Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
02-0788
PETITION pFOR PROBATE and GRANT OF LETTGERS Estate of ~Clf/~-L,2/1 < ~'~/~'O No. _~i ~' Q ~' 7 a ~V also known as To: Register of Wills for the Deceased. County of Cva,~ r/5 n c~ _ in the Social Security No. ~?~~' ~ 3 ^~~',L5 ,~ Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or of er an the execut CJr named in the last will of the above decedent, dated rv ~ ,E~ _, 19 ~'~ and codicil(s) dated ~" (state relevant circumstances, e.g. renLLunciation, death/of executor, etc.) Decendent was domiciled at death in ~Ui~ D~~"~4~i ~-~/ County, Pennsylvania, with h ,~ C" last family or principal residence at .~~_~y~/~ ~'~~" p/pi V/~_ G (list street, number and muncipality) Decendent, then 6 / years of age„died (Jd o~ , -l~g a ~U;~ /, Except as follows, decedent did not marry, was of divorced and did not have a child b rn or adopted after execution of the will offered for probate; was not the victim of a killing and was never .adjudicated incompetent: Decendent at death owned property with estimated values as follows (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Penns lvania situated as follows: _~ c) ~ . Sli%++/.=/~ cSE' ~T ,/~/?'/ VG b~ ~~ .~ y x~ bo G / ~~ ~~~ ,~~ u a ~ c c: c, os"~ ~~ ~--- ~~~ di~~w~~ ~%~~ ~r OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 1 COUNTY OF CC~i-+Q,~Q~~-~Y.1> ~ S3 The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and ly adm' ist state according to law. c Sworn to or affirmed and subscribed ~~~ _ t„ b f ~ 9 `~' e ore e this day of _ ~ Regist r _ WHEREFORE, petitioner(s) respectfully request s) the probate of the last will and codicil(s) presented herewith and the grant of lettersTF'„s 7'fl/yt,___ ~Y_f-it'S/ (testamentary; administration .t.a.; administration d.b.n.c.t.a.) theron. No. 21-o2-7s8 Estate of RICHARD R. CAIRO ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW AUGUST 30th, X~ 2002 in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated 02-26-1998, Codicil dated 04-07-1998 described therein be admitted to probate and filed of record as the last will of RICHARD R. CAIRO and Letters TESTAMENTARY ' are hereby granted to RICHARD A. CAIRO 4c~ r~r~ YI1. LE ltrs f ~f ~,~.. ! (1 ~l; ~c~ ~ _ Register of Wills FEES Probate, Letters, Etc.......... $ 235.00 Short Certificates(5) .......... $ 1 00 ~~€~.~QDIG~?........ $ 10.50 EXTRA PGS $ JCP TOTAL $ 277.50 Filed .AUGiIST. 3.0, . 2Q02 ............... . RICHARD A. CAIRO, ESQUIRE 27733 ATTORNEY (Sup. Ct. LD. No.) 6348 BENNINGTON RD, MECHANICSBURG PA 17050 ADDRESS 717-238-0423, EXT 306 PHONE MAILED TO ATTORNEY AUGUST 30, 2002 ;~. n sr, rs ~s ro rL•,n ,~ r r r .c ,i'ormarion i)ere g(vcn i rorrectl~' copied front an original cerrif)L~ate :,~ r~;t) duiti• filed with nie ati .-I_Ical Re~;i,tl.li ~71)c oll,'i(1)1 certificate will he forwarded ro the Stare Vital i~erords Offir~ for pcl•)r,( r~:°nt•'filing. V1-ARNING: It is illegal to duplicate this copy by photostat or photogratah. l~l_. foL [I;i~ rrru;i~a(c, `>'.Op ~' ____8 _~_J_6 2 4 ~ .,: --- n I OS. I c3 Rev 7187 TYPEiPRIN7 IN PERMANEN, NAME BL ACM INK t COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH L!Ul Nl IF Vy. Mgde. Layl _ -- Richard R. Cairo 81 Yn • '^~ nuaatlsy lSUar. CM6w1. Star. Z9 Ca 309 Somerset Drive Shiremanstown, PA 17011 NAE~E IFvy, Midp,. Lay) AmedeO Cairo - 7. Male 7. 204 rn,NlM, Ua, bar, - 03 - 5 d DATE OF &RTN rr1« !MO/~n Day 'bnl 99Ei .. BWTIwUCE iC,ty a PLACE OF DEATH IChcMaW me--•ee,ny, 3 August 22, 2002 -- uleaFCregnCaururyl NOSPIW. uamvrn urK, Wly -_ E. 8/23/ 1920 Steelton PA '"Pa'""' ^ EfiDMPym^I ^ OTNE.0. DDA ^ "~ G,M _ iO. TWP OF DEATH , , N. FACKT' NAME Ill n • 'I Nery1 ^ r 1 Reagerlc• ~ iSpaOayl IJ Allen gy l Mly UIMM, glue wen arq numeyi 30 MMS~ CEM NAT GF NISPANK: ~~RIGINi Id J Y» Wecl Gp BEN' m.n[an Inuan. BYCk.1Ma. N< p. N. 4 Somerset Drive Y . n. w.rrnvwnoR,carlac GF BUSWESS.nNl1lIS7RY wAS DECEDENT EVER IN ' ~' White ta U. S.ARYED FORCES) S DECEDENT S EDlK: ~1pN MARITAL STATUS~Marr,q~r . De t Y 111x® N,^ •d EYYS«ond.1Y CrIN e WwMmIM. Wgowd. l Dnpced l$Pecf l SUMIVING Si'q/5E Ill mr gwm.gen nartl•I t7. It . S I a 121o,zI y M . art EM'9 ~ te. led ,,,. ~,,,~ Pennsylvania ,y r+cE Dia lTe. `LJ' We, d.l.o.n lined „__ ~aRrn. ^c.d.m tTb. ('tTmFwrlanF•1 b'"'"p7 t7d.^.erl.~wrawa_ MOTHER'S NAME IF.y, Mqu•. Mogen SvnarMl Elizabeth Santana aleir tpl GerI1.11on ^ Ra el tro-w SIM• ^ Otlw ISOecfvl 1a11Y 1101 av1aMbr MleMbOarYNb °my •nowl IS eaYae d ba111 glnua aM TNI N.]E muN N eoraMerd M a7.. Mb Pmrbvrlue dea111 TIME OF DEATH 2:37 : RTC Emer IM age•we, iryuriea or CMgYCali .. oM rMic11 wu d I L W a1rV aM cauN M •efJl Ilan. M M 4a1N VATE GUSE Ifvul n.DW. lbarl aOnw PMCV '111N'NMMaC«Iwary. Gmn August 26, 2002 7t! Holy Cross Cemetery LK:ENSE NUMBEfl NAPE ANDADORESSOF FAGIIT 77b. _ tEe occurred M IM Um,, d•IS arld pace Mned. LICENSE NUMB DATE PRONOUNCEOOEADIMmn. Oay. >ra<I 770. YulS CASE REFI a. Au ust_ 22, 2002 3town, PA 17011 PqN ~ Cy/hn. SIMe. Zp Code Harrisburg, PA 17101 .Dal'. YeYI 7x. MEOICAI EIV WINEiUCOHONERT q LILT E: OYV1r agnakeN mrldaioru caarrdArg Io IASeas,u corgnlm ,~1./ ~1,Y /, ,/ jp1••a ono daaN not malynp nbm lrrldrvl7vly crrle {,vent ,•aJrgn want--- •[ S~"~" ~ !/~_ 1 OIAE 70IOR AS A CONSEQUENCE DFI: - SWmmM•Y'e•1corldar,rre D --- -._. .._ ~ tart EmertINDERLYUID aAF TOll7R A$ACl7NSEQUENCE QFI' '-_. _____ r a •m. wdrgbrnvll•dI•le ~ -__.__ 1 _ _.__. _ _. ____ _-_ CAIgE IDe1ur a v}v y < 1 eW .MNIeU evnR -.- ._----.__ ._ 1 :: r+a~mpnu•anILAET __ ._..___ _. .___ DI1E IOIOR AS A CONSEOUENGE OF)'. . - _-.. - 1 "Y -,--___-_ _.. 0. 1 .. - ___.. VAS AN AUTOPSY MERE AUTOPSY FRIgFpS MANNER OF DEATH ------------- - PERfORMEDT AMMLABLE PRIOR TO DATE OFIFUURY T:faC (INJURY COMPLETgNIY CAUSE ~ IMmn. oay, War) !!L'UR: .^. VJC,RiC7 LESCnIOE HC.v uvURY GGCUrv¢' OF I)EATH7 MrvY Ilom ~M ^ u. _ ACCgnY ^ Pertlr9lmeygalbn ^ 1M ^ No ^ .- '"" ^ "° ~ Y•• ^ N, ^ su•:w ^ coved na w der«m,rrd ^ M. 7a. v PLACEl1FIWURY-M 11•rrm. rrm, aYM.ladory, office LOCQION --- 7N. yN, Zf. b`rildnY. •v:. ISpacavl IStray. fi1yliimn. Su1el CERTIFIER IC~rc•myOrel 70e. ~. 'CERTIFYUIG PHYSICIAN IPnya¢vm ceryyvq caused Uean nnen anoner onyyc,an MS walourr:eu seam anO CVnplelrq ltcn 171 IGNRURE ANO TITLE OFC RTIFIER --- • ~ ro IM WM or my aro.rgbe, rr.m «cumd aa. r IM uu•ela) and mar.Mr w •rtw............ T ........................ ... .............. ~ 7lb ~ u I'l i{. II~ ~ ~% w 'TRUy011NC'NG MIrOCERTIFYING PHYSICIANIPnyYanpM;vy,OOr,cug aeon arq cenAynq wcaOSedceanl L~ N DATE ~ wMdpe, daeb occurred a11M Ya1•, Nte, arq _- u ~ Prce, arq dw to dM c•ua•(•) eee menn•r a• Me1W.......... [] 7 ~/ tp. W NAME D _____ 7 ~ SS PERSON WHO COMPLETED CAU C • 'MEDICAL El1AMINER/CORONER (Item 27) Type a Pint On Me baai• of eaaminallon er1Nw Inveall lion, in my opinwn, death occurred I Ifie time, dale, and lace, and due la IM uuNla) and hy1,6~,s1 ,J / yyi L'y~N ~ {'~~ 71.m•nner as stated........... 9• • P .............................................. .... ....... ..... ..... ^ .J r REGISTR,q' SIGNATURE AND NUMBER 77, oQ Cd __l 1~~ I ,. 7 I ~--. ~ 1~ DATE fILED (MOMr. Day. Rvl ]a ~ • ~- 7../~u v'sT-may , o~l~ ay 1br1 __.