Slrt'~r c.rlbJe. P^ FRX NO. 2436510 Jul. 25 2002 10:56RM P3 FIFTH In addi~~on co the powers conferred by law, = authorize any personal ~e9~esentat~ve acting under t~is i~stru~ent. l~ his absol~ce d~scr~cion: A. To re~ain i~ the form ~eceived~ or to se:: e~t~er at public or pr~vate sale a~y real or personal prope=~y; B. To exercise any o9t~ons to SUbscrlbe :or stocks, bonds, or oche~ ~nvestments; C. To join in any p:an oE lease. mortgage, consol~da~icnf excha~ge, reorganizacion or :oceclos~~e cf a~y Go=po~at~o~ i~ wh~c~ ~y es~a~e oy a~y ~r~st may ho~d s~ocks, ~o~ds O~ o~her sec~=~t~es; D. To sell, tra~sfer, ca~vey, ~or~9age, pledge, :ease or excha~ge ~ny p~operty, ~eal O~ personal I which ae any t~me ~ay form part of ~y es~ate, for the pa~e~t 0: debts or; :::axes J c= Eor a:!y pu~~ose 0: adrn.:.n:.s:::::-ac icn o"!:' d.:.s~ribu::.:.or~1 for such p~ices a::.c uf'or: such t2r;ns as my persona: ~e9rese~ta:ive, i~ h~s sole discre~~~~, may deem w::se, ap..c to execute and del i vet"" deeds c f ccr:veyance O~ transfer t~ereaf; E. To make set:.':~eme!lts ar:d. compr.omises on such c.e!:7i',~ as my pe~sonal represe~tative in ~i5 sole cisc=etion may deem wise wit~ou~ the necessity of obtain~ng any cou~~ dp9roval t:he~eof ; 3 FROM: SRIDIS.SHUFF.FLOWER+LINDSRY FRX NO. 2436510 Jul. 26 2002 10:57RM P4 SAIDIS ruFF. FLOWER ~ LINDSAY ~J\T~W 6 W. Hlj;ft Streef c.atll~le.I'A C" To make d~s~~ib~L~G~ he~e~nder e~t~er ~n cas~ 01:- k~nd, as my personal representative ~n h~s d~scretion may deem wise. SIXTH : do hereby nom~nate. constitute and appoint my son, WILLIAM G. HARDIE, to ace as Executor of t~is my Last W~ll and Tesca:tter..t:.. My named Sxecuto= shall be entitled co ccmpensatian for his services in administering my estate. ?rovided. however, that if he is unwilli~g or u~able to act as Exec~tor, : d~=ect ,I . I tne I I , I I :11 " " dut:ies of Exec~tor to be performed by THOMAS G. HARDIE. SF.VENTH guard.:.a:-:. t !:"us tJ'~e cha::. c.o persona~ ~ep~esen=ac~ve, _ d:..rec':. or ot~e~ fiduciary appoiQted u~de~ c~is in8~rumenC shdll ::Je requ~=~d to give bo~d fo~ t~e fa~tn~~: gerfor~ance oE ~he:~ duties ~n a~y Jurisdict~o~. IN WITNESS WdEREOF, LAURINE HARDIE, have he:cel:nto set my ! r k, , , :1.\' hand ace. sea~ , i to t.r:::...s my Lase Wil:' and :'est:aMent, cO~9.:..sc.i:"'J; of the t~rs~ ch~~e 0: w~~ch bea~ ~y EoL.:.r- ~ypewriL~e~ pages, :.n.:t.ia:'s in the margi~ for identi~icacion, 1'-1-,.C' ...... ~. ..L... 7" .!..::!- day c= May, 2002. iz~~/ J!~ "GAURINE HARDIE I I I i i I I .. SRIDIS, SHUFF ,FLOWER+L I NDSRY II I " !\ ,/ S~gned, seal~d, publishec and decl~~ed by ~he above-r.amed \1 LAURINE HARDIE, ~estatr~x. as and for her ~a3~ Will and 1'1 7es+:.a\:\. er'.t. i::. :::--~e 9resen~e of us. who ha'Je :-tereanta subsc~.:.bed au:: r:ames at ~er :=eq'.....:.est. as WJ.::::lesses '::~e=e:'o I i:1 the 9resence 11',1 c~:~scatrix and of each other. k/ ~ ADDRESS 2 c. '-' J~~~ I c"", " L ~ L.. r1< FROM :1 !! :1 I I. I' :\ II " 01 i,.,I' SAIDIS JFF. FLOWER . , LINDSAY I i I w. High Slr~r C.rlislf>. PI\. FRX NO. 2436510 JI.l!. 252002 10:57RM P5 i &?(~~ \\ I' ,I \1 COmITY :1 " 'I II r ,I II ! i ~ 4/'c~J ;; / -1 0dd. bd~ AD::J!<.2SS (i1l.'~ I ,'sf" PA , , COMMONWEALTH OF PENNSYLVANIA OF CUMBERLAND We. Laurine Hardie, Rnhprr r ~~i~,~ dnd Charles E. Clepger the Testacrix and w~cne5ses. cespeccively whose na~es a~e signed to c~e fo~eso~~g G~ a~~ached ~~strumenc, bei::.g firs::: c.t,.;,ly swo~:;., do he:ceby dec::"are '.:0 ::r:.e U:1d~!"s:gDed a~tho~~~y t~a~ ~~e Tesca~~ix sig~ed and exe~~~ed ~~e ~~s~~~m~~t ,: as ~e:: ':"ast. Will ac.d Test:ame!l.T.: ac.c ;:::at. s:;.e s:.gned l"r:..:.lir-gly a~~d. cha: exec~ted as ~e~ =ree a~d vc:~~~ary a2C :o~ ~~e 9u~poses t:he~elr;. ex?~gsse~, a:-..c. that eac~ 0:: c::e wi~::-:esses, ~i1 c~~e p~~se~ce a~c ~ea~~ng of ~~e ~es~ac~~x sis~ed ~~~ Ni~: as w~tnesses and :~a~ co ~~e besc o~ ~~eir ~~ow~edse ~~e 7estacr~x was at :he t~~e e~g~~ee~ (18; O~ mo~e years 0: age, of SOl~~C :1',.!..::d ar..c. :...:.r.:..c.e:::- ~o COQs~::-ai:1.t O~ 'c.!!!.cc..:.e :.r:=l.:...:e~::::=. ~~u~ ~(j.-",,,tcU LAURINE HARDIE ~ Robert C. Saidi~Wi=nes$ itf'-,f;,), .f?'" ~~ Charles ~. C ep ~~~ess :1 I I ! S~bscr:..bed, swor~ ~o a~d ack~ow:edged be:~re me by LAUR~NE HARDIE, t:.:re ::-e:s::at!:"ix, end s'llbsc-::::-ibec. to ai'~c. SWG~r".;. O~. aff:-::med to before me QYR~)b~C. Said~s E..-0~~, wit~esses, t~is day of ~ay, i I ~1i I ! i NCrAPIAL.. SEAL RENEE L. ~..WrH~'~Y. Notary Public Carllsie f3(':~f) CumOarfand Co.. F'A My Comml:l&icn ,;'xptres Decamcef 13. 2005 5 C'NA Continental Casualty Company 100 CNA Drive Nashville,TN 37214-3439 LTCN LIFE CLAIMS ForAU IheCoh1",llmenl' You Mlik.@ DATE BATCH CHECK NO. AMOUNT 09/03/2002 5945.1.5 01983266 $* ** '* '* '* .aS6.0B SURRENDER 076347632 POLlCY 076347632 SURRENDER PAYEE: Estate Of Laurine Hardie SURRENDER CLR FULL SUR PAYOUT I REQUESTOR IDENTIFICATION: IPH2 r y-fi.( ~--~, ",f / r (i,:-r"' RE: LAURINE HARDIE DATE OF DEATH 7-25-2002 ACCOUNT INFORMATION L-CHECKING SAVINGS ___CERTIFICATE OF DEPOSIT SAFE DEPOSIT SHARES OF STOCK DATE OPENED 11-3-1998 DATE CLOSED STILL ACTIVE ACCOUNT NUMBER 33-15827 ACCOUNT BALANCE AT DATE OF DEATH $26,722.48 ACCRUED INTEREST $.37 TOTAL ACCOUNT BALANCE $26,722.85 NAME(S) ON ACCOUNT LAURINE HARDIE & WILLIAM G. HARDIE JOINT SINCE 11-3-1998 DATE OPENED --------------------------------------------------------------- ACCOUNT INFORMATION x CHECKING SAVINGS ____CERTIFICATE OF DEPOSIT SAFE DEPOSIT SHARES OF STOCK DATE OPENED 3-5-1999 DATE CLOSED STILL ACTIVE ACCOUNT NUMBER 70-41837 ACCOUNT BALANCE AT DATE OF DEATH $10,014.80 ACCRUED INTEREST $.26 TOTAL ACCOUNT BALANCE $10,015.06 NAME(S) ON ACCOUNT LAURINE HARDIE & WILLIAM G. HARDIE JOINT SINCE 3-5-1999 DATE OPENED ------------------------------------------------------------------ RE: LAURINE HARDIE DATE OF DEATH 7-25-2002 ACCOUNT INFORMATION _CHECKING X SAFE DEPOSIT SAVINGS _CERTIFICATE OF DEPOSIT MORTGAGE DATE OPENED 4-5-1999 DATE CLOSED STILL ACTIVE ACCOUNT NUMBER 16-195 ACCOUNT BALANCE AT DATE OF DEATH -0- ACCRUED INTEREST NON-INTEREST BEARING ACCOUNT TOTAL ACCOUNT BALANCE -0- NAME(S) ON ACCOUNT LAURINE HARDIE ------------------------------------------------------------------ ACCOUNT INFORMATION CHECKING SAFE DEPOSIT SAVINGS CERTIFICATE OF DEPOSIT INSTALLMENT LOAN DATE OPENED DATE CLOSED ACCOUNT NUMBER ACCOUNT BALANCE AT DATE OF DEATH ACCRUED INTEREST TOTAL ACCOUNT BALANCE NAME(S) ON ACCOUNT ------------------------------------------------------------------ zoo ':'J~)Vd " . o ~ a liQ l a6ed 8LOS-l Z8--Z! Z -4' ~ "0 ~ ~ "- cr ~ C <D </> " . 5 . '" . cr cr ~ r ~ . " </> o ~ n ~ ~ . n in 5!? o . ,,- </> ~ ~ ;; 3 . =' O"::T.o >-'I {'e e.. A:I ~ b'" C':I .....< 0 {'e m ~ {'e S- A:I l'lI{'eO"'re,.O'" ~ a.. ('e l'lI 0 ::3..., ~ ~-< ..'::;'{'e p) CP ..... !::::"" 0 0". Q.I lJQ ~. 0'" l'lI ~ " ~ or g.S I!l '" 15'''' s ~ 0'" CP C':I ~ a ~ a.. 0 ('e~~a....... 8..1!l g e.'3 . CP P ; n' g g; a.. m ....~g-' " ... '" '" Q.I s. Z 1 : Z 1 Z o. S 1 DO\! J U:J H ~ ~ G)::: ~I:j .....,looO')I.OW(') ~gJ~~to~ ::~~~~ 8~g5:g iJiJZO~J ::!lCOO<O N (IJ CD ;;c ~-< 3 ~?iFii~):>Dl -cnOZ-:l Z-lO~~Z o 0 ::tI Z Ql ;;c 1) () ~ i!i m z () Id 0 J\J..... .....I~ a5g~~RJ3 J\Jww-..J.....<II NNW O>O>N Coow ~8~ c ~ . "- c' . WJ\J to WN Co ~ ~I~ Q '" -g or NNW -..JUlOW.... J\J 0, 0 0 0'115" gJ~~gg;:E NNW ~ Ul 9 t..I :-"IQ 00,....00')0 -..JJ\JO')UlWln OOOOOltl ')..,,~ft..t;I._.~~ ~'f'::---:""'':'''"~ <) -,,}.> -. lI' "V--"'~ W 1< NO J\J-..J..... Q. ~g~~RJ3 NWW-..J....<II W )> ~t..I!'J % tAtAN III ~ ~ ~I;t:; a Q NJ\JtA III -..JUlOW.... " ~~@~~I~~ NN 0>0> 0, 6 wo 00 NNW ~ Ul 0 t..l:-" IQ o Co' 0 OJ 0 -..JNO'lUlc.oln 00000<11 Ii\Jd zo:ao:r: :aW!l lOl9L/a :alea o . ;; a "0 ~ n ~ . ~ " ~ 2s N ~ , Q C -.. "-J ';-J ~ ~ ? ,0 \:) , ....j ~~ l~ t 0> '" '" 2s N a6pJng uaallO~ ;01 UOSUllOr aqe9 :WOJ::/ ~======~==~========~============~============~=======================================~============~=== JN0017 IE:66 Account Inquiry(position (P}) - HARDIE LAU HH CF (as of 08/16) jrtsc 08/19 02 12:00 PM RETURN: MIX RISK: 1) MODERA~E 2) UNKNOWN 3) UNKNOWN LSTMT:07/02 ======~=============================================================================================== LAURINE HARDIE TOD THOMAS L HARDIE, WILLIAM G HARDIE, DARLENE A HARDIE-MUNCY 11 ENCK DR BOILING SPRINGS PA 17007-9729 Net MM Funds Cr/Dr Balance Tot Portfolio Liquid Equity HS Excess/Call 161 o 214,820 214,819 o D.O.P. 7(~~11!J~ frv 111~ ~(fJAY}~.s~()AJV T-DATE POSN TICKER SECURITY DESCRIPTION PRICE VALUE TP CUSIP LOC REINV L 4 AV 1.470 AVAYA INC SEG E L 100 GLW 1. 590 CORNING INC SEG E L 100 NE 33.980 3,398 NOBLE CORP NEW ORD SEG L 2744 MFPWQA UBS PACE LARGE COMPANY NAY .$/3.71 ~EQUITY INVESTMENT 14.980 41,105 SEG FUND CLASS A L 866 3AOD41 1000TH UBS FACE LARGE 0.000 SEG COMPANY VALUE EQUITY INVESTMENT FUND CLASS A L 223 PSAPRM PUBLIC STORAGE INC 25.880 5,771 SEG 8 3/4% CUM PFD SER M DEP SHS EA REP 1/1000 SH L 975 PFE 33.120 23.870 32,292 4,869 PFIZER INC SEG Y L 204 MFAMEP AMERICAN FUNDS EURO !yAy 1~3.'J./~FIC GROWTH FUND CL A MFA L 376 543PF4 1000TH AMERICAN FUNDS MFA 0.000 EURD PACIFIC GROWTH FUND CL A L 10045 MFFKFD FT-FRANKLIN FEDERAL NAV 111.9~ ~ INC A 119,836 MFA 11. 