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Home My WebLink About02-0998PETITION FOR PROBATE and GRANT OF LETTERS Estate of S. RUTH ADAIR also known as Deceased. Social Security No. 174-20-4939 To: Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioners are 18 years of age or older and the Executors named in the last will of the above decedent, dated July 21, 1997 and codicil(s) dated [none]. Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 1655 Trindle Road, Carlisle, Middlesex Township. Decedent, then 78 years of age, died November 4, 2002, at Cumberland Crossings, South Middleton Township, Carlisle, Pennsylvania. Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $unestimated (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $unestimated situated as follows: Middlesex Township, Cumberland County, PA WHEREFORE, petitioners respectfully requests the probate of the last will and codicil(s) present herewith and the ant of letters testamentary thereon. c_ Thomas J. Sh ffer ~ Virgi E. Gutshall, Sr. 1140 Forge Road R.D. #1 Carlisle, PA 17013 Blain, PA 17006 (717)245-0334 (717)536-3444 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ) . SS. COUNTY OF CUMBERLAND The petitioners above-named swear or affirm that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioners and that as personal representatives of the above decedent, petitioners will well and truly administer the estate according to law. ~ - ~, Sworn to or affirmed and subscribed ~ ~ , ,/~~~ ~~~ L- ~ --~'~ ' - ~ -~ ~. before me this 7th day of Thomas J. Sheaffer' y' November 200 7 -, Donna M. Otto, lst DeputyRe iste ~ Virgil .Gutshall, Sr. ~~`c:' No. 21-2002-998 Estate of S. Ruth Adair, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW, November 7th , 2 0 0 2, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument dated July 24, 1997, described therein be admitted to probate and filed of record as the last will of S. Ruth Adair and Letters Testamentary are hereby granted to Thomas J Sheaffer and Virgil E. Gutshall, Sr. Will Book # ~ '~ ~ ~ ~~ Page Register of Wills Donn M,~Ot to 1st Depufy FEES Probate, Letters, Etc. Short Certificates(4 ) ~>i~>~~ x-Pages JCP $ 235.00 $ 12.00 $ 12.00 $ 10.00 $ 269.00 Mark A. Denlinger, Esquire (83794) ATTORNEY (Sup. Ct. LD. No.) MARTSON DEARDORFF WILLIAMS & OTTO 10 East High Street Carlisle, PA 17013 (717) 243-3341 TOTAL Filed November 7th, 2002 CALLED ATTORNEY ON 11-8-02 F \FI LES\DATAFILE\ESTATES W 0501-petition.ltr 'pis ;s rr.+ (r tr~~ i~7 ~ ,. ~~ hers iv:°n is corre~ I!~- cop ,~~~ ,m an ty .~ tl•3"1 ~_ 1<<rlc:~.•, c~E t__ 1+-s t,i~~_. ~ _, .., .~ ~ _..'. 1~ .,,; '.'.- l I .~, _ l' ~W'!!~ „i.fO;v~,33~~1'C~ rJ C~?~ '`„ _ .. i~.t...c ,__s t_'„l.i .~ _ ",_ .1,_ VY.hi!fT iY9~~3'~.,w`. s`''. ~~ ~~I~'~t~9 ~O ~I~.~~~~{ar z~t~ li ld~ °)~~.~IM ,.S'jl~ ~~~I'sAi~F,9'~K`~. '~3~ ~~7 \~i ai~"~~.-.•i •,a.. ~~.__ ~~a~6.46---_ H105. ; t3 Rev. 2187 VT NT K 7i+ - ., r'y~,, r,' .. ;( ~ , ~:;~ . ~ ~>. ~~ ~~,~~; ~, N 0 V ~ 200 - Rr. ~:~____ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH NAME OF DECEDENT IFirm. Mddle. Laml SEX SOCIAL SECURITY NUMBER GATE OF DEATH,MaM. Day. fir) ~ +. u}- A i ]. Female ]. 