-.._ LAST WILL AND TESTAMENT OF RICHARD R. CAIRO I, Richard R. Cairo, of 304 Somerset Drive, Shiremanstown, (Lower Allen Township, Cumberland County), Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking and making void any and all prior wills, codicils, writings thereto, by me at any time heretofore made. ITEM I I specifically give, devise and bequeath the following items to my wife, Loretta M. Cairo: a. The automobile considered to be the primary automobile of the family, whatever make and model that may be. b. The remaining proceeds of any Individual Retirement Account held by me. ~ c. The right to remain rent free in our martial residence at 304 Somerset Drive for so long as she desires, provided that she continues to pay in a timely fashion all f;xpenses attendant thereto including taxes, municipal services, repairs, assessments, and like items. This shall not be considered a life estate and this right shall terminate upon her permanent departure from said residence. ITEM IT All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give devise and bequeath unto my children, Lynette I. Ascani of Mechanicsburg, Pa., Richard A. Cairo, of Camp Hill, Pa., and Renee Cairo-Iocco of Silver Spring, Maryland, to be divided equally among them. If any of my children do not survive me by at least sixty (60) days, then, in that event, their respective share of this estate shall pass to their surviving children, per stirpes. If any of my children do not survive me and are not themselves survived by a child, children or other issue, them, in that event, their respective share of this estate shall be divided equally between my remaining children or their issue, per stirpes. ITEM ITT I direct that my earthly remains be buried in the family plot of ground located in Holy Cross Cemetery, Harrisburg, Pa. Page 1 of 3 pages ITEM IV I nominate, constitute and appoint my so::, Richa,:d A. Cairo of 3501 Hawthorne Drive, Camp Hill, PA 17011 as the executor of this, my last will. If, for any reason, he cannot serve as executor, I nominate, constitute and appoint my daughters Lynette I. Ascani, and Renee Cairo-Iocco as the co-executrices of this my last will. No fiduciary acting hereunder shall be required to post bond or enter security in any jurisdiction. IN WITNESS WHEREOF, I have set my hand and seal to this my last wiill and testament, consisting of this and one other page which I have signed in the margin, plus a self probate form, this .,?L-,~ .day of _ ~~~rc~:~ y , 1998. Q.~-rf -~~ , ; Richard R. Cairo We, the undersigned, hereby certify that the foregoing will was signed, sealed, published and declared by the above named testator as and for his last will and testament, in the presence of us, who, at his request and in his presence and in the day and yf;ar above written, have signed below as witnesses; and we certify that, at the time of execution thereof, said testator was of sound and disposing mind and memory. L~~~' Residing at ~ // , _ ~ ~ ~ ~ Residing at ~~ 7 IC, l~'~~./4ND ~ ~ - fLc1~L ~~ v 7 ~, ~/~ 1' C~ c Page 2 of 3 pages COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss We, Richard R. Cairo, ~~ ~P y ~~~ ~,~, and ~'"'~''~~' `~ ~~'~~~ v ,the Testator and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and that he signed willingly, and that he executed as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the will as witnesses and that to the best of their knowledge, the Testator was at the time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. /~~~,~, Sworn to and Subscribed before me this ~~ ~ day of F~6.e ~~ y , 1998. Notary Public Seal Commission Ex Tres: ""'°~°-- r ~, 1=. ~ ~~ ~0!1!ltY ~~ i i ~ n I~ Page 3 of 3 pages L~ CODICIL TO LAST WILL AND TESTAMENT OF RICHARD R. CAIRO I, Richard R. Cairo, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this Codicil to my last will and testament of February 26, 1998. My last will and testament, dated February 26, 1998, is hereby amended as follows: Having executed a separate release to this affect, I nevertheless reiterate that I have relinquished and do hereby relinquish and quitclaim any right, title or interest I may have by marriage or otherwise to the property at 217 Mahantongo Street, Pottsville, PA. in consideration of my wife's mutual release of any of her rights in 304 Somerset Drive, Shiremanstown (Lower Allen Township, Cumberland County ). This property shall pass in accordance with the legal procedures made by my wife in the title to that property or in her last will and testament. IN WITNESS WHEREOF, I have set my hand and seal to this, the codicil to my last will and testament dated February 26, 1998, consisting of this single page plus a self probate form, this ~ day of ~~~,/ , 1998. ~ 1 ~ ~~z Richard R. Cairo We, the undersigned, hereby certify that the foregoing codicil was signed, sealed, published and declared by the above named testator as and for a codicil to his last will and testament, in the presence of us, who, at his request and in his presence and in the day and year above written, have signed below as witnesses; and we certify that, at the time of execution thereof, said testator was of sound and disposing mind and memory. ~/ ~ `~ ~~ / / Residing at a S Cr/ ~~~ ~:~L~ `~ c ~~ ~ ~i ' ~ ~~+,, Residing at 'y~0 /(~_ ~,q-1n,'"~,-f- S-{- ~ ~- dolly ~~19- ,~ 7Q~ S COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss We, Richard R. Cairo, ,4i~; v~. ,yi ,-„ Ps _, and - ~~Ak'~ /Y1e ~ ~ g ,the Testator and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as a codicil to his Last Will and that he signed willingly, and that he executed as his free and voluntary act fur the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the will as witnesses and that to the best of their knowledge, the Testator was at the time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. ~~ ~ ~ 1 c l Sworn to and Subscribed before me this 7~! day of ,~a~; / , 1998. ~~~ Notary Public ~ ,-V~~-T`!~-'1!~ .. ,... . ~...., ...,_._...~...........-....,_...........J MUTUAL RELEASE AGREIFMENT This Agreement made this ,,?~,~/, day of Fd.~v~y , 1998 by and between Richard R. Cairo, husband, and Loretta M. Cairo, wife, both of 304 Somerset Drive, Lower Allen Township, Cumberland County, Pennsylvania. WHEREAS, both husband and wife own, exclusive of their spouse, interest in certain real property, namely; Husband - 304 Somerset Drive, Lower Allen Township, Cumberland County, Pennsylvania, with approximate value of $120,000; and Wife - 217 Mahantango Street, City of Pottsville, Schuylkill County, Pennsylvania with approximate value of $65,000.00; and WHEREAS, both husband and wife wish to freely dispose of their respective real property in a way that each deems appropriate without legal claims being made ;against this real property by their spouse. NOW THEREFORE, in consideration of the mutual promises made herein, and intending to be legally bound hereby, the parties agree that they shall make no legal claims against the real property of their spouse herein, as described above, either by election against a will, divorce action or otherwise. IN WITNESS WHEREOF, the parties have executed this agreement in duplicate in th ace provided below. l~ -u-~-~ Witness Richar .Cairo ~~ lG~~`-- Loretta M. Cairo _ ~ -;.~ .. _._ ~_ , - ,; _,- ~, , F~~ ~ 1 ~ ~ c >.. pry CERTIFICATION OF NOTICE UNDER RULE 5.6 a w Name o f Decedent : /C;. - G ~//~ ~ Date of Death : ~/_ `,~~~ .~ Will No . Admin . No . ~ -'C.~.,~ ~- ~' To the Register: I certify that notice of beneficial interest .required by Rule 5.6(a) of the Orphans' Court Ruies was served on or mailed to t}ie following beneficiaries of the above-captioned estate on Name Address /~~ n J J N / ~l- ~ / / ~~ / i / G ~ 7tn G t ~ 5 i ~ ~%~u ~~ C~ ~'1~v Notice has now been given to all persons entitled thereto under Rule 5.6(a) except- , /~'~ ~ y F- ter. Date: ~ C ~ G, ~~d,~' Signatures, Name /~~/~/i'/~ /~~~ c~ r'./ _ ~~~' (J _ b Address - ..C hh/'~ ;~,.,~ ~ / ~. CicJ Telep one ~c.3 --~'~--~3 ~~t~~~ Capacity: personal Representative Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX111-96) N0. CD 001832 CAIRO RICHARD A 6348 BENNINGTON ROAD MECHANICSBURG, PA 17050 told ESTATE INFORMATION: ssN: 204-o3-5sss FILE NUMBER: 2102-0788 DECEDENT NAME: CAIRO RICHARD R DATE OF PAYMENT: 1 1 / 1 2/2002 POSTMARK DATE: 1 1 /09/2002 COUNTY: CUMBERLAND DATE OF DEATH: 08/22/2002 REMARKS: RICHARD A CAIRO CHECK# 0100 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ S 12, 000.00 TOTAL AMOUNT PAID: INITIALS: CW S '12, 000.00 SEAL RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS t `~- s~ f~^ ~' (~ I \~ f _ ~ `~^ t ` .. ,.