930 L 165 544HA7 1000TH FT-FRANKLIN MFA 0.000 FEDERAL TIF INC A L 86 MFJNTA ~Il" !2.'3.0& ~EO 30.470 2,620 JANUS TWENTY FUND MFA MFA 0.000 1000TH JANUS TWENTY FUND L ~O MFJNJA JANUS FUND NP,v l,17:J 'J- 268 545MN7 1000TH JANUS MFA 19.170 4,600 MFA 0.000 FUND The above summary/prices! quotes!statistics contained herein have been obtained from sources believed reliable but are not necessarily guaranteed. PAGE 1 OF 1 5 1 053499109 159 1 219350105 1 G65422100 1 90262L651 o 1 90262LIA7 1 74460D794 1 717081103 1 298706102 o 1 298706904 1 353519101 o 1 353519903 1 471023408 o 1 471990028 1 471023101 o 1 471023911 The Union Central Life Insurance Company 1876 Waycross Road PO Box 40888 Cincinnati, OH 45240 (513) 595 2200 U~181 Insurance and Investments January 29, 2003 3060648 LAURINE HARDIE NOTICE OF PAYMENT UNDER AN ANNUITY CONTRACT, INCOME POLICY OR SETTLEMENT OPTION AT THE DEATH OF A PAYEE Name of decedent: Laurine Hardie Date of death: July 25, 2002 Residence of decedent: II Enck Drive, Boiling Springs P A 17007 (X) Annuitant o Beneficiary under Settlement Option Date of issue of Annuity or effective date of Settlement Option: December I, 1998 Kind of Annuity or form of Settlement Option: Payable in annual installment for fifteen years certain, withouth the right of commutation Name of Beneficiary: See Below Relationship: children Residence of Beneficiary: See Below Method of payment to beneficiary: o Single Sum - Amount of proceeds on deposit Accrued interest o Single Sum - Commuted value of Annuity or Installment Option o Single Sum $87,900.25 (X) For Estate Tax purposes the commuted value of the remaining certain installments is Other details of settlement: Thomas L. Hardie 845 Bryn Mawr Ave Newtown Squ re PA William G. Hardie 310 Norwich Lane a burg PA 19350 Darlene A. Hardie-Muncy 2 Patrick Henry Place Ringoes NJ 08551 By Ind i ual Life Claims UC 2791 03/95 Securities products offered through registered representatives of Carillon Investments, Inc., a subsidiary of The Union Central Life Insurance Company, P.O. Box 40409, Cincinnati, Ohio 45240-0409. (513) 595-2600 4>< c.-, ., . ..~-_.. '- -'.- '-, -', " <. ','-. ", -.>', .... .... ..../....',....:,.<. '\ . -c_, .. -) . .~ . " -' - THEVanguilJ"dJRoup, AUG 2 6 2002 ROBERT C SAIDlS LAW OFFICES OF SAIDlS, SHUFF, FLOWER & LINDSAY 2109 MARKET ST CAMP HILL, PA 17011 August 21, 2002 All Funds 09896819969 ESTATE OF LAURINE HARDIE Dear Mr. Saidis: We are responding to your letter requesting the values of the above-referenced accounts. As of July 25, 2002, the number of shares, the price per share, the value of each account, and the accrued dividends (if applicable) were as follows: Fund Shares Price Value Accrued Dividends International Growth Fund 273.049 $12.54 $3,424.03 N/A Inv 500 Index Fund Inv 58.718 $77.51 $4,551.23 N/A If you have any questions or need further assistance, please contact a member of our Transition Specialist Team at 1-888-237-9045. A dedicated Transition Specialist will be pleased to assist you. Sincerely, Client Services Department bc 50163649 Post Office Box 2600, Valley Forge, Pennsylvania I94~12,-26oo (610) 669-1000 . www.vanguard.com SCUDDER INVESTMENTS P.O. Box 219669 Kansas City MO 64121-9669 1-800-728-3337 August 14, 2002 Law Offices Saidis Shuff Flower & Lindsay A Professional Corporation Attn Robert C Saidis 2109 Market Street Camp Hill P A 17011 Inquiry #: Fund: Account #: 20328932 Growth and Income-Class S 09966791341 Dear Robert C. Saidis: We are writing in response to your request for information regarding the value of La urine Hardie's account. Please accept our condolences for your loss. The information below is only for the date you requested, July 25, 2002: FUND NAME(S) NUMBER OF SHARES 991.332 SHARE PRICE $15.70 ACCOUNT BALANCE $15,563.91 Growth and Income Fund If you have any further questions, please call us toll-free at 1-(800)-SCUDDER (1-800-728- 3337), Monday tJrrough Friday, from 8:00 A.M. to 7:00 P.M., Eastern Time. We will be happy to assist you. Sincerely, ~~ Liana Stephenson Service Specialist I ~_~~tlY ON THE CARLISLE PIKE BOX 1177 MECHANJCSBURG,PA 17055 766-4733 CUST,# MllEAG-=-----. I ETCH ~URCHASE PLAN MAKE......"...,. -~-~ODEl-I.aur.us -- I YEAR ~ I . SERIAL # 1 ~Ol~ STQCK# ~ i N~W i'/.....USED rYl I U SALESMAN: Alan W. Riddle CASH PRICE OF CAR 08/09/2002 ACCESSORIES' 310 Norwich L n' CITY Landenberg RES. PHONE (610) 274-2374 STATE PA ZIP 19350 BUS. PHONE (610) 331-1281 SOCIAL ECURITY # COLLISION COVERAGE PHONE ---L ADDRESS POLICY NUMBER VERIFIED BY STOCK # lNV. VALUE , I ------'- TITLE # LICENSE # SERIAL # lFAFP55S7YA199068 BALANCE OWED TO: F.M.C.C. ADDRESS EXPIRATION DATE ALLOWANCE ON TRADE-IN DIFFERENCE BETWEEN ESTIMATED PAYOFF SHOWN AND ACTUAL W1LL BE CUSTOMER S RESPONSIBIL [TY $3,908.43 BAL. oweD ON TRADE-IN PAYOFF GOOD UNTil NET ALLOWANCE The above described vehicle may be reappraised if it has suffered damage or seriouS mechanical deterioration since the date of the Originalllaluatlon and prior to its defl...ery 10 the dealer, or if part or accessories or boll'l, including tires or radios halle been remOVEld or rEiplaced will'l parts and accessories of interior quality. EXPRESS WARRANTY (NEW VEHICLES ONLY) THE ONLY WARRANTY APPLICABLE IS THE PRINTED MANUFACTURER'S NEW VEHICLE WARRANTY WHICH WILL BE DELIVERED TO PURCHASER WITH VEHICLE. AS IS THE MOTOR VEHICLE IS SOLD "AS IS" WITHOUT ANY WARRANTY EITHER EXPRESS OR IMPLIED. THE PURCHASER WIll BEAR THE ENTIRE EXPENSE OF REPAIRING OR: CORRECTING ANY DEFECTS THAT PRESENTLY EXIST OR THAT MAY OCCUR IN THE VEHICLE. DISCLAIMER OF WARRANTIES I UNDERSTAND THAT YOU (THE DEALER) EXPRESSLY DISCLAIM ALL WARRANTIES. EITHER EXPRESS OR IMPLIED,INCLUDING ANY IMPLIED WARRANTY OF MERCHANT- ABILITY OR FITNESS FOR A PARrlCULAR PURPOSE. AND THAT YOU NEITHER ASSUME NOR AUTHORIZE ANY OTHER PERSON TO ASSUME FOR YOU ANY LIABILITY IN CONNECTION WITH THE SALE OF THE VEHICLE, EXCEPT AS MAY OTHERWISE BE PROVIDED IN WRITING BY YOU IN AN ATTACHMENT TO THIS CONTRACT OR IN A DOCUMENT DELIVERED TO ME WHEN THE VEHICLE IS DELIVERED Jb. {tfl/J1 1,1 NtI -It SUBTOTAL $ EXTENDED SERVICE PLAN $ ~ $ TOTAL CASH PRICE TRADE-IN ALLOWANCE NET BALANCE LOCAL TAXES % OF $ LICENSE TRANSFER ENCB FEE TITLE $ 4. TOTAL CASH ~/ 6. / BALANCE -..~----- PAYOFF Me c /' ELIVER'l'_ ..------ AMOUNT FINANCED OTHER CHARGES 8. LIFE o $ o $ $ YES 0 YES 0 NO 9. A&H NO UNPAID BALANCE (Amount Financed) 10. LINES 7-8-9 NAME OF FINANCE COMPANY ADDRESS', 'AMT. OF ENCB New YOrk State Teachers' Retirement SlIstem 10 Corporate Woods Dnve Albany, New York 12211.2395 (800) 356-3128 or 447-2666 (Albany-area calls) Web Site: www.nystrs.org Gearge M. Philip, Execullve Dlrectar Member Relations September 16, 2002 Attn: Shelby Yingling Saidis Shuff Flower & Lindsay 2109 Market St Camp Hill PA 17011 Dear Ms Yingling: RE: Laurine 0 Hardie Ret. #096936S This is with further reference to the estate of Laurine 0 Hardie: We are enclosing a check payable to the Estate of Laurine 0 Hardie, in the amount of $1,738.10, which covers the benefits due for the days the retiree lived in July 2002. We would appreciate this check being presented for payment promptly in order that our records may be complete. There are no further benefits due from this System. If you have questions concerning this letter, you may write or call us at 1-800-356-3128, Ext. 6140. When calling from the local Albany area, use 447-2900, Ext. 6140. DMP-1 Sincerely, Anne Westfall Retired Member .PrU(fential ~ Financial Evelyn Burke Senior Investment Operations Associate Prudential Investments Prudential Mutual Fund Services LLC POBox 8098 Philadelphia. PA 19101 (800) 225-1852 www.prudential.com SAIDIS, SHUFF, FLOWER & LIND SA Y A TTN: ROBERT C SAIDIS 2109 MARKET STREET CAMP HILL PA 17011 Shareholder: Laurine Hardie, Dec'd Account Numbers: 02703511255 and 02703511259 August 22, 2002 Dear Mr. Saidis: Thank you fOr your recent inquiry regarding the Prudential Global Total Return Fund, Class A accounts referenced above. Please note that these are not educational IRA accounts as referenced in your letter of August 9, 2002. Each of these accounts was registered as individual accounts with a designated "Transfer on Death" beneficiary. The beneficiary of account 02703511255 is Erica Muncy and the beneficiary of account 02703511259 is Paige Muncy. '\ 'J On July 25, 2002, there were 225.200 shares of the Prudential Global Total Return Fund, Class.1 in each account. The price per share that day was $6.96, for an account balance of$I,567.39 per account. The account balance is determined by multiplying the total number of shares in the account by the Net Asset Value (price per share of the fund). Please keep in mind that the Net Asset Value of the fund fluctuates on a daily basis and therefore, the account value will also fluctuate. lL. In order to distribute the proceeds of Mrs. Hardie's accounts, the following documents are ~necessary: ~. A certified copy of Mrs. Hardie's death certificate. A photocopy will be acceptable as the proceeds of the accounts are less than $100,000.00. ,V t,\ \ . An Inheritance Tax Waiver or Affidavit of Domicile, if applicable. . A letter of instruction signed by each of the beneficiaries, requesting the shares be transferred to a new account. If the beneficiaries choose to have these shares redeemed instead of transferred to new accounts, please indicate to whom the check for the proceeds of each account should be made payable. !t.. A completed Prudential mutual fund application for each of the new accounts. I have enclosed two applications with this letter. it is not necessary to provide an additional copy of the Short Certificate as it was provided with your letter. Please include a copy of this letter along with the documents listed above. r' I hope you find this information useful. If you have any questions, please call the Prudential Mutual Fund Service Center at (800) 225-1852. The Service Center is open Monday through Friday between 8:00 a.m. and 8:00 p.m. Eastern time. Sincerely, t~~ Evelyn Burke Senior Investment Operations Associate Enclosures @ '" o S o ~ ~ " ~ en o ~ ~ 0- 0<> o 0. 