174 - 20 - 4939 .. November 4, 2002 AGE (Lam BMhday) UNDER 1 YEAR UNDER 1 DAY DATE OF BIRTH BIRTHPLACE (Cay x4 PUCE OF DEATH (Check dny one - uro imm~,cuma on OmN noel Momma D.ya HoVa r MinNaa Mdnm. Sletea FCregn Cwnrryl Au ~ ~b HOSPITAL: OTNER: (ag~us 78 Perms) Co. , PA Vb. 1924 ~l Iripaliant ^ ERIOulpetienl ^ DOA C "°'"'g °in~ Nom. RJ R.aEanp LJ ecl S ) ^ s. e. T. , D Y a. COUNTY OF DEATH CITY, BORO. TWP OF DEATH FACILRV NAME III not inm~Nlron, q,ve soeN and number) VIA$ DECEDENT OF HISPANIC ORIGIN? RACE-Amancan Indian, Black, NTKa, etc. ~ No ® 1Ye ^ M yM. edecdY Cla!•n, ISOecMI Cumberland S. Middleton Cumberland Crossings Retire. Comm M iu P n Ri cK rr, w can,Ne. o w k. ed. f. 10.' Whlte DECEDEM'S USUAL OCCUPQION KIND OF BUSINESSlINDUSTRY WAS DECEDENT EVER IN DECEDENT'S EDVCATION MARITAL STATUS-MenNd SURVIVING SPOUSE (Give kurd d work done davg mom U.S. ARMED FORCE57 ni nan NavM Martied. W idowd, In ,vds, qna ma~osr rwnel d waking Ma; W na uea rNncd l ElamantarylSacorWary Coupe DOarced ISDa'cMl r.^ "°® Secrete School District '°'~' "'dp5" Never Married DECEDENT'S MAILING ADDRESS (Strem.CMR n,Sbb. ZiD Cade) DECEDENT'S pA Middlesex Twp 7 ® 1655 Trindle Road . ACTUAL 17a.slab Did 1 0. Yba,aec.daralWedM hey Carlisle PA 17013 RESIDENCE OacsWm ~,n°';s; ` Cumberland yi ? ND a.~nika.d ,e • p ,7d ^ enk lN . w . lactua nad py,~,b_ 770. car FATHER'S NAME (Fain. Mode. Lam) MOTHER'S NAME (Fqm. Middle, Mayen Sunamej Oscar S Adair Mar aret E G t h ll ,,, . ,,. . u s a INFORMANTS NAME (IypdPrad) INFORMANT'S MAlLINO ADDRESS IS1raN. Diry/iown, Slale. ZD CodN Tom Sheaffer 1140 For e Road Ca li l PA 17013 20i. t00. g , r s e METMOOOF dSPOSITION GATE OF OISPOSITK)N PUCE OF DISPOSITION-Nama dCwmetery. Crematory LOCATION-CaylTOwn, Stela. Z'p COW Crematgn ^ Removal nom SIN ^ (MOnm, Day, rear) a OIhN Pbq ^ . Donation ^ ~ SpeCM November 9, 2002 Blain Cemetery Blain PA 2L. ]tb. ]ic. , ],d ' SIGN OF UNEMLSERVK; S OR E ONACTINGA ~ ~~~, ~ LICENSE NUMBER NAMEANOADORESSOFFACILITI' Hoffman-Roth Funeral Hone . + • ]2,. ~-~L~l ]m. 013144-L . rx. exams 23ae ~~ty wean unityirg To lM Dealdmykro ,Waln xuured allW lima, Oneaw pace mated. LICENSE NUMBER DATE SIGNED .. Dllyaicbn a1 not eva8e0b al IinM d Wath 10 (Sgnmure and Tine) (MMtl1. Day. Marl ' cermy tAUMMOeNR A 2a.. ab. - ~~ L 2x. ~l- tl `~ -0~- ' aama 2s-2e mum WCOmpb,eO by TIME OF OEQH D EPRONOU ED DE.;D (Mwm,O SCASE REFER REDTO MEDICAL EXAMINERICORONER7 i' ~~ - parew w1r0 Prarlountea WaN. ~ '~ ~ ~ Ws ^ No ~" L ].. M. ri. ]7. PART I: Einar 1M Oifaasaa, injuriM or wmOlKerbM which uufad the W ctn. Do 1 anler IM mach al dying, ersJl as prdiae a raepiralory arrem, alwck or Man lailute. r ADaoKimNa PART 11: gher signitkam wndikar oonnMkq to WaM. but LqI Onty OW GIM M a«J1 NM. I I rrol leaullirlg in d1e unWllykg W1M gtia,'n PART 1. IMMEdATE CAUSE (Fmm disease a wrweia, ~ m ~~~' , \~ {mil/// anOat eM Wetl1 ' reaWWgn WNhl-- UE 70( ASACONSEOUENCE OFl: SeowrMeay llm wndlions o. ear~y, Nadkq birtKrbdleb OUE TO (OR ASACONSEOUENCE OFl: I drrsa. Emer UNDERLYN/G • CAUSE (Dasmsa ryay c. • em aMiNW evanb DUE TO (OR ASACONSEOUENCE OF): reeubp n Welh) LAST I d. WA$AN AUTOPSY WERE AUTOPSY FINDINGS MANNER OF OEATM DATE OFINJURV TIME OFINJURY IWURVQNgRKt DESCRIBE HOW INJURY OCCVRRED. PERFORMED? AMUUBLE PRIOR TO (Mwlh.Oay. Year) COMPLETION OF CAUSE Natasl ~' H i iW ^ OF DEQH7 / om e Vaa ^ No^ AttiWm ^ Pending lnveatlgstbn ^ ~j ~ Msa ^ Mop./' Yea ^ No ^ SuiciW ^ DOVId na W Wlermirred ^ aW. 700. M. ]Oe. 70e PUCE OF I W URY -AI home, brm, mreN, laday. o8ke LOCIRION (Seem. ay1,OrN1, State) L twikwrq, Nc. ISpenlyl ]M. 2eb. 29. aW. ]0,. CEATiflERlCnrrdr aray anal SIGNAT A TITLE OF CERTIF 'CERTIFYING PNYSICIAN (Phys,oen cerlayrtrg Cauee d deem .Man andha p+ye[ien he9 announced Waln and cpndele0 hem 271 .. Te dN Wet o, my krowNdge, W.M otturtad dw b Ma cauae(al and manner n aletb ..................................................... ~ ]10. ' UCEN N MBE DATE SIGNE M , Dsy. ybarl ' '-iIONOUNCiNG AND CERTIFYING PNYSICIAN(Pnys,Can oolh aonounnng Wam arW CenlMn9lo Cauudeeen+l Ta IW beat d my krowlapa, daab oeeurrw al Ma Lime, Wte, and place, and dw to tW eauaala) ane manner es atatad .......................... ^ , .