~ ~.~ Jl S .~ ~ ,~' `~ ~ ~~ ~~ u ~~~ W ~ M '~ ~ J ,Q ~~ ~ \' ~ ~ \~ u0 ~ ~ ~r ~~~ ~~~~ ~ ~ ~, ~ cam- 0~ ~ ~~ ~ ,~. ~.~ •'~ ~ ~v ~. ~, _ ~~ ~ / ` ~ I .- `, ti~ ~ti.S i'.{ !' i'~f .~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE REV-1162 EX(11-96) BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. C:D 002056 CAIRO RICHARD A 6348 BENNINGTON ROAD MECHANICSBURG, PA 17050 ACN ASSESSMENT AMOUNT CONTROL NUMBER fold TOTAL AMOUNT PAID: REMARKS: RICHARD A CAIRO CHECK#102 INITIALS: CW SEAL RECEIVED BY: DONNA M. OTTO REGISTER OF WILLS 5536.04 DEPUTY REGISTER OF `dVILLS y c e 4 ~ ~ ~ r..~ r ~~ _'~ ,J r ~~ ~. ~~ ~, I ± f ' . : , .. ~ J ~~ - 1~ J p~~ ^~ 1( ~J ~ ~.3. ~__ ~ ~ ~T'~ \ VVV l-~~i ~~ ~ ~ V .1 ~ .v 1 ~ `hY;; ~1~; ,: ~ . ~ U C ;J ~ c,~ . ~ i ~ , ~; ~,~ ti ~ ~ 1 T { ` P Rw-a INVENTORY OF REAL AND PERSONAL ESTATE ~n ~s lNgRsr of rl~s £ei~s of .......l ~~1;~! ~J.? ...., .~~..... ~; ~l ~; c~ .................. late of ..f-~'!?:':~!!:..~f.l.'~:'~..1 U!'~!1~.~~,,,,,,,.in the County of Hwplein, State of P'enna., deceased. ,~ 1ltidpt~ , of the real and personal estate which were of the above-named ti ,. ....... ~.~C.~: ~~... ...!..... ~~~~ ~? ...... ~~``~ ••••••••••••••••••••••••••••••••• deceased. Taken and ap raised .... day of ~./ h t!. ~ U C~ the ... .~i..... .... ...ll.,.. ~.'y .....~- .~ (Date of death ..~~1.:'.7~`....~...) Si~-~/~. ~~< / ~-f o~-, t.l ~ U y` ,..5 ~a h r~.st~, ~~ 6 0~ a o0 --- a~ ~ ssi / ~ ~ l7 ~s a f ~'j ~S ~t~ , ~l ~ u~ .--, S, ~~~~ ~~~~~,/I~r~~~~Y~;~~~,~ ~ as s~~ - i ~~ / J , RECAPITULATION QQ~~~ ~ ~/ Appraised value of Personal Property ................................... E '~~~"~"'•S ` ................................. Appraised value of eeal estate .............................................. s ~ .... ,~. ~ r~°~S Total appraised value .......• .............................................................. 5~~..~.~c.1. / AFFIDAVIT OF PERSONAL REPRESENTATIVE County of uphin ss ~ ..... Execut ~ of the Estate of.... ~1.G f .fd.~a~.N ..~.:.•....C1~~~~:.. Wit .................. Administrat "" "°' ' ••••'••• deceased, being duly..........~.~.1::.~~~~~ ~Y••••••••••••••••••••••••••••••• according to law, depose and say that the items appearing in the Inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said decedent; that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the decedent's death; and that decedent owned no real estate outside the Commonwealth of .Pennsylvania except that. which appears in a memorandum at the end of the Inventory. ~" -' /' ; ,. S~ ~ 1?, n!.. Tz~ ............... and subscribed ~'L ~ , ~~ . ~ `~ ~ `~:.1.:: before me this....../ ............................,day of IDzeentor - Administrator .~~~ ."--~• drew ~ ~ . - .:~:.........~..~, ............... ~ 7 ~C,~ IN3TRLTCTIONS 1. A tare t[sY•l~e-•~3i~dlVi9ti8l~'nP months after appointment of personal repressntskire. mod:' "` ~>~ l'tgi~"~h~~l'>tled thin thirt7 days o! discovery of addltfonsl sussb. 8, A -savvy-~i ~ ~ personalty or realty. 4. $ee Article IV, P'iducisries Act of 1848. 0 V V 1 7 0 .9 ~' r U: '~ a 0 U ~ ~~ --.~ ~ ~ ~~ ~: o A :~ ,~ ~ u ~• O ~ aV.. ... D '~ ,~ ~ ~~ 0 v ~ g ~D 0 Li., U P4 a+ v "" .~ o 0 BUR OF INDIVIDUAL TAXES =-~HERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 RICHARD A CAIRO 6348 BENNINGTON RD MECHANICSBURG PA 17050 REV-1547 E% AFP (O1-OS) DATE 02-25-2003 ESTATE OF CAIRO RICHARD R DATE OF DEATH 08-22-2002 FILE NUMBER 21 02-0788 COUNTY CUMBERLAND ACN 101 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 (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF-TAX ESTATE OF CAIRO RICHARD R FILE NO. 21 02-0788 ACN 101 DATE 02-25-2003 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 136,050.00 NOTE: To insure props 2. Stocks and Bonds (Schedule B) (2) .00 credit to your accour 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper port 4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this fore with yon 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5l 15,6 05.09 tax payment. 6. Jointly Owned Property (Schedule F) (6) 7,460.63 7. Transfers (Schedule G) (7) 147,109.87 8. Total Assets ~~ (g) 306,225.59 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule Hl (9) 9,958.07 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 1.53 1.47 11. Total Deductions (11) 1 1 .489 _ ~4 12. Net Value of Tax Return (12) 294,736.05 13. Charitable/Governmental Bequests; Nonelected 9113 Trusts (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax (14) 294,736.05 NOTE: if an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Aeount of Line 14 at Spousal rate (15) • 00 X 00 _ . 00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 294, 736.05 X 045 . 13, 263.13 17. Aeount of Line 14 at Sibling rate (17) .00 X 12 - .00 18. Aeount of Line 14 taxable at Collateral/Class B rate (18) •00 X 15 - .00 19. Principal Tax Due (ly ). 13,263.13 DATE NUMBER 11-09-2002 CD001832 01-16-2003 CD002056 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX INTEREST/PEN PAID (-, 631.58 .00 PAYMENT MUST BE MADE BY 05-22-2003*. AMOUNT PAID 12,000.00 536.04 TOTAL TAX CREDIT 13,167.62 BALANCE OF TAX DUE 95.51 INTEREST AND PEN. .00 TOTAL DUE 95.51 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT•• (CR), YOU MAY BE DUI A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) #~ ~~ * ~, , 5 'L ' i - A j i ~ if q ~~ . , 8 i ~, ~ ,. ~'_ .;~ ~Y;~ r ~ ~. .~ ~ ~~~ ~~ v ~~~ v . ` '~ \~ ~ J ,. ~~~ ~o ,h ~ ; ~ ~:, `' ~~ ~ ~ ;,3 r ~ r~:~ r~~ ~ ~,. ;.., ~~. ~ v ;-. •r•! REV-1500 EX+ (7-94) w ,.. ::.:::!~ ",,,.. w"'''' =C>C> ",,,~ ..... ... .. * COMMONWEALTH OF PENNSYlVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME llAST, FIRST, AND MIDDLE INITIAL) - . J7-Y~'7--JO FOR DATES OF DEATH AFTER 12/31/91 CHECK HERE IF A SPOUSAL POVERTY CREDIT IS CLAIMED 0 FILE NUMBER d-./ COUNTY CODE ,.. z w C> w '" w = INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) DECEDENT'S COMPLETE ADDRESS ,3 0 ~ SCJ ;'?(i~" c5" -C r 1))y'c c..- ..5~in"""i'lo7ak/'l ) .PAl /701/ COUI'II 0 -e-Y-O AMOUNT RECEIVED (SEE INSTRUCTIONS) df -.L'~)( .~Jj 000 I'>, V'd/'rf-/1cd;-. dJ7V/O 03. 05. Al. 04. 06 Original Return D 2. Supplemental Return Decedent Died Testate (Attach capy of W;II) o 7. Future Interest Compromise (for dotes of death after 12-12-82) Decedent Maintained 0 Living Trust (Attach copy of Trustl _8. Total Number of Safe Deposit Boxes u).... o7rY Limited Estate o 4a. (I) (2 ) (3 ) (4 ) (5 ) /S)f,.,DS:07 /;p~r O~ ~ 66/ '1 ) 7 S-li , 0 7 (j\'5/'Lf? YEAR NUMBER Remainder Return (for dotes of death prior to 12-13-82) Federal Estate Tax Return Required .,.. "z Ww "= "z C>c> "'''' COMPLETE MAILING ADDRESS .-l-;:J ..,Je 63~.f /Je/l ?IV/Cfl-t "10<; ':$ 'FiaT; 1'1 ccA "'1t'U6I>O,. l'pk )70 OD jJ.