0;- o ;;; "'. ~ 1n " ~ m ~ 0- ;;:: m 3 0- ~ en 'ii o Z -< en m ;;:: " -i '" 'i 'r: ~ S "'0 - (J) ~ '" (J) <: _. '" _. .... 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'" m m '" o .., ~ '" '" ~ o '" '" w m m o o '" w m m o o o ... o '" w ... m !;; o '" .., o ~ .. i tIl l'J ~ H ~ tI l'J tIl o ~ 'd >3 H ~ o .., ~ '" '" ~ o '" ... o o o o ... o o o o t"' il "- tIl H tI ... o o o o o ~ o '" .., ~ gj [ii~ H >3 >< till' HO ~o ~ ~ I o ~ Z >3 tIl Ii c~ III - _I: CD III - o -. ...0 c::l CD C III III - - ::?'~ o c:: tIl H 'd I~ tIl~ [ii "- 00 ...,..., -- NN <.n <.n -- 00 NN m (f) i! -oj m o CJ)~ <.n ~s;: me ~2!1 oZ m I )> ::0 2 m . ::0 CD 'tl o ::I- c'tl III III _10 ~ ~ ~ e ~ <.n - o N m en ... III ... CD m < III e- III ... o' ::l [fJ CJ 0:: ~ [fJ tr'J CJ ~ ...., ""-3 ...., tr'J rn ~ r ~ ~ ...., o 2 [fJ tr'J ~ ...., CJ tr'J @ CARLISLE INVESTMENT CLUB Partial Distribution October 21,2002 MEMBER Laurine Hardie Estate SHARES HELD 379 8934 TOTAL CLUB SHARES 333] 6107 TOTAL MONIES DISPERSED $ 16,Oill.tilll MUL TIPLlER 11.4 % or 4.80248 x shares held ( 16,000/3331.6107 ) and 0.01440 x shares held ( 48/3331.6107 ) YOUR DISTRIBUTION $ 1829.49 ( 1l.4 % x $ 16,000 ) . . CARLISLE INVESTMENT CLUB TOTAL CLUB PARTIAL DISTRIBUTION OCTOBER 21, 2002 NAME SHARES HELD % OF CI,UB DISTRIBUTION ($16,000.00.00) Bartoli,Maria 381.8582 11.5% $ 1,845.54 Dunkleberger, P. 562.6559 16.8% $ 2,696.08 Garrett,Anna M. 197.6841 06.0% $ 962.89 Hardie,Laurine 379.8934 11.4% $ 1,829.49 (Estate) Hoelscher,Barbara 390.2246 11. 7% $ 1,877.64 Hontz,Patricia 77.8327 02.3% $ 369.11 Ingle,Mary 82.6577 02.5% $ 401.21 Kirk,Elizabeth 411.6159 12.4% $ 1,989.97 Long,Jane 94.7473 02.8% $ 449.35 McMiIIen,John 346.0200 07.4% $ 1,187.56 Mowery.Marjorie 409.7768 12.3% $ 1,973.92 Parsons,A. 87.3972 02.6% $ 417.24 CARLISLE INVESTMENT CLUB FINANCIAL REPORT 5-31-02/10-21-02 Balance carried forward DEPOSITS: Partial share Agere Sale of Hershey 39.14J2 shares@.65.9224-18.91fees Sale of Diebold 154.6255 shares @. 33.9000 - 10.00 fee Sale of Colgate Palmolive 105.6J2 shares@. 53.530 - 17.72 fees Sale of Abbott Labs 69.2340 shares@. 38.7188 Sale of Agere A 1 share @. 1.60 $ 3.26 $ 2,565.28 $ 5,216.19 $ 5,625.69 $ 2,680.66 $ 1.60 Brokerage Dividends Bank Interest $ 16,092.68 $ $ $ 5.85 70.32 3.35 TOTAL BALANCE DISBURSEMENTS: Check #311 Check #304 $ 16,172.20 $ 579.81 $ 537.54 FINAL BALANCE $ 1,117.35 $ 1,612.17 $ 17,784.37 $16,667.02 "CONEST0GA"TITLE INSUAANCE co. u.~ uUt=rl:bCl::IDeer;l:elOo~~~~~ng ~ 1r . B. Type 0'" Lpa,ll Convtntional 6. File Number I' Loan Number 8. MOrtgage Insurance Case Number . 02-296123 8010061615 C. Note: This1form is furnished to give ~ou a statement of actual se~tlement costs. Amo~nts ~aid to and by the I?eft emelJ.t a~ent are shawgo lte s mGlrkid "~P,O.C.l" werr pa1-d outsl.de the closl.ng' hey are shown here for 10 ormatl.ona purposes an are not J.nc ude 10 the tota s. ' D. Name and Address of Borrower E. Name and Address of Seller F. Name and Address of Lender TIMOTHY E. BANKHEAD ESTATE OF LAURINE HARDIE NAVY FEDERAL CREDIT ONION KATHLEEN J. eANKHEAD EXECUT~R: WILLIAM G. HARDIE efi~~r~r~rI1R~~db8~~~te F Bb~~rWp~tt7!i~cle 11 ~nc Driye Boi i09 Spr1ngs PA 17007 G. Property Location H. Settlement Agent 11 Enck ori ye PA Real Estate Services, Inc. ~~~l~~~c~~ri?g: fu~. 17007 40-28-2100-190 Place of Settl~ment I. Closing Date 10 W~SI Porn ret Street Carl~s e PA 17013 Sept. 1] . 2002 J. Summary of Borrower's Transaction K. Sununary of Seller's Transaction 100. Gros& Amount. Due Prom BorroWElr 400. Gross AInount Due To Seller 101. Contract sales price 149,000.00 40l. Contract sales price 149,000.00 102. Personal Property 402. Personal property 103. r~ttlernent Charges to borrower 4,546.54 403. ( ~ne 1400) 104. 404. 105. 405. Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance 106. City/town taxes to 406. City/to'Hn ta~es to . 107. County taxes 9/13/02 to 1/1/03 100.10 407. County taxes 9/13/02 to 1/1/03 100.10 108. Assessments to 408. Assessments to 109. School Taxes 9/13/02 to 7/1/03 1,297.B6 409. School Taxes 9/13/02 to 7/1/03 1,297.B6 110. 410. 111. 41l. 112. 412. 120. Gross Amount Due From Borrower 154,944.50 420. Gross Amount Due to Seller 150,397.96 200. 1unoutlts Paid By Or In Behalf Of Borrower SOIL Reductions Itl AInount Due to Seller 201. Deposit or earnest money 1,000.00 SOl. Excess deposit {see instructions} 202. Principal amount of new loan (s) 149.000.00 502. r~ttlement charges to seller 10,862.50 ( ~ne l400) 203. Existing loan (s) taken subject to 503. Existing loao(s) taken subject to 204.. 504. Payoff of first mortgage loan 205. 505. Payoff of second mortgage loan 206. 506. 207. 507. 208. 508. 209. S09. Adjustments for items unpaid by seller Adjustments for items unpaid by seller 210. City/town taxes to 510. City/town taxes to 211. County taxes to . 511. County taxes to 212. Assesaments to 512. Assessments to 213. School Taxes to 513. School Taxes to 214 . 514. 215. 515. 216. 516. 217. 517 . 218. SIB. 219. 519. 220. Total Paid By/For Borrower 150,000.00 520.Total Reduction in Amount Due to 10,B62.50 Seller 300. Cash At Settlement From/To Borrower 600. Cash At Settlemetlt To/From Seller 301. 'HosS ,""oynt due from borrower 154,944.50 601. 1195S ~~8rnt due to seller 150,397. 96 ~ne 120 'ne 302. y'ss ~~ynts paid by/tor borrower 150,000.00 602. r~SS redyctions in <imount due seller 10,B62. 50 ( ~ne ( ~ne 520. , 303. Cash from Borrowers 4.944.50 603. Cash to Sellers 139,535.46 OMB No 2502 0265 rEV, HUD-l (3.186) ~A mLE lliSUB8.OCE CO U.S, DEPARTMENT OF HOUSING AN~E~V~f~ . ,I L. S~ttleme~t Charges: 700. Total sal~s';Bllbker' s Commission based on price $ 149,000.00@ 6t; . $ a, 940, 00 Pflf.JjOM Pml FROM Divi!tion of Commission (line 'Jool as follows: :i R Nt' R'~ . S TLIM~NT 10L $ <1,<195,00 to George L. Ebener and Associates 702, $ 4,445,00 to Century 21 Associates: Coon & Co, 703, Commission paid at Settlement e,940,00 704. Settlement. Fee to Century 21 Associates: Coon & Co. 125,00 800. Items Payable in Connection With Loan 801, Loan Origination Fee a02. Loan Discount ,250% to Navy Federal Credit Union 312,50 B03. Appraisal Fee to Absolute Real Estate Appraisals (POC $300.00) 804. Credit Report to Equifax 14,00 805, Flood Determination to Flood Data Serll'ices, Inc. 13 .50 806. Tax Set.-up Fee to 1.~ American R,E. Tax Service, Inc, 1.00 807. Tax Service Fee to lOt American R,E. Tax Service, Inc. 45.00 a08. 809. alO. Wire Fee 1$5.00) and Courier Fee ($15.00) to PA Real Estate Services, Inc. 20.00 811. 900. Items Required by Lendet' to be Paid in Advance 901- Interes.t from to @ $ jday 902. Mortgage Insurance Premium for months to 903. Hazard Insurance Premium to USAA 339.88 904. 905. 1000. Reserves Deposited With t.ender For . 1001. Hazard insurance 2 mont.hs @ $ 28.32 per month 56.64 1002. Mortgage insurance months . $ per month 1003. City property taxes months . $ per month 1004. County property taxes 7 months @ $ 21.81 per mont.h 195.09 1005. Annual assessments months @ $ per month 1006. School Taxes 3 months . $135.77 per mont.h 40'J.31 1007. months @ $ per month 1008. Aggregate Escrow Adjustment - 275.13 nOD. Title Charges 1101, Settlement or closing fee to 1102. Abstract. or title search to ABCO 1103. Title ex.amination to 1104. Title insurance binder to H05. Document preparation to 1106. Notary fees to Denise Pinamonti 14.00 1107. Attorney'g fees to Saidis, Shuff, Flower & Lindsay MC { includes o.Dove it.em numbers: 1101, 1105) 1108, Title insurance to CONESTOGA TI'l"LE INSURANCB Co. I PA Real Estate Services, Inc. 1,103.75 (includes above item numbers: 1102-1105) 1109. Lender's coverage $ 149,000.00 1110, Owner's coverage $ 149,000,00 1111. Endorsements: 100, 300, 8.1 150.00 1112, DRO Lien Search to DRS/Lien Search 1113, Closing protect.ion Letter to Conestogel Title Insurance Company 35,00 1200. Government Recording and Transfer charg$s 1201. Recording fees: Deed $28.50, Mortgage $54,50; Releases $ 83,00 1202. City/county/stamps: Deed $ 1.490,00 1,4.90.00 120) . State tax/stamps: Deed $ 1,490,00 1,490.00 - 1204. 