~ 710. ~ O ~ `rr / ~ 71 d, 1 O NAME ANO ADDRESS OF PERSON WMO COMPLETED CAUSE OF DEATH ~~ 'MEDICAL E%AMINER/CORONER On the Oaele o/ eaemrnnlon and/or fnvestigatlon, In my opinion, death occurred el the time, date, and place and due to the cause(s) and (Item 271 T a Prim ~ r ~ ~O r, „~ (~ ~ F YJ~I ,p ~~' r~ P r7 W ~ l ~ : m.nn«aart.,ad ....................................... ........... ^ lJ ~~~t'~ J ~ CG(r Zz 7,a ]:. (7~1 REGISTRAR'S SIGNATURE AND DATE FILED (Month. OaY Mean ..~~- \\ ]]. A• ~~~.~t~. 4~ 7.. 0. ~ 62s' .a F:\FILES\DATAFILE\W ILLS\4050. W IL LAST WILL AND TESTAMENT ~`~~~ ~~~ I, S. RUTH ADAIR, of Middlesex Township, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. 1. I direct that all my just debts, funeral expenses, testamentary expenses and all inheritance taxes (whether such taxes may be payable by my estate or by any recipient of any property) shall be paid from my residuary estate as soon as practicable after my decease and as part of the administration of my estate. My Executors shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. I further direct my Executors to convert all of my estate into cash and distribute the same as herein set forth. 2. I give, devise and bequeath ten percent (10%) of the residue of my estate unto MARGARET IRENE STEELE; however, in the event she shall predecease me, this legacy shall lapse and be paid to THE FIRST LUTHERAN CHURCH, East High and South Bedford Streets, Carlisle, Pennsylvania. 3. I give, devise and bequeath ten percent (10%) of the residue of my estate to VIRGIL E. GUTSHALL, SR.; however, in the event he shall predecease me, this legacy shall lapse and be paid to PA T RiCIA A. GUTSHALL. 4. I give, devise and bequeath ten percent (10%) of the residue of my estate to PATRICIA A. GUTSHALL; however, in the event she shall predecease me, this legacy shall lapse and be paid to VIRGIL E. GUTSHALL, SR. 5. I give, devise and bequeath five percent (5%) of the residue of my estate to JOANNE E. ~,~~~.. ~~~ S.R.A. Page 1 of 5 Pages ROBERTS; however, in the event she shall predecease me, this legacy shall be paid, in equal shares, to her children. 6. a. I give, devise and bequeath five percent (5%) of the residue of my estate to VIRGIL E. GUTSHALL, JR.; b. I give, devise and bequeath five percent (5%) of the residue of my estate to ANN LOUISE GUTSHALL; c. I give, devise and bequeath five percent (5%) of the residue of my estate to REBECCA SUE GUTSHALL; d. I give, devise and bequeath five percent (5%) of the residue of my estate to LUCINDA EILEEN EGOLF; e. I give, devise and bequeath five percent (5%) of the residue of my estate to GABRIELLE ELIZABETH EGOLF; £ If any of the legatees in this paragraph shall predecease me, his or her share shall be divided equally among the survivors named in this paragraph. 7. I give, devise and bequeath five percent (5%) of the residue of my estate to WILLIAM A. STEELE; however, in the event he shall predecease me, this legacy shall lapse and shall be paid to THE FIRST LUTHERAN CHURCH, East High and South Bedford Streets, Carlisle, Pennsylvania. 