(; J 0,\0, OD 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule 8) 3. Closely Held Stock/Partnership Interest (Schedule q 4. Mortgages and Notes Receivable (Schedule DJ 5. Cosh, Bank Deposits & Miscellaneous Personal Property ISchedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule GI (Schedule L) 8. Total Gross Assets (total Lines 1-71 9. Funeral Expenses, Administrative Costs, Miscellaneous Expenses (Schedule HI 10. Debts, Mortgage Liabilities, Liens (Schedule II 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (line 8 minus line 111 13. Charitable and Governmental Bequests (Schedule J) 14. Net Value Subject to Tax (line 12 minus Line 131 15. Spousal Transfers (for dotes of death after 6-30-94) See Instructions for Applicable Percentage on Reverse Side. (Include values from Schedule K or Schedule M.J 16. Amount of Line 1.4 taxable at)J( rote ~J7o (Include values from Schedula ~r Sche~~le M.) 17. Amount of line 14 taxable at 15% rate (Indude values from Schedule K or Schedule M.l 18. Principal tax due (Add tax from lines 15, 16 and 17.1 19. Credits Spousal Poverty Credit Prior Payments + (()",noo.oo + , 20. If line 19 is greater than line 18, enter tne difference on line 20. This is the OVERPAYMENT. 110 z C> >= :5 => ,.. ii: .. '" w " z C> ~ ,.. => ... .. C> '" ~ ,.. 16 ) (7 ) (9) (10) (151 (8 ) 3 ():lJ ~ 01, J/ Ill) (12) 1131 1141 //,~n.J~ <Q t'1; 1'1)" · Or- (16) x = ~/~ I/~'OJ- x~~ /1//Z6,OY- (17) x .15 = Discount {,()O.cJO Interest 21. Check here If you are requestmg a refund of your overpayment (18) (19) (20) 1'J."t..6o.oo / ~QC o,/- 63t ~ 0 '/ If line 18 is greater than line 19, enter the difference on line 21. This is the TAX DUE. A. Enter the interest on the balance due on line 21 A. B. Enter the total of line 21 and 21 A on line 218. This is the BALANCE DUE. Make Check Payable to: Regl.t.r of Will., Agent (21) (21A) (21 B) 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, correct and complete. I declare that 011 real estate has been reported at true market value. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SlGNATU PER" 0 LE IlING RETU'N ADDRESS Di'~ /;?, J/01 ADDRESS DATE C. Act #48 of 1994 provides for the reduction of the tax rates imposed on the net value of transfers to or for the use of the spouse. The rates as prescribed by the statute will be: . 3% (.03) will be applicable for estates of decedents dying on or after 7/1/94 and before 1/1/96 . 2% (.02) will be applicable for estates of decedents dying on or after 1/1/96 and before 1/1/97 . 1% (.01) will be applicable for estates of decedents dying on or after 1/1/97 and before 1/1/98 . Spousal transfers occurring on or after 1/1/98 will be exempt from inheritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (v-) IN THE APPROPRIATE BLOCKS. YES NO 1. Did decedent make a transfer and: b. retain the right to designate who shall use the property transferred or its income, ............... a. retain the use or income of the property transferred, ....................................................... C. retain a reversionary intere.st; or ............................................. ...................................... d. receive the promise for life of either payments, benefits or care? ....................................... 2. If death occurred on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequate consideration? 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' bank account at his or her death?...................................... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. REV.1502 EX+ (12.85) .. SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ~l___OJ.- 073-cP (Property jointly-owned with Right of Survivorship must be disclosed on Schedule F) All real estate should be reported at fair market value which 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. ESTATE OF m' 161JlfA jJ /f , Cmfio ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. LSJ'rU/G KA./7 BOA-C I 30 ~SOI'7('".se:/- .J /J0 OJO.~ fJ Y'I V -e: ) S -4;}<. IV,., d W,,? c/o iv('v /f /Ie'? 7ZWf16'~p) CO;"~~Y"/<1c1 ~(f,,+ / X,J 1( CUi>, ~~vk,l COU'"'7; Oo</o'j i ;l-$GJ- /11-t:YJ -f) is- / ;( ~/ 60 TOTAL (Also enter on line 1; Recapitulationl (If more space is needed, insert additional sheets of same sIze.) S IJ{,OS-o.OO " REV-1508EX+(2.87) .. SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Please Print or Type FILE NUMBER bl/ d.-i -o7.fcf- COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF 0. I\klflt/?,O J? eM/w (All property jointly-owned with the Right of Survivorship must be disclosed on Schedule F) ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH J, /lu.~ /<s-r PC-V fly-a-j-;..</v-r S-"'YI1;S /kui: :# Z'-63/-0S- ~ . Ii 6/ f}tJ~J\ uvt'G /Juju 1/~Jr;7~60 $ I/~ (), 60 JJ-f S'7k 3 . PrOG-<-"-c!~) pre. -/J~c,f~s..~ d f1.u~'1/t<,1 J),cS ~ ~. c5 h J<. t"C<: -ct~ L L "'I -/Y v' <:Ie if ~ 1-. C;\1S' /YJ-<<:!t-c; ""-<- ~/j., jlJ Y J c.1>t < i/- t ~ 7tJ:Oo :!;{O.67' TOTAL (Also enter on line 5, Recapitulation) s /0. CDS". 09 J (Attach additional 81f2" x 11" sheets if more space is needed.) " REv..1509 EX+ (I2.88) '* SCHEDULE F JOINTLY -OWNED PROPERTY COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER d.,! 0;<' -o7J- r ESTATE OF r.:? ~ I \ to..,!t/([) ,'K (' MIIf 0 Joint tenant(s): C. 1\(,1)<:..6 C.,,'\-o-Iocw ADDRESS RELATIONSHIP TO DECEDENT ~3't-f)jJC~?j,"'Jr/u,., &1. :idlY /VIcJ,""ilG,f,;;(J~) ?fiJ IlOaO 't'7 g L -r/V /&'1 ,AV<. ftJ 1..0~"""&6,6(;J l~ 17M(j- [Jc,r..JJ ~icV' I (oiJ~i"t.J",k Ccvvf- .s t' I YC" Jty/~U I Iv., E u. l!J lt1--6r' 'a. 0 5a.J NAME A. /?t'c./I/it'./J If, U/lfu B. L y,., ,Ik- L !I-<5G5 "1/ Jointly-owned property: ITEM LETTER DATE FOR TOTAL VALUE DEeD'S DOLLAR VALUE OF NUMBE JOINT MADE DESeRI PTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTEREST TENANT JOINT 1. 1+1l!>~ 0~ Pl-Vh.. ":I tGrFCU AJ-. ,,(( f..1.] C 0'7 ~ l/iJ/-tJO ~. A, t/Y't3 f1<."i"C".J luf'pcu/td. I ~ 1CS:1~ ~ />SCf.:{. jp -J1=. e p, 7 -()O J If J ' J~'y'jJ 3. A. 0~ SCYILj Ee'0;CJ{J(J,o() ~ 1> /1, ~().(f()-It U. s. 5-'l'-"lJ Z> {)6 '-)d r)/'},OO,CfQX 15, 0~ If 5' ?/ IIA. C, 6Jr~ 11 r t; 1..<. r! I~u() .6()~ TOTAL (Also enter on line 6, Recapitulation) $ I. b * R-i~ up~ o~~la~::; ~~i:7:;e/;~: '* ~ sflllh;i) REV.1510 EX+ (2.87) . SCHEDULE'" b TRANSFERS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECED~IIIT_ ESTATE OF---- --------- !0cHI-rR]J J?, a~/f() PLEASE PRINT OR TYPE FILE NUMBER ;;{ / O~ ~()7 ?j-- ITEM NUMBER DESCRIPTION Of PROPERTY Include nome of the transferee, their relationship to decedent, dote of transfer. THIS SCHEDULE MUST BE COMPLETEDAN~FILED IF THE ANSWER TO ANY OF THE QlIESTIONS ON THE REVERSE SlllEClF THE COVER ~HEET IS YES. TOTAL VALUE DECD. DOLLAR VALUE EXCLUSION % Of DECEDENT'S _____~__ Of ASSET INT. INTEREST f. K eJ ,S~-v/~5A:a-;:3 <~..ll~=7~-.J ~ l~~rJ:yj A~"j,,--...J kf FCU Ad. #-;l,/67S-~'" A-.l~. 5 ,\vl'; p (::l../1J7ocr-ou) B. ({d-(. 10< /()7,su- '1-1) C, L<--h{ :;1,,('.<) tJ7uu-Y-;l, ') D.Lc.rh{l(,;I,1 07~C-'t'3) c2. t?ej' J<;Y/"J5 Co.",} :3 cUfrf'u-.f-o t JraJH) f1c"')-t'i/:] I,:, T rCU !rU-/+. ;;, lo7S-b /I. JfGj.J~Y(iJS(~/07~ -0 oJ p. uv-h&, I C.~/070b-~;) Ie , LcvAt ;z C:l,1 o7n- Y:J..; j) . 6vtf :1 (J./ OJJ& -'1:1) /Yo ~ G ':<s-;ou i /0010 ,1 ~ (l, 00 II P,/J 31'/.70 II J :J.1)3'i'7]O /1 S /'1; oS'J. 77 'I :I /'1;00/.77 (I t O,~sr: ~8 II ~ 10 1:l1s': g-8 /yo"",- 1:t~o0. /Doio ~'?O:6 D :J7?}7J/.'f31/ 1Ji7J/.'1J I; ~.n;l'V .$ <ro/ t S":? ' 47 I; il jI 17; J^ifrJZO t; TOTAL IAI,o eolec 00 lioe 7, Remp;lololioo) S {If- '2/ 16lL &-7 (If more space is needed, insert additional sheets of some size.) .~~Q. SCHEDULE H ~W FUNERAL EXPENSES, COMMONWEALTH OF PENNSYlVANIA ADMINISTRATIVE COSTS AND INHERITANCE TAX RETURN MISCELLANEOUS EXPENSES RESIDENT DECEDENT ESTATE OF C/f/RO} J(t'clflh/i. P ITEM NUMBER REV.1511 EX+ (7-88) A. L ';), J. f(. Please Print or Type FILE NUMBER ,;2/ O~ -07c::rJ-- DESCRIPTION Funeral Expenses: IV),I/JC7..z/ fC'J CV'vl IIOf'7<-'- FU") <.""