1205. 1300, kdditional 3attlement. Charyes 1301. Radon Mitigation to American Radon Solutions 350.00 350.00 1302, Pest inspection to Lloyd's Home Inspect.ion, Inc. (Buyer POC $ 50.00l 1303. Property Inspection to t.o Lloyd's Home Inspection, Inc. (Buyer POC $250,00) 1304. Final Water/Sewer to South Middleton Township, Account ~o. 004054 82.50 1305. Radon Testing to Lloyd'S Home Inspection, Inc. tBuyer poe $100.00) 1400. Total Settlement Charges (enter on lines 103, Section J and 502. Section K) 4,546.54 10,862.50 I have carefU~1 revlewed the HUD-1 S~TgLEMENT STAIEMEN~ and to the best ofbmy knowle~e and bellef. It lS ahtrlle and accura~at nt ot ail rece'gts an lSbU/isemeo sTma e on myTaCCQunt r I.me l~ t IS transactla",~ .~urc er certHy t ave ~elv~a1 opy 0 he H D-1 S T LE oN1' STA "MENT. 1V or I./V...- f-wJ~tu...- .o/~= _t t Borrower To t.he best. of my knowledge, the HUD-l SETTLEMENT STATEMENT which I were re~~na h;ve been or ~il1 be disbursed by the undersigned -.-_ ,'R~ Settlement Agent rue and accurat.e account of ement of this t.ransaction. 7.-- the funds which Date /7-7 2.- ~ REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT ;.lEV.1500 EX + (6-00) , CAPB HpRL EplO CRAC KOTK ES FILE NUMBER o E C E o E N T COMMONWEAlTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128.0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Hardie Laurine DATE OF DEATH (MM-DO.YEAR) OFFICIAL USE ONLY 21-02-0682 YEAR NUMBER COUNTY CODE SOCIAL SECURITY NUMBER 123-34-4047 nIIS RETURN YJST BE AI..BJ III DUPI.JCA REGISTER OF WILLS SOCIAL SECURITY NUMBER 1. 4. X 6. X 2. 4a. 7. Supplemental Return 3. lflol~rM~ca~~ Compromise (date of death after 12-12- 2) 5. Beqai:tedt Maintained a Uving Trust 1 8. ~pyofTrusl) (da pM Federal Estate Tax Return Remainder Return Tolal Number of Sate Depo Election 10 tax under Sec. 9 C P o 0 R N R 0 E E S N T Original Return limited Estate Decedent Died Testate 09. (AttachcopyoIWI!l) litigation Proceeds ReceivedD 10. Spousal Poverty Credit 011. OFFICIAL USE ONLY ::0,. (8) 0.00 (11) 3.373.38 (12) (3,373.38) (13) (14) (3,373.38) (15) (16) (17) (18) (19) 0.00 0.00 0.00 0.00 0.00 NAME Robert C. Saidis FIRM NAME (If Applicable) Saidis, Shuff, Flower & Lindsa TELEPHONE NUMBER COMPLETE MAILING ADDRESS 2109 Market St. Camp Hill, PA 17011 R E C A P I T U L A T I o N 3 -34 1 Real Estate (Schedule A) 2Stocks and Bonds (Schedule B) 3Closely Held Corporation, Partnership or Sole-Proprietorship 4Mortgages & Notes Receivable (Schedule 0) Seash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6Joinijy Owned Property (Schedule F) Deparate Billing Requested 7lnter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) a:rotal Gross Assets (total lines 1-7) 9Funeral Expenses & Administrative Costs (Schedule H) 10Jebts of Decedent, Mortgage Liabilities, & Liens (Schedule I) l1Total Deductions (total lines 9 & 10) talet Value of Estate (Line 8 minus Line 11) 1 ~haritable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) toilet Value Subject to Tax Line 12 minus Line 13) (1) (2) (3) None None Np(\e (4) (5) None None (6) None (7) None (9) (10) None 3,373.38 C o M T C A T X A T I o N SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 1 ~mount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(I.2) 160.mount of Line 14 taxable at lineal rate 17Amount of Line 14 taxable at sibling rate 1 ~mount of Line 14 taxable at collateral rate 19rax Due 20. X .0 0 .045 x (3,373.38) X X X .12 .15 Copyright (c) 2000 IOnTI software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 11 Enck Drive CITY STATE I ZIP I Boiling Springs PA 17007 Tax Payments and Credits: Uax Due (Page 1 Line 19) 2CreditslPaymenls A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 Total Credits ( A + B + C) (2) 0.00 3Jnterest/Penalty if applicable D. Interest E. Penalty Totallnterest'Penalty ( D + E ) (3) 41f Une 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) SJf Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line S ... SA. This is the BALANCE DUE. (5B) . . Make Check Payable to: REGISTER OF WILLl)!AG..NT "'[i;i;;:::;::::;:;;:::::::::::,i:::::::::::::;:;:m::::;::::::::::::::!1111111111:1:11::::::::::::::::::111Iii:!:::::::::!!!:!;;;;::!!::!!:!!:::::::::::';;::::!::::;:::::::;::::::i::!i::m:::::;:;:::: :::::::::::;;:::::::::::::::::::::::::::::::::::::::;;:::::::::::::::::;::::::::::!:Wm:;;:il:::::L;;;;:::::;.;:':i;;;;;:i%i;];lii;;;;;;";':'"'' . PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS . ().IJJ{) 's 1,IIl nOR 0.00 0.00 mm!I!!!!! 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? . . . . . . . . . . . . 211 death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . , . . . . 30id decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............,. . . . . . . . . . . . . . .. ....... 40id 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. Yes No ~~ IT] IT] []] o o o Under penalties 01 pe~ury. I declare that I have examined this retum, Includin~ al:;companyllVlJ schedules and stat9!T\9nts, and to-the best 01 my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the pelSOIlal representative is based on all information of which preparer has any knowledge. William G. Hardie 310 Norwich Lane ,. iandenbe':",' 'PA' - '19356''' -"',"',' m""" Saidis, Shuff, Flower & Lindsay 2109 Market St. "'Cani . 'Hili - 'Pi..' -noii -,' ". '" ,,' -" ",- -"',' ~/;43 o A T 8 A T E for dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 9116 (a) (1.1) (i)]. For dates of dea.l:h 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) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty.one years of age or younger at death to or for the use of a natural parent, an adoptive parent, 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 P.S. 9116(a)(1)]. The tax rate imposed on the net value Of transfers to or for the use of the decedent's siblings is 12% [72 P,S. 9116(a)(1.3)]. 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-1512~ +(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Laurine Hardie SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SS/f 123-34-4047 FILE NUMBER 21-02-0682 07/25/2002 Include u"reimbursed medical expenses. ITEM NUMBER 10 1 DESCRIPTION The following were checks written on the decedent's checking account which cleared after date of death (acct. titled jointly with decedent's son - therefore 1/2 of the amount of the amt. is shown) *see attached copies of checks and dates checks cleared F&M Trust return of automatic deposit of pension and teacher's retirmement (full amount was 3,217.62) 1,608.81 AMOUNT 2 State Farm insurance premium (full amount $279.00) 139.50 3 Home Instead Senior Care (full amount $1175.33) 687.67 4 Carlisle Imaging Assoc. (full amount $24.13) 12.07 5 Judy A. Campbell Tax Collector (full amount $1596.64) 798.32 6 Comcast (full amount $37.54) 18.77 7 CME (full amount $25.00) 12.50 8 Verizon Wireless (full amount $38.72) 19.36 9 Judy A. Campbell Tax Collector (full amount $9.80) 4.90 Dr. Patel (full amount $142.95) 71.48 TOTAL (Also enler on line 10. Ree"oilul"tion) S 3.373.38 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 lonn software only CPSystems, Inc. Fonn REV-1512 EX (Rev. 1-97) CHAMBERS BURG BOILING SPRINGS MARION MONT ALTO NEWVILLE SHIPPENSBURG WAYNESBORO CARLISLE TRUST rot Clf P<l1>d,,,Q (7/31) cr....th,U'l5{02. =I:.../. T'''leho,""fu!t. (1131) 3;l':I5S27 TOClA,Y W~ ....\IE: ......'T.... YO,," ""call""' "" Otf'el'l"m lI""aw o..c..,.....,.. 815/02 ] ...o~... ,)217.1>2 1ID.~" F...t:~t:.. 'n hr.cok II.. V' ::Bo:llln&SPtlngll.PA170D7 I~03B01,,30101: ~,~.......>::..---- Hl.!:Bi':?lI" ,...00003in.,?!;,U 0&/06/02 Transaction Amount $3,217.62 v JAURINE. HARDIE \VlLUt\.\fG..HARDIE: ~t6 998 I1rs~tKt. %I':::;:r . w~Csr~CS.PA I:u!? ~~~~~-;.~ '-'VTn ~~ ~_ I $~11 ""'W-ul.'f3oas3099 '"'400 i'1 41.91 4~1.~1r .""I:t -:h..=~~ 1'" ",:a~'?JJa~ Fsr.t S~ Sj}M9S,OJ't . ~ & ~~-'l<O-'i -;;)';!J!::t$.~::L " ':03.l.;Oa.:iOSI: 33-1.5827'" O"iqg "-000002?G:OO..- ~ _.- 07/30/02 Check #0998 Amount $279.00 I . ,/i ! Li\UlUNEHMOIE \vtLUA..\fC.liARDlE ~1Ei 1000 UL....O':lXL Y'.' t.Q1.L'I;CSPRt\"'CS.I'Ar.301 l'_".!!I_~2..~ hY_Tt'l>_~..\..A.nt...-....Q ~ :.., r. is 1175'," ~.._.....~.... ~;;> __1'........... --e,.. ~ ./..._...~ -Gl....:..~:.r... u.,.....O:;;s:::- ~ t..l G<lln~ C-L D.' ~~.'"',. ",,-c),>-... .2l'(4~4f;-r...-Z '" -a:O:1I,30a.30gl: 33-\581:'71;& 1000 .r000011.75::1301" 07/30/02 Check #1000 Amount $1, 175,33 LAU1UNE HARDIE \m1JfJ\.ic.HARO~ UDiCJ(Plt t.O:u."Csnu:.~.PA t:'llQ1 ~'6 1.002 .-..., t=~,.1<.-'" ./ r~~~~~"fI. ...t~~_~~ '$~<(.I~ ~'n:~~ -.J,... '!>/11b l'~...g FeW 0500S,,705 Sm~~:.1'R TRUST -.off- I i~ r - 17 ~""",'.~'c5.'L_ ~k_LL'" ~'" .a:O:;U30a..3QSr: ::U-J,S&i!?ao: lOO~ "'000000i!\,),1..- 07/31/0:2 Check #1002 Amount $2413 LAURlNE HAAD1E WILLlAM G. .H.ARJ)lE tlt."CKt1;;t. Co:w,;csP~~.r.\ l::m' ~J:::t6 lQ04 ..~ ~~~~~ Co- "~'t_m~_{"\,to....c.''t_lL-c.:.--"''~~~~ $ ',Sqs,. "''I , ..,...>f1 J" . / ~,.... _-,"~ ~,.,,0l2:;' \ n }.