8. I give, devise and bequeath five percent (5%) of the residue of my estate to CINDY ELIZABETH ROBERTS. 9. I give, devise and bequeath five percent (5%) of the residue of my estate toTONY EGUENE ROBERTS. 10. I give, devise and bequeath ten percent (10%) of the residue of my estate to THE FIRST LUTHERAN CHURCH, East High and South Bedford Streets, Carlisle, Pennsylvania. ,~ .'"' S.R.A. Page 2 of 5 Pages 11. I give, devise and bequeath five percent (5%) of the residue of my estate to THOMAS J. SHEAFFER; however, in the event he shall predecease me, this legacy shall be added to his children's shares equally. 12. I give, devise and bequeath five percent (5%) of the residue of my estate to each of KARA MARIE SHEAFFER and MATTHEW THOMAS SHEAFFER. These shares shall be held by THOMAS J. SHEAFFER for the benefit of the legatees until each attains the age of twenty-one (21) years; however, the income and principal may be applied for their secondary education. In the event THOMAS J. SHEAFFER is unable to serve, REV. STERLEN S. SHEAFFER shall serve. 13. In the event both VIRGIL E. GUTSHALL, SR. and PARTICIA A. GUTSHALL shall predecease or fail to survive me, I direct that their share aforesaid shall pass to their children in equal shares. In the event any part of my estate shall pass to any person who shall be a minor, I direct that said share shall be paid to the parent or parents of said minor child to lie held for the benefit of such minor child until they shall attain legal age. Such fund shall be applied toward the cost of secondary education of such children if it shall be their intention to pursue same. If not, then the parent may distribute such sum. 14. I nominate, constitute and appoint VIRGIL E. GUTSHALL, SR. and THOMAS J. SHEAFFER as Executors of my estate. 15 I direct that my Executors shall not be required to file a bond to secure the faithful performance of their duties in any jurisdiction. 16. I authorize and empower my Executors, in their sole and absolute discretion, to purchase or otherwise acquire and retain any investments of which I die seized or any real or personal property ;~~ S.R.A. Page 3 of 5 Pages of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in regard to any or all property of any kind forming a part of my estate for such terms and such prices as they may deem advisable; to borrow money for any purposes connected with the protection and preservation of my estate; to mortgage or pledge any real or personal property forming a part of my estate or to join in or secure the partition of same; to compromise any claims or demands of my estate against others or of others against my estate; to make distribution in kind and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share; to employ agents, attorneys and proxies and to delegate to them such power as my personal representatives consider desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys and proxies; and to execute and deliver such instruments as may be necessary to carry out any of these powers. In addition, I direct that my personal representatives shall have the power to conduct an inventory of any safe deposit box necessary to the administration of my estate. IN WITNESS WHEREOF I have hereunto set my hand and seal this ~'g~ day of .Ju1+~ , 1997. ~ -- t,. ~'.~.~'~t.