<; / L O'TG~) tJ'iV-<-7vV'l!s :FA/t~ 7 OVC"J U6rJ'-'- '( C.-t,(df,.;~ CO'l<./-<vt0 CGr<i'<"-?(:M1'v) L B. Administrative Costs: Personal Representative Commissions Social Security Number of Personal Representative: Year Commissions paid 2. Attorney Fees 3. Family Exemption Claimant 4. C. L 2. 3. 4. 5. 6. 7. 8. Relationship Address of Claimant at decedent's deoth Street Address City State Zi p Code AMOUNT '?l/("Y:O ;i 01(., cf-6--' t b 70: dO Probate Fees >' :z 77.60 R'( <..- X'tv/,nvy';"".:p., 1. Ii", !(.cfuv"t .If :<0: 00 -p, 1<- K~/t..,. S <-#(<." '--vI /J J T'''-''- ""-<o. r . , Miscellaneous E,(penses: ~ '7, 0 u f'vid'J<- - 200@ 5.;<,.S-4- rev h,/(t-:t 7& ,DO pusl';J<::'- -I (,0,00 IfJvuJ/d-c.. ~l<I-L- P"ilr,~f ,...veiVS rJ--Cor;j,L{'VJ.' :}O/(ywy 1 /'-f~.f7 R cc-.,..l peel -fu fk( jr -5. i .;? 0: 00 TOTAL (Also enter on line 9, Recapitulation) If more space is needed, Insert additional sheets of same size.) $ 9, 7Ja, 07 f REV1512EX."93I. COMMONWEALTH OF IlENN5YlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS Plea.e Print ar Type FILE NUMBER ~ () -07 cfcf-- litO. ITEM NUMBER DESCRIPTION AMOUNT 1. J. If. C::'''j' Y<- Jil(ev E;x'7's-eJ - C<fY"o! tJoy~ .- L'lV-c... (;'y~V~ AJ-c'17 .J :;(!O,Ou J 0000 ), /YI~t'1~ /s-;- ViJ'i C,vd JJ)/'1'1C~ tOG ,oJ ,lJO: tr- f)tJlf Orrf1. r;.,Q'-li:/f<- t PA- 5p;..d-:cl qU'lVTcvj' 7:'x 1:J/I'I1~~ UJ. -n6cJ....-c 7:;y <1'1 1- ~r I/v,:;Of't r=:. 7A>J If) ~ /JUG 9/Njo,),; I-'l//) P1J2~GT>=- PfeJIV) Fs17tTE /}-sJP"TS I~ 1//70":OJ $ /.S-J/ I Lf- 7 TOTAL IAlso enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of same size.) . R~V- 1513 EX+ (2-&7) .. COMMONWEALTH OF P~NNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BEN EFICIARI ES ESTATE OF FILE NUMBER t:;/}jj(o ITEM NUMBER 1. .;{. '3. If, d../ 0), -07cf,r- RELATIONSHIP AMOUNT OR it". SHARE OF ESTATE leHA-leD NAME AND ADDRESS OF BENEFICIARY A. Taxable Bequests: f?t'<--HfrJ\b If. C-A-iJro 6:3 't-fJ Dc-/) 11 /U ft ~ 1':0 "j, ~t:JJ4",/~buO) PA--17CUQ L'IIJc..1TG i: ;AsC<l~;' 't)'3 LC)<"(7; 1])'1 AYe jl1cc:Ac,'?,c--Jbu'J) J.:Jt )70SJ~ /?e..I1'C-cC<JIY-o- IOu:.. 0 / Lou'?-fr;-ai~ Couvf ~/v-cv S,?nJ) /vlD .qO'!QJ- O!=TA-XA-tJLE fJeqvF::.T.5 .s ohG //3 /J"i uJ4k ~:.? Ifi i.(j 1-f-c v- Y::s ITEM NUMBER AMOUNT OR SHARE OF ESTATE NAME AND ADDRESS OF BENEFICIARY 1. B. Charitable and Governmental Bequests: TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) $ (If more space is needed, insert additional sheets of same size) j ~ 1 ~ LAST WILL AND TESTAMENT OF 21-02-0788 RICHARD R. CAIRO I, Richard R. Cairo, of304 Somerset Drive, Shiremanstown, (Lower Allen Township, Cumberland County), Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking and making void any and all prior wills, codicils, writings thereto, by me at any time heretofore made. ffElvi I I specifically give, devise and bequeath the following items to my wife, Loretta M. Cairo: a. The automobile considered to be the primary automobile of the family, whatever make and model that may be. b. The remaining proceeds of any Individual Retirement Account held by me. c. The right to remain rent free in our martial residence at 304 Somerset Drive for so long as she desires, provided that she continues to pay in a timely fashion all expenses attendant thereto including taxes, municipal services, repairs, assessments, and like items. This shall not be considered a life estate and this right shall terminate upon her permanent departure from said residence. ITEM l~ AlLthe rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give devise and bequeath iinto my children, Lynette I. AscaIu of. Mechanicsburg, Pa., Richard A. Cairo, of Camp Hill, Pa., and Renee Cairo-Iocco of Silver Spring, Maryland, to be divided equally among them. If any of my children do not survive me by at least sixty (60) days, then, in that event, their respective share of this estate shall pass to their surviving children, per stirpes. If any of my children do not survive me and are not themselves survived by a child, children or other issue, then, in that event, their respective share of this estate shall be divided equally between my remaining children or their issue, per stirpes. ITEM II! I direct that my earthly remains be buried in the family plot of ground located in Holy Cross Cemetery, Harrisburg, Pa. Page 1 00 pages ... --"_.----~---..-.- .._~_._--- ITEM IV I nominate, constitute and appoint my son, Richard A. Cairo of3501 Hawthorne Drive, Camp Hill, P A 170 II as the executor of this, my last will. If, for any reason, he cannot serve as executor, I nominate, constitute and appoint my daughters Lynette I. Ascani, and Renee Cairo-Iocco as the co-executrices of this my last will. No fiduciary acting hereunder shall be required to post bond or enter security in any jurisdiction. L . ~ INWITNESSV.rHEREOf, I have set my hand and seal to this-my 1a.<t wi!lilrid~-' testaInent, consisting of this and one other pa.8e which I have signed in the margin, plus a self probate form, this ~/,./t.. day of k-f;eu4-?i!y ,1998. @ a.J,O-A-J Rr;,;.....~ Richard R. Cairo We, the undersigned, hereby certifY that the foregoing will was signed, sealed, published and declared by the above named testator as and for his last will and testament, in the presence of us, who, at his request and in his presence and in the day and year above written, have signed below as witnesses; and we certifY that, at the time of execution thereof, said testator was of sound and disposing mind and memory. &:JIId4~ Residing at 1"10 -1 t<:. V/L.At-JD s:,_ . C~P. ___H!.l-.I....c.,,}?,4- IJQll,.~--,,-,"'_'~ -_..--- G(0rd..."'''-~ ~D-'-1- Residingat 'tl../l. "b~~l r~Ju (;).1 O{)A.JH',~ 1. ').4.. /7c/y ---- . ,- "----. Page 2 of3 pages COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND We, Richard R. Cairo, ::p.#R"y A;e11-n1"'A'" , and T s"ak4-Y 117. Jrd JI2 k v' ' . the Testator and the witnesses respectively, whose names are sign'ed to the attached or foregoing instrument, peing firSt duly sworn, do heret..)' d..d;:rrc to the unoeiSigUed authority that the Testator signed and executed the instrument as his Last Will and that he signed willingly, and that he executed as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the will as witnesses and that to the best of their knowledge, the Testator was at the time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. . artin Rip~cn, Nota,.., Pubfic Harf':pdsn iwp., Cumberfand County My Commis3ion Expires Jury 27, 2000 @~~~L~, ~~A1~ & 1!J<kQ/'<.J'fY7~ ~D.o Sworn to and Subscribed before me this g,(d/. day of /e,f,eclALy ,1998. U~N~~~'~ Seal Commission Expires: Page 3 of 3 pages 21-02-0788 CODICIL TO LAST WILL AND TESTAMENT OF RICHARD R. CAIRO I, Richard R. Cairo, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this Codicil to my last will and testament of February 26, 1998. My last will and testament, dated February 26, 1998, is hereby amended as follows: Having executed a separate release to this affect, I nevertheless reiterate that I have relinquished and do hereby relinquish and quitclaim any right, title or interest I may have by marriage or otherwise to the property at 2 I 7 Mahantongo Street, Pottsville, P A. in consideration of my wife's mutual release of any of her rights in 304 Somerset Drive, Shiremanstown (Lower Allen Township, Cumberland County). This property shall pass in accordance with the legal procedures made by my wife in the title to that property or in her last will and testament. IN WITNESS WHEREOF, I have set my hand and seal to this, the codicil to my last will and testament dated February 26, 1998, consisting of this single page plus a self probate form, this 7.,11,. day of /tp~/1 ,1998. . cf2A~~ ~ Richard R. Cairo We, the undersigned, hereby certify that the foregoing codicil was signed, sealed, published and declared by the above named testator as and for a codicil to his last will and testame~t, in the presence of us, who, at his request and in his presence and in the day and year above written, have signed below as witnesses; and we certify that, at the time of execution thereof, said testator was of sound and disposing mind and memory. ~'d1L;.I Residing at /~() ~. ~/ d ;:/;JI J ,1/u/,'fi'lIfh.