~~ qold:;'l101lll.Jf1\~' C'J. lJ 1\ --;1//) :/." ~--.:L~~...l.R:::L~D _...:::J.;~/~:?Z"_~'?:<4 I:O~a30";?0I;li: :303-1582....1:" 1,00l., ...OOOO.5IU;&-.... 08/12/02 Check #1004 Amount $1596.64 Account: 3315827 Statement Date 8/23/2002 Page I of2 LAURlNB HAltDIE \VJLUMf G. HARDrE l1L"CKll;t. 1lD:u.",csr:.....-x,.I.." 1:<:m' ~~6 r'= r'-!!.~+l-- 991 f~~-~~-Y-~'~~'t"'_-- ~~~-,-~~Q ~/n~.. FSM . TfIUSf 1.~" ~..lllSs:...l.~ I::O::n301.3.0&1: 33-J.SA.2?t" O1il9? 1$ d7.<V .. __ G--""'" 29$J7Z2U.: .,nOOOOO3.15"'~ 07129/02 Check #0997 Amount $37.54 ~~:r~lE rw'6 999 Ux:.;G::D'- ':1\=.. . oo:usq~('f:[!I;Q;,PA l:tx::r> r.'!1'~2~~...'t.- I ",.~~_~J'M" , $ .:<s.,.., ................"" . . J i ~~bef1{,1 ":.,." ~~ v'! ~ 06~02.fl2qS ~ 1:1 t.2OQ !.232 -1Mf ~">.I.nr~~'L.If,.A ~~tr-""Zb'~.:nt.__ 4;ft,.~ ~>/i-~ J:03\3.01.30&1: )3....1582?J!' Oqqq ...OOOOOO:t!5iJO'" .____.__ -c- .. 07/30/02 Check #0999 Amount $25.00 I U~~~~~,q~7001b5 ~~nt G. ~i f.) ~4 $1.1:)111 [1 CO:uo,;CS.l"Jlt"\C$.l"A .r.oo'1 q:,~~16 P.i:~'7M~~"L. -----1 $ 3~,),- 1001 f>.\'_m-,.I..,..~1:r - L...~ ,.....~... -\:!",.;;~~~_"-~~"" . ___' Gl =- FS'M i;..l.~~ c'!.'u . =-"'=~.sz..~~, _J.b~"A~_._" .:03'13:0'.3061: :n-1.SBi!?l1'" l.001 ...OOOOOOla1'lJ' 07/29/02 Check fllOOl Amount $38.72 ''''-' I uUIUNF.: HARDIE t~ \\1LUAM G. HARDIE n-16 Il[XO::~ 13~.t;;1 r:O:J..l."C;~~C"I.r/I. Y.';1.'1 .c~J.'-%~~~'l..- ;~,:'c)~""'J.(.LCc~k<.'-,~I:._J $ 'l.1Jo ~..J."-/L}!::b",, ._._. !il = 1 O~:1 ~ Ci ~(O;ta""~. c c., , 1BlJST "".~ f<-,~ -c //I..C h'l/ < "~ ~crinC>",-,,'I1'tL_ _.Jh,';i.;,A',.1~~1tL._~ .:031::101.3.0&1: :;I3..1Sa2?1I" ;'00:1 - o'"oanOr;ooqf\iJ... 08/12/02 Check #100~ 0.m.-~_RO ttAURINE HARDiE WIUJAM G. HARDiE nC:CKt)lt. CO;:U!\:CS.W~[;':O,l'''' 1;-;;m STi"U$ 1005 ~.,..~ ~Y!"_~..,--=Z;Sr-~O'l.. i NY~JO_O-.....-.L.~td--I"\;1.....\.. o!.....C.d.'~' 1$ I"tJ.qS i ~=t~~_.~~--l:,db~~:L_nLq-O q,<<:"l-=- l_~,l~"" rJ ;::;::;:- 1 ~ EJ /"f'.c,!'r~7;f ')'" "".'.krr_f.692L.__1J-Al! ../?--4r'?k-- .~ ...J ':03:' 30l.=lOt:',.: 3, '1"'\5.8 -~7'" 1005 0"'00.:'00 {It.., 2'>15'" 07111102 Ch~d "lOW, /'.lI)nllnt$I.f1.95 ESTATE OF LAURINE HARDIE FILE NO. 21-02-0682 SUPPLEMENTAL INHERITANCE TAX RETURN NOTE: Executor proposes to include as additional deductions not included on the original return, checks written on behalf of the decedent from the F &M bank account owned jointly by decedent and her son, William G. Hardie. These checks and deductions were posted after the date of decedent's death and so were not reflected in the date of death balance stated on the original return. The additional deductions reduce the amount of assets subject to the 4.5% tax rate. (i.e. $449,997.20 - 3,373.38 = 446,623.82 x 4.5% = $20,098.07). Therefore, the executor is requesting a refund of$151.80, the difference between $20,249.87 and $20,098.07. LAW OFFICES JOHN E. SLIKE ROBERT C. SAIDIS GEOFFREY S. SHUFF JAMES D. FLOWER, JR. CAROL J. LINDSAY KIRK S. SOHONAGE THOMAS E. FLOWER LINDSAY GINGRICH MACLAY JACLYN M. SMITH SAIDIS, SHUFF, FLOWER & LINDSAY A PROFESSIONAL CORPORATION 2109 MARKET STREET CAMP HILL, PENNSYL V ANI A 17011 TELEPHONE: (717) 737-3405 - FACSIMILE: (717) 737-3407 EMAIL attorney@ssfl-Iaw.com www.ssfl-Iaw.com CARLISLE OFFICE: 26 W. HIGH STREET CARLISLE, PA 17013 TELEPHONE: (717)243-6222 FACSIMILE: (717)243-6486 REPLY TO CAMP HILL February 21,2003 Register of Wills Cumberland County Courthouse Carlisle, PA 17013 Re: The Estate of Laurine Hardie File No. 21-02-0682 Dear Ladies: Enclosed please tind an original and copies of an inheritance tax return in regard to the above estate. Also enclosed is a check for the tiling fee. Kindly return a time-stamped copy of the return to our office in the envelope provided. Very truly yours, _SAID", SH~F., F, FLOWER & LINDSAY \ ..ILI U; I '/ 8h~lby L. :kidjlflng, Estate Paralegal u /sly Enclosures - ~;~f'-:i:t~;:~!:r ~:;:?;'1f"::;:.;~ fC; \~:;:;:i'(;2' , >~ ,~ ::~) .s ~~ ::f:.>/ , d.~, j:()::, i:;( SAlOIS SHUFF, FLOWER & LINDSAY ATTORNEYS-AT.LAW 2109 Market Street Camp Hill, PA 17011 .ter of Wills lerland County Courthouse .Ie, PA 17013 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX("-96j RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SAlOIS ROBERT C 26 W HIGH STREET CARLISLE, PA 17013 nn fold ESTATE INFORMATION: SSN: 123-34-4047 FILE NUMBER: 2102-0682 DECEDENT NAME: HARDIE lAURINE DATE OF PAYMENT: 10/23/2002 POSTMARK DATE: 10/22/2002 COUNTY: CUMBERLAND DATE OF DEATH: 07/25/2002 NO. CD 001766 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $32,500.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK#1028 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS $32,500.00 MARY C. lEWIS REGISTER OF WILLS Q Ul 3 2': -0 '" 0 :I:~ - ==g~01 ~ 1 UHU J'~Z:I::!i ='~O~O ~sa.~..,,3 '< ~ ~ () <sa-<~m Ol ~ , 2.m 0 Ol~ ::E ~ m ~ ::0 ~ ~ .... .J o .... (J ... iJ (J .!l '" o '" ()():;D 00 c: (1) ::l.. 3 <e. (ii.'O"~ -(1)(1) ~co :l. ~ iJlllO )>:J_ -'~~ -..10== oc:'" -':J 0>,..,. '< () o c: ;:+ =:; o c: '" (1) ~ \ ~ , \. 1-'/- :JR. ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN ROBERT C SAIDIS SAlOIS ETAL 2109 MARKET ST CAMP HILL PA 17011 04-14-2003 HARDIE 07-25-2002 21 02-0682 CUMBERLAND 101 *' REY-1541EX AFP (Ol-U) LAURINE Allount Rellitted 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 ~ REY=i5'4rEX--AFP-[oFiiiY-NoT"icE--OF-i-NHERifiiN"CE-,.-A"X-APPRAISEHEN''-~--Ai:.IiiwAi.fcE-oR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF HARDIE LAURINE FILE NO. 21 02-0682 ACN 101 DATE 04-14-2003 TAX RETURN WAS, (X) ACCEPTED AS FILED CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule AJ 2. Stocks and Bonds (Schedule B) 3. Closely Held stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule OJ 5. Cash/Bank Deposits/Misc. Personal Property {Schedule EJ 6. Jointly Owned Property (Schedule f) 7. Transfers (Schedule Gl 8. Total Assets (1) (2) (3) (4) (5) (6) (7) 149.000.00 232,604.44 .00 .00 19,798.67 18,368.96 162,820.01 IB) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule HJ 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax [9) (10) 32,726.65 NOTE: To insure proper credit to your account~ submit the upper portion of this form with your tax payment. 582,592.08 41 .~94 88 540,997.20 35,000.00 505,997.20 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 (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: .00 X 00 ; .00 449,997.20 X 045 ; 20,249.87 20,000.00 X 12 ; 2,400.00 36,000.00 X 15 ; 5,400.00 (19); 28,049.87 8.868.23 [11) [12) (13) (14) rAmeR' <+, AMOUNT PAID DATE NUHBER INTEREST/PEN PAID 1-) 10-22-2002 CDOO1766 1,402.49 32,500.00 TOTAL TAX CREDIT 33,902.49 BALANCE OF TAX DUE 5,852.62CR INTEREST AND PEN. .00 TOTAL DUE 5,852.62CR . IF PAID AFTER DATE INDICATED~ SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1~ NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)~ YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) \., /;7- ??'" '} BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG7 PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REY.U07 EX AFP (01.03) Rar',-" ,,",,"",'-'- RHfi" , :t: : .03 liAY 16 DATE ESTATE OF DATE OF DEATH 1\\0 :1l'9-E NUMBER COUNTY ACN 04-28-2003 HARDIE 07-25-2002 21 02-0682 CUMBERLAND 101 LAURINE RDBERT C SAIDIS SAIDIS ETAL 2109 MARKET ST CAMP HILL Cis'fl;- Cl!mb2.~, PA 17011 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD CDURT HDUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV': i6ifj-EX"Af'P-fiiFo3Y------iiio..ufNifERii:ANCE--fAiCs";.YEME-N'f-oF'-Ac-coiiirf--..-...."-------------------- ESTATE OF HARDIE LAURINE FILE NO.21 02-0682 ACN 101 DATE 04-28-2003 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-07-2003 PRINCIPAL TAX DUE:.. 28,049.87 PAYMENTS (TAX CREDITSJ: PAYMENT RECEIPT DISCOUNT (+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-J 10-22-2002 CDOO1766 1,402.49 32,500.00 04-09-2003 REFUND .00 5,852.62- TOTAL TAX CREDIT 28,049.87 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J LAW OFFICES JOHN E. SLIKE ROBERT C. SAlOIS GEOFFREY S. SHUFF JAMES D. FLOWER, JR. CAROL J. LINDSAY MATTHEW J. ESHELMAN' KIRK S. SOHONAGE THOMAS E. FLOWER LINDSAY GINGRICH MACLAY JACLYNSMITH SAIDIS, SHUFF, FLOWER & LINDSAY A PROFESSIONAL CORPORATION 2109 MARKET STREET CAMP HILL, PENNSYLVANIA 17011 TELEPHONE: (717) 737-3405 - FACSIMILE: (717) 737-3407 EMAIL: attomey@ssfl-Iaw.com www.ssfl-Iaw.com CARLISLE OFFICE: 26 W. HIGH STREET CARLISLE, P A 17013 TELEPHONE: (717)243-6222 FACSIMILE: (717)243-6486 REPLY TO CAMP HILL September 3,2003 Register of Wills Cumberland County Courthouse Carlisle, PA 17013 Re: The Estate of Laurine Hardie File No. 21-02-0682 ~ '" Dear Ladies: Enclosed please find an original and copies of a supplemental inheritance tax return in regard to the above estate. Also enclosed is a check for the filing fee. Please return a time-stamped copy of the return to our office in the envelope provided. Thank you. /sly Enclosures UFF, FLOWER & LINDSAY t Board Certified by the American Board of Certification in Creditors' Rights Representation SAlDlS SHUFF. FLOWER & LINDSAY ATTORNEYS_AT_LAW 2109 Market Street Camp Hill, PA l70ll , Q~\'I/~g)J c9J.I 'rJ1 If TO: Register of Wills Cumberland County Courthouse Carlisle, PA 17013 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA L1K STATUS REPORT UNDER RULE 6.12 Name of Decedent: Laurine Hardie Date of Death: July 25, 2002 Will No. 21-02-0682 Admin. No. 