~~~ (SEAL) S. Ruth A air SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, have hereunto subscribed our names as witnesses thereto, in the presence of the said Testatrix and of each other. • r ~'~` ~ Page 4 of 5 Pages COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) I, S. Ruth Adair, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ~ ~-. S. Ruth Adair Sworn or affirmed to and acknowledged before me by S. Ruth Adair, the Testatrix, this ~` ~~ day of ~U,~ ~J , 1997. _ 1 Notarial Seal ~ r Trivia L. Bailey, Notary Public Notary Public Carlisle Boro, Cumberland County Uiy Cornm;ssr;^ Expires Nov. 24, 1997 L~..~..~..,..».«.,...,......,.,....... ~.........,~ COMMONWEALTH OF PENNSYLVANIA ) . SS. COUNTY OF CUMBERLAND O~ We,(~~~~- ~ v "~~ ~ / V, thole ~ , ~rand~ the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw S. Ruth Adair, the Testatrix, sign and execute the instrument as her Last Will; that the Testatrix signed willingly and that the Testatrix executed it as her free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the Testatrix, signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. ~.. Address /'1' r /I~i O~1 /~ v r 3 Address ~~ ~~m,12~: ~ ~C.L~`i.k Sworn or affirmed to and subscribed before me this o~~Stday of ~ ~y , 1997. r r Notarial Seal Public Trivia L. Bailey, Notary Notary Public Carlisle eoro, Cumberland County s,j,, `,.,rn~Y~;~slon Expires Nov. 24, 1997 Page 5 of 5 Pages `..r,^. F: \FILES\DATAFILE\ESTATES\FORMS\4050-1.notice.cen Name of Decedent Date of Death File No. To the Register: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) S. RUTH ADAIR November 4, 2002 ~_- ~ l 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 beneficiaries of the above-captioned estate on or about January 15, 2003. Margaret Irene Steele 590 North Middleton Road Carlisle, PA 17013 Virgil E. Gutshall, Sr. RD # 1 Box 896 Blain, PA 17006 Patricia A. Gutshall RD# 1 Box 896 Blain, PA 17006 Joanne E. Roberts 10 North Road Mechanicsburg, PA 17056 Virgil E. Gutshall, Jr. RD# 1 Box 932 Blain, PA 17006 Ann Louise Gutshall 37 Fort Street Lemoyne, PA 17043 Rebecca Sue Gutshall Dum 3141 Erly Road Elliottsburg, PA 17024 Lucinda Eileen Egolf Box 23 Baker Lane Landisburg, PA 17040 Lucinda E. Egolf, Guardian of Gabrielle Elizabeth Egolf Box 23 Baker Lane Landisburg, PA 17040 William A. Steele 700 North Middleton Road Carlisle, PA 17013 Cindy E. Roberts Bedorf 6207 Elaine Avenue Harrisburg, PA 17112 Tony Eugene Roberts 322 North Front St. Apt.#3 Wormleysburg, PA 17043 The First Lutheran Church 100 East High Street Carlisle, PA 17013 Thomas J. Sheaffer 1140 Forge Road Carlisle, PA 17013 Thomas J. Sheaffer, Guardian of Kara Marie Sheaffer 1140 Forge Road Carlisle, PA 17013 Thomas J. Sheaffer, Guardian of Matthew Thomas Sheaffer 1140 Forge Road Carlisle, PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: N/A Date: Janua 15, 2003 Si ature rY Zm Name rk A. Denlinger, Esquire MARTSON DEARDORFF WILLIAMS & OTTO Ten East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Personal Representative ~' ,I MARTSON DEARDORFF WILLIAMS & OTTO INFORMATION • ADVICE • ADVOCACY TEN EAST HIGH STREET CARLISLE, PENNSYLVANIA 17013 TELEPHONE (717) 243-3341 FACSIMILE (717)243-1850 INTERNET www.mdwo.com February 4, 2002 HAND DELIVERED Office of Register of Wills Cumberland County Courthouse Carlisle, PA 17013 RE: Estate of S. Ruth Adair Estate No. 21-02-0998 Date of Death: November 4, 2002 Dear Clerk: ATTORNEYS HC