--'Avrz, ;1; 17t711 ~ /l?1~^ Residing at 468 /V W~Jrv..",.+ s+ /11+ No/IYl Ph- 17005 ~ COMMONWEAL TIl OF PENNSYLVANIA ss COUNTY OF CUMBERLAND We, Richard R. Cairo, kl8i,L}. HI rn'-5 . and .s;/,q,e~ fife j 14 . the Testator and the witnesses resp~ctively, whQse nllfilCS lUe gigJ,ed to ihe ailached' or foregoinp; instrument, being first duIy sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instnunent as a codicil to his Last Will and that he signed willingly, and that he executed as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the will as witnesses and that to the best of their knowledge, the Testator was at the time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. ;t~~~ ~f~~ /f~:n. Sworn to and Subscribed before me this 7 ~ day of If'RI/ ,1998. QnMf;.... Notary Public \ Notc:.ri.::-.ISo.C:1 Ha:'.~~;~~ '~';:~:;:~~_c;.l~:i~~~~(~;~~;~unty My Comrr::s~!;;l!l ,::;-;j:mes ,JulY 27, 2000 .~ /' / MUTUAL RELEASE AGREEMENT 'This Agreement made this ..<'6,4( day of r;..lR(//H!.Y , 1998 by and between Richard R. Cairo, husband, and Loretta M. Cairo, wife, both of 304 Somerset Drive, Lower Allen Township, Cumberland County, Pennsylvania. WHEREAS, both husband and wife own, exclusive of their spouse, interest in certain real property, namely; Husband - 304 Somerset Drive, Lower Allen Township, Cumberland County, Pennsylvania, with approximate value of $ I 20,000; and Wife - 2 I 7 Mahantango Street, City ofPottsviIIe, Schuylkill County, Pennsylvania with approximate value of $6'\,000.00; and WHEREAS, both husband and wife wish to freelv dispose of their respective real property in a way that each deems appropriate without legal claims being made against this real property by their spouse. NOW THEREFORE, in consideration of the mutual promises made herein, and intending to be legally bound hereby, the parties agree that they shall make no legal ' claims against the real property of their spouse herein, as described above, either by election against a will, divorce action or otherwise. IN WITNESS WHEREOF, the parties have executed this agreement in duplicate ~ace provided.~e:w. ~4." ~ ~0Jr-J tK ~J Witness Ri~. C~o _ /? ~~l~ Loretta M. Cairo '::',("."'~i: '_". ~;- .: ~',' ; ~._;.r;_..,,~:. :-t!O ~5"~.....,...;;;t/!;~ 'l"Wr l.J"oJ~ ......; '-'.!...(:I!~_y, ___'-~r_ MBr~in f~GSGd. ~,;~ ~::i-'l 'FJ'hUc Not1rial Seal Martin Ripscn, Notary Public Hampden Twp., Cumberland County My Commis~ion Expires Juiy 27, 2000 , . ~"d", ~_~,~=--,. ~..~-~~....__~~'"~'-~---<,.,~... , '" . -'~~W<ll~Jti.~.._~,,~-.q~_.,,'i-~,e,;o"""#-'_""'f~'~~~~"':----'!("".-':::,- ~",,'~"'''''''C''''", - 'f,'....1":t '''l".''"_ \'ii;'....";~~"-" )~ '" ~ 'f. 'V-'" ~ , ~~~ "'-~J_<;~;, ~;"~_;.~~'!~~~<...~~~~~-tJ~'>"':;:J7$"'J:".~}_~-'i-_-"; '~,:'~ ;.::-;'~-",,_~;'"~'-' r _;~~;.~ 'i.~~" ': CI): "MuTtRvL RGlcAie::': '~, k y, LAS! WI/I ~ -rpS7kM,eN T o,F r;.~ FeS ttt't~ ~ coP lelL 10 l~51"Wl1I AN D lESlt't Mervr- :~"1!;<,!;"qUli'~,,l)' '8qUU'~) , ''JI;!" :'1'" n,h..-.;""'" -;__ _.- <t.H)~,,_';':Ji~ .l'.;l:';_.>' ",' ,.;'-: t,t.:r:~._,.. , ZS: l d 6lZ\!l'J'u\ dZQ;il 9f1\1 ZOo , , r, ~ "3'.1 ,';':'C~\:J , ;:{;;,;;~;~~ '..(C1JVy"tj Cumberland County Board of Assessment Appeals Old Courthouse One Courthouse Square Carlisle, PA 17013 (717) 240-6350 (717) 240-6354 (fax) Board of Assessment Appeals Lloyd W. Bucher R. Fred Hefelfinger Sarah Hughes RANDY L. WAGGONER Chief Assessor STEVEN D. TILEY Assistant Solicitor DECISION ORDER MAILING DATE: November 5, 2000 PARCEL NUMBER: 48-24-0795-066. CAIRO, RICHARD R 304 SOMERSET DRIVE SHIREMANSTOWN PA 17011 Dear Property Owner: This letter is to officially notify you of the decision of the Cumberland County Board of Assessment Appeals regarding the above-referenced parcel. DATE OF APPEAL HEARING: 10/31/2000 DATE DECISION RENDERED: 10/31/2000 EFFECTIVE FOR TAX YEAR: 2001 DECISION RENDERED: [] Withdrawn By Applicant [ ] Abandoned For Failure To Appear [ 1 Denied - No Change [Xl Approved Review Appraiser's Changes [l Revised Assessment Based on Hearing [l Other: TOTAL VALUE FAIR MARKET CLEAN AND GREEN CLEAN AND GREEN STATUS Old Assessed Value: New Assessed Value: 142,790 136,050 NOT APPLICABLE Any person aggrieved by the order of the Board of Assessment may appeal to the Court of Common Pleas by filing a petition in the Prothonotary's office on or before December 05, 2000. MemberslSI FEDERAL CREDIT UNION PRIMARY OWNER: REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner/Date Joint Ownership Created CHECKING ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principai and Accrued Interest Name of Joint Owner/Date Joint Ownership Created INVESTMENT SAVINGS ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Certificate Purchased Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner INSURANCE DEPARTMENT 5000 Louise Drive P. O. Box 40 Mechanicsburg, PA 17055 1-800-283-2328 or (717) 697-1161 Richard R. Cairo 4631 -00 01/13/1959 $667.56 $.67 $668.23 Lynette I. Ascani - 09/03/1997 Loretta M. Cairo - 09/03/1997 Richard A. Cairo - 01/07/2000 Renee E. locco - 01/07/2000 4631 -11 03/01/1984 $408.53 $.00 $408.53 Loretta M. Cairo - 09/03/1997 4631 -05 1 0/03/1985 $12,664.29 $15.21 $12,679.50 None 4631 -56 18 MO 01/03/2000 $23,048.71 $56.62 $23,105.33 Loretta M. Cairo 4631 -65 18 MO 03/09/2001 $21,711.26 $73.57 $21,784.83 Loretta M. Cairo Page 1 DOD Values Richard R. Cairo Page 2 IRA CERTIFICATE OF DEPOSIT: Account Number/Suffix Date Certificate Purchased Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Beneficiary VISA CREDIT CARD ACCOUNT: Account Number Date Account Opened Balance at Date of Death Name of Joint Cardholder PRIMARY OWNER: REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner/Date Joint Ownership Created CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Certificate Purchased Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Certificate Purchased Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner 4631 -15 5 YR 01/31/2000 $10,152.94 $39.66 $10,192.60 Loretta Joulwan Cairo 4121449998046317 09/16/1986 $56.59 None Richard R. Cairo 210755-00 10/30/2001 $25.00 $.00 $25.00 Richard A. Cairo - 10/30/2001 210755 -4118 MO 10/30/2001 $21,399.70 $50.73 $21,450.43 Richard A. Cairo 210755 -4318 MO 10/30/2001 $10,265.80 $20.08 $10,285.88 Richard A. Cairo Page 2 210755 -4218 MO 10/30/2001 $14,024.34 $27.43 $14,051.77 Richard A. Cairo DOD Values Richard R. Cairo Page 3 PRIMARY OWNER: REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner/Date Joint Ownership Created CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Certificate Purchased Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Certificate Purchased Principal Ba!ance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Richard R. Cairo 210756-00 10/30/2001 $25.00 $.00 $25.00 Lynette Ascani -10/30/2001 Renee locco - 10/30/2001 210756 -412 YR 10/30/2001 $32,602.38 $129.05 $32,731.43 Lynette Ascani 210756 -43 2 YR 10/30/2001 $17,827.63 $70.57 $17,898.20 Lynette Ascani Page 3 210756 -42 2 YR 10/30/2001 $50,493.02 $199.87 $50,692.89 Renee locco 000 Values Richard R. Cairo Page 4 PRIMARY OWNER: REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death T otai Principal and Accrued Interest Name of Joint Owner/Date Joint Ownership Created Estate of: RICHARD R. CAIRO Date of Death: 08122/2002 Social Security Number: 204-03-5996 Richard A. Cairo 6127 -00 01/02/1963 $1,104.91 $1.05 $1,105.96 Richard R. Cairo -01/02/1963 ~S~DrrUN~N Denise A. Anders Insurance Products Supervisor October 3, 2001 /:-~ BUREAU OF INDIVIDUAL TAXES ,~ INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 RICHARD A CAIRO 6348 BENNINGTON RD MECHANICSBURG PA 17050 DATE 02-25-2003 ESTATE OF CAIRO RICHARD R DATE OF DEATH 08-22-2002 FILE NUMBER 21 02-0788 :COUNTY CUMBERLAND ACN 101 Amount Renitted~ MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE _--- RETAIN LOWER PORTION FOR YOUR RECORDS ~ _ __ --------------------------- ------------------------------------------- REV-1547 EX AFP (01-031 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF CAIRO RICHARD R FILE N0. 