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: complete: 1. State Yes ~; whether No administration of the estate is 2 . representative complete: If the answer is No, state when the personal reasonably believes that the administration will be 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes ; No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes~; No d. Copies of receipts, approvals of formal or informal account Clerk of the Orphans' Court and may b"~ tt Date: ? ~ u/,3 releases, joinders and may be filed with the ched to this report. / / Signat Name: obert Esquir~ I.D. No. 21458 SAIDIS, SHUFF, FLOWER & LINDSAY 2109 Market Street Camp Hill, PA 17011 (717) 737-3405 Capacity: Personal Representative X Counsel for Personal Representative 1"7- ?J?- P ~ 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 RU-1547 EX 'FP (Ol~05l ROBERT C SAIDIS SAIDIS ETAL 2109 MARKET ST CAMP HILL DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-29-2003 HARDIE 07-25-2002 21 02-0682 CUMBERLAND 101 LAURINE Allount Remitted PA 17011 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 ... RW=iS4'-EX-AFP--filFoiY-NoTicE--oF-i-NHEifiTAifci-l:Ax-APPRAisEHENT:--ALi-oWAifci-oR"----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF HARDIE LAURINE FILE NO. 21 02-0682 ACN 101 DATE 09-29-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN NO. 01 1. Real Estate (Schedule A) (1) 2. stocks and Bonds {Schedule BJ (2) 3. Closely Held stock/Partnership Interest (Schedule C) (3) 4. Hortgages/Notes Receivable {Schedule OJ (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule FJ (6) 7. Transfers (Schedule G) (]) 8. Total Assets . 00 NOTE: To insure proper . 00 credi t to your account, . 00 sublli t the upper portion . 00 of this forll with your . 00 tax paYllent. .00 .00 (8) .00 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) .00 3.373.38 1111 (12) [13) (14) :I 373 :\8 3,373.38- .00 502,623.82 NOTE: If an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and 19 will reflect figures that include the total of ~ returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due .00 X 00 = .00 446,623.82 X 045 = 20,098.07 20,000.00 X 12 = 2,400.00 36,000.00 X 15 = 5,400.00 (19)= 27,898.07 TAY CREDITS: ,., AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 10-22-2002 CDOO1766 1,394.90 32,500.00 04-09-2003 REFUND .00 5,852.62- TOTAL TAX CREDIT 28,042.28 BALANCE OF TAX DUE 144.21CR INTEREST AND PEN. .00 TOTAL DUE 144.21CR . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. [ IF TOTAL DUE IS LESS THAN 01, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIP' (CR) 1 YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~ /7- '7R-;? BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT ROBERT C SAIDIS SAIDIS ETAL 2109 MARKET ST CAMP HILL DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN '*' REY-16D7EK'FPUI-OJ> 10-27-2003 HARDIE 07-25-2002 21 02-0682 CUMBERLAND 101 LAURINE Allount Remitted PA 17011 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account~ submit the upper portion of this for.. with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ iiifV"=i60Tix--AFiQiiFiii-J-------...--iNifERITANCrf;.x--STAfEHE}if-o-F"-;.cfciiUirf--.-..--------------------- ESTATE OF HARDIE LAURINE FILE NO.21 02-0682 ACN 101 DATE 10-27-2003 TNIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-29-2003 PRINCIPAL TAX DUE:~ 27,898.07 PAYMENTS (TAX CREDITSJ: PAYMENT RECEIPT DISCOUNT (+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-J 10-22-2002 CDOO1766 1,394.90 32,500.00 04-09-2003 REFUND .00 5,852.62- 10-09-2003 REFUND .00 144.21- TOTAL TAX CREDIT 27,898.07 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATEI SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. [ IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. J ---I 15056041147 REV.1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX.280601 Harrisburg, PA 17128-0601 ENTER DECEDENTlNFORMATION BELOW Social Security Number Date of Death . OFFICIAL USE ONLY County Code Year INHERITANCE TAX RETURN RESIDENT DECEDENT 2 1 0 2 Date of Birth 123 34 4047 07 25 2002 04 18 1928 Decedent's Last Name Suffix Decedent's First Name MI HARDIE LAURINE (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW [J 1. Original Return 2. Supplemental Return o o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 6. Decedent Died Teslate (Attach Copy of Will) [!J o o o 4a. Future Interest Compromise (date of death after 12-12-82) D 4. Limited Estate [K] 7 Decedent Maintained a Living Trust . (Attach Copy oITrust) 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received 10 Spousal Poverty Credit (date of death . between 12-31-'91 and H-95) o 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT. THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ROBERT C SAlOIS 717 243 6222,_ Firm Name (If Applicable) SAlOIS, FLOWER & LINDSAY REGISTER OF WlLLS USEONL Y ;"',__-t First line of address r. " 26 WEST HIGH STREET ~'l Second line of address City or Post Office { 'I DATE FILED i...-\ CARLISLE State PA ZIP Code 17013 Correspondent's e-mail address: William G Hardie ;J1krc.{ /?'/ 2009 310 Norwich Lane, Landenberg, PA 19350 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE Robert C Saidis ADDRESS 26 West High Street, Carlisle, PA 17013 Side 1 L 1505b01l11117 1505b01l11117 ---I --.J 1SDSbDlf21lf& REV-1500 EX Decedent's Name: La u ri n e Hard i e Decedent's Social Security Number 123 34 4047 RECAPITULATION 1. Real Estate (Schedule A).......................................................................................... 1. 2. Stocks and Bonds (Schedule B)............................................................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D).......................................................... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E)................ 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 Separate Billing Requested............. 7. 8. Total Gross Assets (total Lines 1-7)....................................................................... 8. 9. Funeral Expenses & Administrative Costs (Schedule H)......................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)................................ 10. 11. Total Deductions (total Lines 9 & 10)...................................................................... 11. 12. Net Value of Estate (Line 8 minus Line 11)............................................................. 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J)................................................. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13)................................................. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, of transfers under Sec. 9116 (a)(1.2)X~ 0 .00 16. Amount of Line 14 taxable at lineal rate X .045 1 , 3 7 1 . 2 2 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 15. 16. 19. Tax Due............. ................................. ...... .................... ........ ..................... ................ 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. S\de '2. \-- \~~~'on\\c.\~tl 5. 1,586.22 1,586.22 215.00 215.00 1,371.22 14. 1,371.22 0.00 61.70 17. 0.00 18. o . 00 61.70 D 1asnSbn,",c1a,",& .-1 REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME Laurine Hardie STREET ADDRESS 11 Enck Drive r---~-- File Number 21-02-0687 -- f--.----- CITY I STATE PA IZIP I 17007 -- Boiling Springs Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 61.70 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (3) (4) (5) 61.70 (SA) (5B) 61.70 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS No o [!J o [!J o [!J o [!J o [!J 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 0 [!J 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?..................................................................................................................... 0 [!J IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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? ....... .................. ....................................... ........................................... ............ Yes 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 three (3) percent [72 P.S. 99116 (a) (1.1) (i)]. 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 zero (0) percent [72 P.S. 99116 (a) (1.1) (Ii)]. The statute does not exemDt 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 zero (0) percent [72 P.S. 99116 (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 four and one-half (4.5) percent, except as noted in 72 P.S. 99116 1.2) [72 P.S. 99116 (a) (1)). The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. S9116 (a) (1.3)]. 