COUNSELLORS AT LAW WILLIA,\A F. MARTSON JOHN B. FOWLER III EDWARD L. SCNORPP DANIEL K. DEARDORFF THOMAS J. WILLIAMS No V. OTTO III GEORGE B. FALLER JR.' CARL C. RISCH MARK A. DENLINGER DAVID R. GALLOWAY ANTHONY T. LUCIDO 'BOARD CERTIFIED CIVIL TRIAL SPECIALIST Enclosed with this letter is estate check number 1045 in the amount of $20,000.00, representing payment of Pennsylvania Inheritance Tax in the above-referenced estate. Will you please issue the appropriate receipt .and forward it to me at the above address. I thank you in advance for your prompt attention to this matter. Very truly yours, MARTSON DEARDORFF WILLIAMS & OTTO /~ • Mark A. Denlinger MAD/vlo Enclosure F. \FILES\DATAF[LE\ESTATES\40S0-Lrow.intx. l INFORMATION • ADVICE • ADVOCACYS" 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 N0. CD 002125 DENLINGER MARK A TEN EAST HIGH STREET CARLISLE, PA 17013 ------- fold ESTATE INFORMATION: ssN: 174-20-4s3s FILE NUMBER: 2102-0998 DECEDENT NAME: ADAIR S RUTH DATE OF PAYMENT: 02/04/2003 POSTMARK DATE: 00/00/0000 couNTY: CUMBERLAND DATE OF DEATH: 1 1 /04/2002 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ $20,000.00 TOTAL AMOUNT PAID: REMARKS: MARK A DENLINGER ESQ CHECK#1045 SEAL INITIALS: JA RECEIVED BY: DONNA M. OTTO REV-1162 EXI11 96) 520,000.00 DEPUTY REGISTER OF WILLS REGISTER OF WILLS ReV. 1.soo EX + 11-6Dl w ~ ~"0 U~~ W~U :1:09 ull:lD ~ " /"7-'79-/ '* / REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 2811601 HARRISBURG. PA 17126-0601 I< w c w u w c DECEDENT'S NAME (LAST, FIRST. AND MIDDLE INITIAL} ADAIR, S. RUTH (;1 FiC,/;L USE ()NL Y FILE NUMBER 21 02 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 00998 NUMBER DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 174-20-4939 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 2, Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a living Trust (Attach copy of Trust) o 10. Spousal Poverty Credit (date of death between 12-31-91 ndl-1-95 p,.AilLrGORRESI'"' CE AN o 3. Remainder Return (date of death prior to 12-13-82) o 5. Federal Estate Tax Return Required o 8. Total Number of Safe Deposit Boxes o 11.Eleclion to tax under Sec. 9113(A) (Attach SchO) Copyright 2000 form software only The Lackner Group, Inc. 11/04/2002 08/30/1924 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) 181 o 181 6. o 9. 1. Original Return 4. limited Estate Decedent Died Testate (Attach copy of Will) litigation Proceeds Received Ten East High Street Carlisle, P A 17013 r: (1) 135,000.Oog.. \..M:)FFICIAI. (2) a" ::3: 27,028.72:;: ~ (3) Noner:" N - (4) None':;,. B (5) 78,427.90 _" 0 S, 0 (6) 2,050.00 '" (7) None (8) 242,506.62 '1< ~w ~c CZ u~ (9) (10) 41,689.81 34,910.37 ElEPHONE NUMBER 717/243-3341 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship Z o 5 ~ ~ ~ " lrl ~ 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter.Vivos Transfers & Miscellaneous Non.Probate Property (Schedule G or L) 8. Total Gross Assets (total lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (11) 76,600.18 165,906.44 16,590.64 149,315.80 10. Debts of Decedent, Mortgage liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 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) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2} Z .045 (16) 0 16.Amount of Line 14 taxable at lineal rate x g ~ 17.Amount of Line 14 taxable at sibling rate x .12 (17) ~ 8 ~ 18. Amount of Line 14 taxable at collateral rate 149,315.80 x .15 (18) 19. Tax Due (19) 22,397.37 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 22,397.37 20. 