21 02-0788 ACN 101 neTF n~-~~-inn; TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1l 136 050.00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) .00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .0 0 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this fora with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 15 ,6 05.09 tax payment. 6. Jointly Owned Property (Schedule F) (6)_ 7 ,460.63 7. Transfers (Schedule G) (7)_ 147, 109.87 a. Total Assets ($) 306,225.59 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 9,958.07 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 1.5 31.47 11. Total Deductions (11) ) ) .489 _ 54 12. Net Value of Tax Return (12) 294,736.05 13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax [14) 294,736.05 NOTE: If an assessment was issued previously, lines reflect figures that includ th t 14, 15 andior 16, 1~-, 18 and 19 will e e otal 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 (16) 294,736.05 X 045. 13,263.13 17. Amount of Line 14 at Sibling rate (17) .00 X 12 - .00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 15 - 00 19. Principal Tax Due X (lq),= . 13,263 13 TAX CREIIiTS~ . DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 11-09-2002 CD001832 631.58 12,000.00 01-16-2003 CD002056 .00 536.04 PAYMENT MUST BE MADE BY 05-22-2003*. * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 E% pFP (P1-037 TOTAL TAX CREDIT 13,167.62 BALANCE OF TAX DUE 95.51 INTEREST AND PEN. .00 TOTAL DUE 95.51 [ IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) W REV-1470 EX (8-88) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 =DENTS NAME Cairo, Richard R. EWED BY Daniel Heck ITEM SCHEDULE NO. F 3a,b,c H INHERITANCE TAX EXPLANATION OF CHANGES FILE NUMBER 2102-0788 101 EXPLANATION OF CHANGES Each of these savings bonds has been increased to'/Z of the date of death redemption value, per correspondence dated 02108/2003. The expenses of the cemetery marker have been added to this schedule. This expense was received through correspondence dated 02/08/2003. ROW Page 1 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE REV-1162 EX(11-96) BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 002225 CAIRO RICHARD A 6348 BENNINGTON ROAD MECHANICSBURG, PA 17050 ACN ASSESSMENT ,AMOUNT CONTROL NUMBER fold TOTAL AMOUNT PAID: REMARKS: RICHARD A CAIRO CHECK#104 SEAL INITIALS: AC RECEIVED BY: DONNA M. OTTO 595.51 DEPUTY REGISTER OF \NILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES COMMONWEALTH OF PENNSYLVANIA INHERITANCE rax DIVISION DEPARTMENT OF REVENUE DEPT. 28061 HARRISBURG, PA I7IZS-o6al INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX 6FP (01-03) DATE 03-17-2003 ESTATE OF CAIRO RICHARD R DATE OF DEATH 08-22-2002 FILE NUMBER 21 02-0788 RICHARD A CAIRO COUNTY CUMBERLAND 6348 BENNINGTON RD ACN 101 MECHANICSBURG PA 17050 Amount Remitted' MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HDUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form wi•kh your tax payment. CUT ALONG THIS LINE __-___ RETAIN LOWER P_ORTI_ON FOR YOUR RECORDS __~ ----------------------------- REV-1607 EX AFP (O1-03) ~~* ---------'--"' ------------------- INHERITANCE TAX STATEMENT OF ACCOUNT ~~~~ ESTATE OF CAIRO RICHARD R FILE N0. 21 02-0788 ACN 101 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATETESHOWN BELOw003 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: 02-25-2003 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 11-09-2002 CD001832 01-16-2003 CD002056 02-25-2003 CD002225 631.58 12,000.00 .00 536.04 .00 95.51 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL DUE ( IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS REQUIRED. 13,263.13 13,263.13 .00 .00 .00 IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) FAMILY SETTLEMENT AGREEMENT AND RELEASE OF HEIRS/EXECUTOR OF RICHARD R. CAIRO ESTATE NO. 21-02-0788, CUMBERLAND COUNTY, PENNSYZVANIA KNOW ALL MEN BY THESE PRESENTS THAT WHEREAS RICHARD R. CAIRO, late of 304 Somerset Drive, Shiremanstown (Lower Allen Township, Cumberland County, Pennsylvania, deceased died testate on August 22, 2002; and WHEREAS, the last will and testament of the decedent, dated February 26, 1998, and codicil thereto dated April 7, 1998, were filed for probate in the Office of the Register of Wills of Cumberland County, Pennsylvania on August 29, 2002; and WHEREAS, by the terms of Items I and II of the said will, the decedent's wife Loretta M. Cairo is the beneficiary of certain specific bequests and the decedent's three children Lynette I. Ascani, Richard A. Cairo, and Renee Cairo-Iocco, are his residuary beneficiaries entitled to equal shares of his residuary estate, and WHEREAS, by the terms of Item IV of the said will, the decedent's son Richard A. Cairo is appointed as the executor of the decedent's last will and testament; and WHEREAS, on August 29, 2002, letters testamentary were issued to the decedent's son, by the Register of Wills of Cumberland County, Pennsylvania; and WHEREAS, the said Richard A. Cairo, executor, wishes to account for and distribute the remaining assets of the estate; and WHEREAS, certain debts, funeral expenses, costs of administration, in kind distributions and reserve funds, including Pennsylvania Inheritance Tax, amount to $$12,631.:>5, leaving a balance for distribution of $0.00 as of the ending date of the attached accounting marked Exhibit A. NOW THEREFORE KNOW YE THAT we, Loretta M. Cairo, Lynette I. Ascani, Richard A. Cairo and Renee Cairo-Iocco, the sole beneficiaries of the said estate under the de'cedent's last will and testament, do hereby acknowledge that we have this day received from the aforesaid executor, in full satisfaction and payment of all sum or sums of money, legacies, bequests, and devises as are due us as of the date of this instrument under the said last will and testament (except for the remainder of any amount held in reserve hereunder and the amount of any additional interest accumulating beyond the date of the attached accounting going to residuary beneficiaries), which amount we have received and which is set opposite our name;; in the table and schedule of distribution in said statement attached hereto and marked Exhibit A. AND we hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, we agree and do consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same force and effect as if they had been filed and confirmed by the Orphans' Court Division of the Court of Common Pleas of Cumberland County, Pennsylvania; THEREFORE, we do hereby remise, release, quitclaim and forever discharge the said Richard A. Cairo, executor aforesaid, his heirs, executors, administrators and assigns, of and from the said estate and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever, touching upon the estate of the said decedent, and his deeds as executor of the said estate and we do hereby covenant and agree that should any liability come due to the estate of the said Richard R. Cairo after the signing of this agreement, which liability cannot be satisfied from any funds held hereunder in reserve, we will contribute pro-rata our respective shares of the estate assets to satisfy any and all claims, demands, suits or causes of action v~rhich may be successfully prosecuted against the said estate of the said Richard R.. Cairo, deceased, or the aforesaid executor after the signing, sealing and delivery of this family settlement and release. AND the parties further agree that this agreement may be executed in ar.