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. Rev-1508 EX+ (6-98) *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Hardie, Laurine FILE NUMBER 21-02-0687 ESTATE OF Include the proceeds of litigation and the date the proceeds were received by the estate. All property JolntJy-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Carlisle Investment Club - Additional assets held by the Club found. 1,586.22 On the original Inheritance Tax Return an amount of $1,829.49 was reported which represented an 11.4% interest in the Club held by Laurine Hardie. Once the process was started to dissolve the Club, checks were found that had not been cashed (replacement checks had to be requested) and stocks were found that were not realized assets at the time of her death. To compensate the Estate for the percentage Laurine Hardie was entitled to receive, the Club issued a check to the Executor of the Estate. TOTAL (Also enter on Line 5, Recapitulation) 1,586.22 (If more space is needed. additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA.1500 Schedule E (Rev. 6-98) REV-1151 EX+ (12-99) . SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Hardie, Laurine Debts of decedent must be reported on Schedule I. FILE NUMBER 21-02-0687 ESTATE OF ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip - Year(s) Commission paid 2. Attorney's Fees Said is, Flower & Lindsay 200.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 15.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 215.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1502 EX+ (6-98) . SCHEDULE H.87 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Hardie, Laurine FILE NUMBER 21-02-0687 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Register of Wills - Filing Fee for Supplemental Return 15.00 Subtotal 15.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) REV.1513 EX+ (9-00) . SCHEDULE .J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER Hardie, Laurine NAME AND ADDRESS OF PERSON(S} RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a}(1.2)] RELATIONSHIP TO DECEDENT Do Not List Trusteelsl FILE NUMBER 21-02-0687 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) I. 1 Thomas L Hardie 845 Bryn Mawr Avenue Newtown Square, PA 19073 Son One-Third (1/3) of Residue 457.07 2 William G Hardie 310 Norwich Lane Landenberg, PA 19350 Son One-Third (1/3) of Residue 457.08 3 Darlene Hardie-Muncy 2 Patrick Henry Place Ringoes, NJ 08551 Daughter One-Third of Residue 457.07 Total 1,371.22 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO T PV< 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 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA.1500 Schedule J (Rev. 6-98) I I I I -1i ~: \ I '~ \11 I ~Il -:-11 ill '>\! .... Nil \ , '-.,)) ~il II Ij \1 I SAIDIS lUFF. FLOWER. & LINDSAY ...... .."ToUW ~b W. IU~ Slrl!el C4rl!,le. P ^ r"h=,...,"\r+J. /1"')01:: _..__....".~------_..~~'_..-- "- LAST WILL AND TESTAMENT OF LAUR.!NE HARDIE 21-02-682 I, LAURlNE HARDIE, of South Middleton Township, Cumbe~land County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will ar.d Testament, hereby revoking all other Wills and COdlCils heretofore made by me. FIRST I direct ths ~ayment of my just debts and expenses of my lase illness and funeral from my estate as soon after my death as conveniently may be done. r direct my personal representative to bury me in the cemetery lot at Saint Patrick's New Cemetery, Lot S8D next to my husband with an existing monumer.t for final engraving_ ''''! ' Further, r autho~ize my persdnal representative to expend ,;') '. "':.4 funds from my est~ce, in such amounc as my pe~sonal represen~acive shall consider necessary and desirable for the inscr~ption on ~he marker for my grave. SECOND I give and bequeach co the persons or entities set fo~th the following cash bequests: a. $10,000 to the Bubbler Foundation; b. $10,000 to the Soiling Springs Civic Association; .~ ~ .~ .,s .~~~I .~ \ '..; \ SAlOIS UFF, FLOWER ~ LINDSAY ~'Dr"""T.LAW 6 W. High Slreet Ctrlisle. P" I i I ,,,,-"--'-"-"',",-,,,,,~-<""",,-~-'-"';""''''''-''~'''~.''''-'''-''''- -..------ '-. c. $5,000 co Domestic Violence Services of Cumberland and Perry County; d. $5,000 to Mary Ann Smith of 9 Enck Drive, Boiling Springs, Pennsylvania; e. $20,000 to my brother, Borden woytkiw; f. $10,000 to my nephew, Doug woytkiw; g. $10,000 to my niece, Michelle (Woytkiw) 1..oBreau; h. $10,000 to my niece, Roberta (woytkiw) McGowan; 1. $1,000 Co Erma Lininger of 90 Pine Hill Road, Carlisle, Pennsylvania; and J. $10,000 to Allison United Methodis~ Church, 99 Mooreland Avenue, Carl~sle, ?e~~sylvania. THIRD -~ ---------. I glve, devise and bequeath .~ll the rest, residue and remainder of my estace to my children 'THOMAS L. HARDIE, WILLIAM ~~~/. ..i G. HARDIE, and DARLENE HARDIE-MONCY, per stirpes. ,:?".-..:/ FOPRTH I direct that any a~d all inheritance, estate, and transfe~ taxes imposed upon my estate passing under this Will or otherwise shall be paid out of the principal of my residuary I I I I I I \ I estate. 2 . ..~.,._~==----":::=--.-:--=--,-=.~;.:,-~ \ ",I il ~ ~ ~' \j ~ ~I I I \ , \ i I I I I I I SAIDIS UFF. FLOWER it LINDSAY ~'LAW ) w. ttl~n Street c.r1iaJ... !' 1\ FIFTH In addit~on co the powers conferred by law, r authorize any personal representative acting under this instrument, tn his absolute discretion: A. To retain in the form received. or to sell either at public or private sale any real or personal propertYi B. To exercise any options to subscribe for stocks, bonds, or other investmentsi C. To join in any plan of lease, mortgage, consolidation, exchange, reorganization or foreclosure of any corporation in which my estate or any trust may hold scccks, ~onds or ocher securit~esi D. To sell, t:.~ansfer, convey, mortgage, pledge, lease or exchange any property, real or personal, which at any time may form part of my estate, for the payment of debts ,""\1 . .,,,', " or t.axes ( or for any. purpos€."'of administrat ion or ,,~-.. . distribution, for such prigeJ and upon such terms as my personal representative, in his sole discretion, may deem wise, and co execute and del~ver deeds of conveyance or cransfer chereof; E. To make sectlements and compromises on such terms as my gersonal represencacive in his sole discretion may deem wise without the necessity of obtaining any court approval thereof; 3 ---~.._:._~--==~~-^~.'--~~ .".~~,.~ SAIDlS [UfF, FLOWER ~ LINDSAY ~t\T.l..\W :6 W_ HI;h SlTeel ~rli,l". P ^ F. To make distribution hereunder either in cash or kind, as my personal representative in his discretion may deem wise. SIXTH I do hereby nominate, constitute and appoint my son, WILLIAM G. HARDIE, to act as Executor of this my Last Will and Testamenc. My named Executor shall be entitled to compensation Ear his services in adm~niste~ing my estate. Provided, however, that if he ~s unwilling or unable to act as Executor, : direct the duties of executor to be performed by THOMAS L. HARDIE. SEVEm'H I direct that no persona~ representative, guardian, trustee or other fiduciary appointed under this instrument shall be requ~r~d co give bond for the faithful performance of t.hei= dut~e5 ~n any jur~sd~ction. ~;'7, ..; IN WITNESS WHEREOF, ~, LAuR~NE HARDIE, have hereunto set my ..,,,...-.. hand and seal to this mv Last. w'l,ll and Testament., consisting of four typewritten pages, the first three of which bear my o/7J. '4../ day of May, ------~ . i.nit.ials in the margin for identificacion, th~s 2002- ~ ;1 a~/ .JJ~ t.r:'. URINE: HARDIE 4 - -."'-..-. ~---..........~~----.-----'- ~_. -...._._"--.."""""-'==~,="'-'- """""."''1;,.. r ~.., "'r Slgned, sealed, published and declared by the above-named LAURINE HARDIE, Tescatrix, as and for her Last Will and Testamenc ~n the presence of us, who have hereunto subscribed our names at her request as witnesses thereto, in the presence of sal statrix and of each other. ADDRESS 2 to I..J J -1-. oS 1. -J. t.- C~ .-L. ~ r.... (1< ~..u;. ~ e ~};:;l ~ j ADDRESS ~ / 3 ;;;cJ d.- ~ " rc. Ie.. r2a i" 1 : <; { c f.,q COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND T'TtJRNI:T54,U4U W 6 W. High 5lreet c....rll:lle. PA We, Laurine Hardie, R~he~~ C ~~irli~ and Charles E. Clepper she Testatrix and w~cnesses, ~espectively whose names are signed co the Eoregoi~g or attached instrument, being first duly swo~n, do hereby declare co the undersigned authorlty chat the Tescatrix signed and exec~ced the instrument as her Last Will and Testame~c and chat she signed w~llingly and that executed as her free and voluntary act for the purposes therein expressed, and that e~c~ of t~e wit~esses, in the p~esence and hearing of the Testatrix signed ~he Will as \':\ witnesses and that to the best of their knowledge the Testatrix was at che t~me eighceen (18) or more years of age, at sound H mind and unde::::, :-10 cm,.straint: or undue infll"e:cxe. \i >?'.';i. ..' ~~Uf~ .Ji...-..-.'t l' j \",.1\ ..,....All ~ '::,' LAURINE HAR.O:O~ I' ~ \ R~~~rt C. SaidisWicness \ rff'-:r~~b t-- ~ .g:- ~~ _ (_/ Charles E. C eg ~tness I I \ I I \ i I SAID IS .oFF. FLOWER ~ LINDSAY Subscribed, sworn HARDIE, the Tescatrix, to before me by Rober witL;.esses, chis to and acknowledged beEore me by LArrRINE and subscribed to and sworn or affi.rmed c. Saidis and _Charles Cl~p~~I' day of May, 4wA1 NOTARIAL SEftL RENEE L MIJRFlll,Y. Notary Public Carl(l;\6 P,C~". CumOctrland Co.. PA My Comml!;siotl Explrl'ls Decamtlar 13. 