~y number of counterparts, and each executed counterpart shall have the same force and effect as the original instrument and as if all the parties to all the counterparts had signed the same instrument. (See attached signature pages) 2 IN WITNESS WHEREOF, I have hereunto set my hand and seal on the date indicated below my signature. ~~ oretta M. Cairo COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS On this, the ~~,G~ day oi' ~,©,Pi~ , 2003, before me, a notary public, personally appeared Loretta. M. Cairo, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within family settlement agreement for the Estate of Richard R. Cairo and acknowledged that she executed the same for the purposes therein contained. In witness whereof, I hereunto set my hand and official seal. l~TOtary Public Comm. Expires: 4,+.e',.~ r .. T : .~~ ~ ~;~ IN WITNESS WHEREOF, I have hereunto set my hand and seal on the date indicated below m~siQnature. R n Cairo-Iocco Date: ~/a~/~~ COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS On this, the ~~ day of ~~y , 2003, before me, a notary public, personally appeared Renee Cairo-Iocco, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within family settlement agreement for the Estate of Richard R. Cairo and acknowledged that she executed the same for the purposes therein contained. In witness whereof, I hereunto set my hand and official seal. Notary Public Comm. Exnir '^" °rbitc mew-~----~ ~. ~?fYlun. c>~ "~= t.~ ....' i'. C.~:;9:.N"J' `i ~1~'!k3 6 IN WITNESS WHEREOF, I have hereunto set my hand and seal on the date indicated below my signature. J a~sc,cJ L tte I. Ascani Date: ~ ~j~ /~~ ~ COMMONWEALTH OF PENNSYLVANIA COiJNTY OF CUMBERLAND SS On this, the /slh day of /~'IAy , 2003, before me, a notary public, personally appeared Lynette I. Ascani, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within family settlement agreement for the Estate of Richard R. Cairo and acknowledged that she executed the same for the purposes therein contained. In witness whereof, I hereunto set my hand and official seal. Notary Public ~---- \~ f F.~I Comm. Expires: ~~ ,~ ~"r4" 4KC?fr(~?QP;~-'C"r11?.ij'ba°Ze9.="s:~,:;71`Dridi~ 4 IN WITNESS WHEREOF, we have hereunto set my hand and seal on the date indicated below my signature. G ~. ~ - . ' Richard A. rCairo Date: J,//(1 ~ COMMONWEALTH OF PENNSYLVANIA ~' v ~/~~1~ SS COUNTY O1~f~3EI~L~B On this, the ~ day of //~ , 2003, before me, a notary public, personally appeared Richard A. Cairo, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within family settlement agreement for the Estate of Richard R. Cairo and acknowledged that he executed the same for the purposes therein contained. In witness whereof, I hereunto set my hand and official seal. Notary Public Comm. Expires: NOTAplA~ ~~ F.M. RICHARD SIM61d~fl~ j~gl~l~ S~;kii.~ Harrisburg, DaUphll9 6r~u~'~L~ ' " My Commission Exp(r®~t ~i~v. ~!::. <:!;t; ..: . 5 EXHIBIT A ACCOUNT OF RICHARD A. CAIRO, EXECUTOR OF THE ESTATE OF RICHARD R. CAIRO AS OF MAY 1, 2003 PRINCIPAL DEBITS The Accountant charges himself as follows: PERSONAL PROPERTY 1. IRA Certificate of Deposit #4631-15 (Membs 1St FCL7) (Specific Bequest) 2. Membs 1St FCU Investment Savings # 4631-OS $10,192.60 $12,679.50 3. 1995 Honda Civic Automobile (In Kind Distribution Item, Specific Bequest -Loretta M. Cairo) 4. 1989 Honda Civic Auto (At Sale) $1120.00 5. Proceeds, Pre-Death Sale of Prudential Ins. Stock Received After Death$1,785.00 6. CMS Medicare Reimbursement $:?0.59 7. Contribution from Residuary Heirs toward Payment of Estate Costs $:(2,000.00 TOTAL PERSONAL PROPERTY $37,797.69 REAL PROPERTY 304 Somerset Drive, Lower Allen Township, Cumb. Co. (Assessed Value) $1.36,050.00 (This real estate is an in-kind distribution item to the residuary heirs Lynette I. Ascani, Richard A. Cairo, Renee Cairo-Iocco. To be transferred to residuary heirs via executor's deed at or shortly after the execution of this family settlement agreement by the heirs named herein) TOTAL REAL PROPERTY TOTAL PRINCIPAL DEBITS $136,050.00 $173,847.69 7 TOTAL LIQUID DEBITS AVAILABLE FOR USE AGAINST CREDITS .FOLLOWING SATISFACTION OF SPECIFIC BEQUESTS AND IN KIND DISTRIBUTIONS `.627,605.09 PRINCIPAL CREDITS The Accountant claim credit for the following: 1. Malpezzi Funeral Home, Mech., PA 97,916.40 2. Funeral Lunch, Davenport's Italian Oven $516.85 3. Office of Catholic Cemeteries (Grave Opening & Marker Placement) $875.00 4. Probate Fees $277.50 5. Advertise Estate $',148.87 6. File Inventory & Inh. Tax Return $25.00 7.. File Family Settlement Agreement (Pending) $17.00 8. Record Deed to Heirs (304 Somerset Drive) $25.00 8. PA State Inheritance Tax (Excludes 5% Credit) $12,631.55 9. Caregiver Expenses (Carol Boyle, Care Givers Agency) $264.00 10. Final Payment, Members ls` Visa Card Balance $56.59 1 1. Payment, DBA Orth. Institute of PA $35.88 12. Estimated Quarterly Tax Payment, U.S. Inc. & PA Inc. Tax, (9/15/02) $1,175.00 13.. Held in Reserve by Executor $3640.451 TOTAL PRINCIPAL CREDITS $:?7,605.03 SUMMARY ~ This figure may not match the final amount in the estate check book when the estate account is closed due to expenses paid after the date of this accounting and the addition of interest. As of date of this accounting, $3544.95 remains in estate checking account, a $95.89 discrepancy over the amount listed as reserve above. 8 TOTAL DEBITS TOTAL CREDITS BALANCE FOR DISTRIBUTION SCHEDULE OF DISTRIBUTION Richard A. Cairo $0.00 Lynette L Ascani $0.00 Renee Cairo-Iocco $0.00 Loretta M. Cairo $0.00 thus exhausting the funds available for distribution. '27,605.03 '27,605.03 .`60,OOZ z Executor will distribute any remaining balance of reserve funds held in estate checking account to residuary heirs by December 31, 2003. Residuary heirs should each report one third of 2003 interest accrued on estate account on their individua12003 tax returns. 9 STATUS REPORT UNDER RULE 6.12 Name of Decedent: ~~ ~ ~ N ~~~V~ ~~ , ~~~" ~~l ~~ Date of Death: ~/ ~-_~ ~C-~ Will No. Admin . No . ~ ~- C ~ -~ -- ~ ~ ~ ~~~ Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state they following: a. Did the personal representative file a final account with the Court? Yes No~. b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes X _ No d. Copies of receipts, releases, joinders and C ~~-r approvals of formal or informal accounts may be filed with the \ Cerk of the Orphans' Court and may be attached to this report. ~ ~y~~~~ :a - -1 Date: L~ __~ (/~ ~ ,~,.~ C. L G2 ~. ,- ig~a re c: ~ ~ J --' a e (Please type or print) ~~= '~~~ Addres s ~ ~ ~~ / 1~ -~- ~ Tel. No. Capacity: ~_Personal Representative Counsel fo:r personal "~ ~ ~ representative (MAH : rmf /AM3 ) ~~ `~ - ~'~~~