2005 5 JOHN E. SLIKE ROBERT C. SAlOIS JAMES D. FLOWER, JR CAROL J. LINDSAY JOHN B. LAMPI MICHAEL L. SOLOMON GEORGE F. DOUGLAS, III DEAN E. REYNOSA THOMAS E. FLOWER MARYLOU MATAS SUZANNE C. HIXENBAUGH LAW OFFICES SAIDIS, FLOWER & LINDSAY A PROFESSIONAL CORPORATION 26 WEST HIGH STREET CARLISLE, PENNSYLVANIA 17013 TELEPHONE: (717) 243-6222 - FACSIMILE: (717) 243-6486 EMAIL: attorney@sfl-Iaw.com www.sfl-Iaw.com CAMP HILL OFFICE: 2109 MARKET STREET CAMP HILL, P A 17011 TELEPHONE: (717)737-3405 FACSIMILE: (717)737-3407 REPLY TO CARLISLE March 26, 2008 :",J I ; I 1'.: Cumberland County Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013-3387 -,:; j'-; C', Re: The Estate of Laurine Hardie File No. 21-02-0687 Dear Ms. Strasbaugh: Enclosed are two (2) original copies each of the Supplemental Inheritance Tax Return for the Estate of Laurine Hardie to be filed in your office. A copy ofthe Supplemental Inheritance Tax Return is enclosed to be time-stamped and returned to me in the enclosed self-addressed stamped envelope. Also, enclosed are two checks, one in the amount of$15.00 to cover the filing fees and one in the amount of$61.70 to cover the additional inheritance taxes due and payable. If you have any questions or comments regarding the documents, please call. Sincerely, SAIDIS, FLOWER & LINDSAY ",-"j ~' ( ! '1 .-:::..~ ( f~ Ann Seker Paralegal for Robert C. Saidis JS Enclosures ,- "V lSOd sn [:3_'. . 1'-)1 I (~ II"'" 1'< j(.t) I ' . 1'1:"- IIJ) I }:r:nS'v'H - - - - - - - - - - - - - - - - 'cO '\": oJ r"') 1- ~ rJ) Cl ~ .-< ~ ~o ~~ J5~ ~~ ...~ ~~~...: ~~ ~:E O~ g E l-l .-< '" ~ NU rJ) ... 8 < rJ) I I . . o It- lJ) ~(!) -00 o :::::l .... 0 (!).c cnt .- :::::l (!) I"-- C'lo....oo (!) " co ('f) O::'-I:::::l('f) >->-0", --CJ)('f) C:C: ...... :::::l:::::l(!)o 00001"-- OO:::::l...... o "C"C.c<( C:C:ta.. coCO:::::l _ "i::"i::o(!) (!)(!)OCi) .0 .0 ._ EE(!)"i:: c: co :::::l:::::loo 00 I I z o - I- Zc Ww 1-1- I-(J) <(w w::> 1-0 <(w oce w ~ ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE -",~REALLQF INDIVIDUAL TAXES DEPT. 280601 HARRIS8URG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT HARDIE WILLIAM G 310 NORWICH LANE LANDENBERG, PA 19350 nn__u fold ESTATE INFORMATION: SSN: 123-34-4047 FILE NUMBER: 2102-0682 DECEDENT NAME: HARDIE LAURINE DATE OF PAYMENT: 03/27/2008 POSTMARK DATE: 03/26/2008 COUNTY: CUMBERLAND DATE OF DEATH: 07/25/2002 NO. CD 009463 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $61.70 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTY CHECK# 4816 SEAL INITIALS: WZ RECEIVED BY: REGISTER OF WILLS $61.70 GLENDA FARNER STRASBAUGH REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX111-961 NO. CD 009826 SAIDIS ROBERT C ESQUIRE SAIDIS SHUFF FLOWER ET AL 26 W HIGH STREET CARLISLE, PA 17013-2922 fold ESTATE INFORMATION: ssrv: iza-34-4047 FILE NUMBER: 2102-0682 DECEDENT NAME: HARDIE LAURINE DATE OF PAYMENT: 06/02/2008 POSTMARK DATE: 05/31 /2008 COUNTY: CUMBERLAND DATE OF DEATH: 07/25/2002 REMARKS: RECEIPT TO ATTY CHECK# 50192 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 512.63 TOTAL AMOUNT PAID: 512.63 INITIALS: CJ SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS LAW OFFICES SAIDIS, FLOWER & LINDSAY A PROFESSIONAL CORPORATION 26 WEST HIGH STREET JOHN E. SLIKE CARLISLE, PENNSYLVANIA 17013 CAMP HILL OFFICE: 2109 MARKET STREET ROBERT C. SAIDIS TELEPHONE: (717) 243-6222 -FACSIMILE: (717) 243-6486 CAMP HILL, PA 17011 JAMES D. FLOWER, JR EMAIL: attorney@sfl-law.com TELEPHONE: (717)737-3405 CAROL J. LINDSAY www.sfl-law.com FACSIMILE: (717)737-3407 JOHN B. LAMPI MICHAEL L. SOLOMON GEORGE F. DOUGLAS, III DEAN E. REYNOSA REPLY TO CARLISLE THOMAS E. FLOWER MARYLOU MATAS SUZANNE C. HIXENBAUGH May 30, 2008 o Q `~ ~ ~ ~; 3 Cumberland County Register of Wills ~~ x <.:~~ ~> Cumberland County Courthouse ~~- _ _J: `_,' One Courthouse Square ~ ,~ --. ~ - ' ~' PA 17013-3387 Carlisle ~ ~ ~ 4 ~~ , Re: The Estate of Laurine Hardie File No. 21-2002-0682 Dear Ms. Strasbaugh: Enclosed is a check in the amount of $12.63 to cover the additional inheritance taxes on The Estate of Laurine Hardie. Please send me a receipt for the additional payment. If you have any questions or comments, please call. Sincerely, SAIDIS, FLOWER & LINDSAY o..G~ ~ Jc~ Seker Paralegal for Robert C. Saidis ~s Enclosures 0 v o h LL W Q Z h H Z w ~ W ~ E ~+ J O "~ a ., p h d O ~ ~ N ~ h v U1 Ol r F E N ;,p'1 W ~ o ~ c 0 O Z ti 0 ~o a o ~ N N o J ~ ~ W i ~~ r a ~p H L11 N W .. S' N A N O ~I W y W ~ OG ~ Z ""~ ~ .~ J ~n a~-~==ate ~o o S o N U rrq y 9 a w U Y d } a s = Q m a H ~ *' Z o ~ W a a ~ ~e ~t 7W X~O 0. W A CO G, d d U ' JZ FAH O E aVj ~ ~ W S N~ w a w W O Z~ C U Z W ZOC i s ui W Q W W Z ~' 7 W ¢° h h h N ~ v w ~ C ~ B a d LL i .~ w u . K U V1 a a W q a Z O LL A W Z Q tL U G ~ 2 Q = w O Z ~4 W o JZ ¢ H a~ -o WQ w ~i O 3 d rr ~ w .cj: O OO z w a ~~ ~ ~ , . _ _ Ni. w ~~ / ~ vy U a~$ 4.. ~~~ ~ a~,:.3 .. ~ Cam, Q .. -. ~ iCIS .cr M l. " J..1 : ~. ~ 1 - ~ ; ~; ~ - --~ ~ U ~° a c~ N W X H ~ ~ ~ N N a Q z° o h U W 2 C9 W ,., ,p ° y o H J > H N p[ H H "O ~ z w A 3 J ~ x W H oa ~ (n N U QUOC7 N m ~ H N X wwm OC ~ x ae ~m~a~ W fn _ O S F- M ~~ N = o J O f~ J U '+ M 3 U a W a O A Z OC a W W J J h ~ ~ N W H H Oq J w = a ~ U U 1 1 ~' N~ Q ~ OCR o. U~ WTI OCR ~, OCi: ~~I Oi~ ~~i i' OCii pii LL i Z~ O~ H 1 h ~ ~~ O~ a. ~~ W~ 3~ O~ J~ 1 Z~ Fri a~ h~ W~ ~~ 1 1' i I Wi Zi w, Ji ~1 M ~ =t hl C9 i Z~ Oi Ji a~ hi 7i U~ p.:. 4i '~'j ~/E i,t: ~..; ~,~. J O t / ~ ~ ~ ~ ~ to (~ ~ t}" ~ CD = (D N r~. T~ ~~SV N ~ ~ O ~Q.. CL c ~i p O O O .~ C C ~~~ W ~ ~ O (D ~I (D C (O ~ ~ , .~' O CD O C G COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX BUREAU DF INDIVIDUAL TAXES ~"'" ~-~j"'' ~CAP¢'RAfSEMENT, ALLOWANCE OR DISALLOWANCE INHERITANCE TAX DIVISION - - - 0'F DEDUCTIONS AND ASSESSMENT OF TAX PO BOX 280601 HARRISBURG PA 17128-0601 ~_.~ __.. REV-1547 EX AFP C06-05) DATE 05-26-2008 C~E~~ ~:~ 3U ~~ I~1 J3 ESTATE OF HARDIE LAURINE ~~_, ,I~ ROBERT C SAIDI~,i ,,~,> ,.r_. ~ SAIDIS ETAL "`" '~li 26 W HIGH ST CARLISLE PA 17013 DATE OF DEATH 07-25-2002 FILE NUMBER 21 02-0682 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 07-25-2008 (See reverse side under Objections ) Amount 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 C03-05~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE: OF HARDIE LAURINE FILE N0. 21 02-0682 ACN 101 DATE 05-26-2008 TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN N0. 02 1. Real Estate (Schedule A) (1) .0 0 2. Stocks and Bonds (Schedule B) (2) .00 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 4. Mortgages/Notes Receivable (Schedule D) (4) .00 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 1,58 6.22 6. Jointly Owned Property (Schedule F) (6) .00 7 Transfers (Schedule G) (7) .00 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; 14. Net Value of Estate Subject to Tax NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. c8) 1 , 586 .22 215.00 C9) clo) .00 C11) ?1 ~i.00 clz) 1,371.22 Non-elected 9113 Trusts (Schedule J) (13) .00 c14) 503, 995.04 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 (15) •00 X 00 = .00 16. Amount of Line 14 taxable at Lineal/Class A rate C16) 447,995.04 X 045 _ 20,159.77 17. Amount of Line 14 at Sibling rate X17) 20,000.00 X 12 = 2,400.00 18. Amount of Line 14 taxable at Collateral/Class B rate C18) 36,000.00 X 15 = 5,400.00 Principal 19 Tax Due c19)= 27,959.77 . rw riDrnrre. PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID C-) AMOUNT PAID 10-22-2002 CD001766 1,397.99 32,500.00 04-09-2003 REFUND .00 5,852.62- 10-09-2003 REFUND .00 144.21- 03-26-2008 CD009463 3.09- 61.70 BALANCE OF UNPAID INTEREST/PENALTY AS OF ^ IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 03-27-2008 TOTAL TAX CREDIT 27,959.77 BALANCE OF TAX DUE .00 INTEREST AND PEN. 12.63 TOTAL DUE 12.63 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 DC CIIMT cCC DCVCDCC CTTIC AC TIJTC GAOM Cf\D TMCT DIIrTTnMC l BUREAU OF INDIVIDUAL TAXES- ;' INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 '~' ~,®: ~ r ROBERT C SA~~ ' ~ + ~-~' SAIDIS ETAI~~~y~,~ 26 W HIGH ST CARLISLE PA 17013 DATE 07-07-2008 ESTATE OF HARDIE LAURINE DATE OF DEATH 07-25-2002 FILE NUMBER 21 02-0682 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE:: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ --------------------------------------------------------------------------- REV-1607 EX AFP C03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT *** ESTATE OF HARDIE LAURINE FILE N0. 21 02-0682 ACN 101 DATE 07-07-2008 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-19-2008 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID (-) AMOUNT PAID *~* SUMMARY OF LL 005 PAYMENTS *** 05-31-2008 1,397.99 .00 05-31-2008 15.72- 26,577.50 27,959.77 TOTAL TAX CREDIT 27,959.77 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATIDN OF ADDITIONAL INTEREST. C IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX AFP C03-D5)