0 ~. 'G<~__"_lIYV"K:ALL)Q~~.F<"Y__P~RSCHECI<I~" ,.;~t..;_J!'?i.~ Form REV-1500 EX (Rev. 6-(0) Decedent's Complete Address: STREET ADDRESS One LongsdorfWay CITY Carlisle I STATE PA I ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Cred\tsfPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 22,397.37 20,000.00 1,052.63 Total Credits (A + 8 + C) (2) 21,052.63 3. Interest/Penalty if applicable D. Interest E. Penalty (3) 0.00 (4) (5) 1,344.74 (5A) (58) 1,344.74 TotallnleresVPenalty (D + E) 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 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. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;................................ ......................,,'................ ~ I :: ~:::~ ~~e~~~i:on:~:~~e~:s~~~.~~~~~.~~~.~~.:.~~.~~.~~. .t.~~~~~~~~~~.~~..it.~. ~~~~~~~:::::..:..:...:::::::::::::::.......... 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?. .... ............................ ..........,............ ............................... .............................. 0 ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........ 0 181 4. Did decedent own an Individual Retirement Account, annuity, or other non.probate property which contains a beneficiary designation? ................................ ................... ....................................... ........................ ~ 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. reparerhasanyknowled e. ADDRESS DATE 1140 Forge Road Carlisle, PA 17013 sho/tJ3 DATE .s/zo/vS ADDRESS ADDRESS RD#I Blain, PA 17006 10 E. High St. Carlisle, PA 17013 DATE , S/zv/03 For ates of death on or a r 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 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)J. 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 retum 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 otthe 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. 99116 1.2) [72 P.S. ~9116 (a)(l)J. Tile tax rate imposed on the net value oftransfers 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. *' SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIOENT DECEDENT ESTATE OF I FILE NUMBER 21 - 02 - 00998 All real property owned solely or as a tenant In common must be reported at fair market value. Fair market vaiue is defined as the price at which property would be exchanged between a willing buyer and a wimng seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. ADAIR, S. RUTH ITEM NUMBER I DESCRIPTION VALUE AT DATE OF DEATH 135,000.00 Residence situate at 1655 Trindle Road, Carlisle, Cumberland County, PA, known as parcel No. 21-23-0585-004, being described in Deed dated July 28,1992, and recorded in Cumberland County, P A, Deed Book "U", Volume 35, Page 881, and being conveyed to S. Ruth Adair. Value is actual sale price. See settlement statement attached. TOTAL (Also enter on Line 1, Recapitulation) 135,000.00 *' SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT OECEDENT ESTATE OF ADAIR, S. RUTH I FILE NUMBER 21 - 02 - 00998 All property Jolntly..owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION UNIT VALUE VALUE AT DATE OF NUMBER DEATH \ \,56\ shares Waypoint Financial Services 17.2\5 26,872.62 2 Dividend and interest accrued on 156\ shares Waypoint Financial Services to DOD 156.10 TOTAL (Also enter on line 2, Recapitulation) 27,028.72 '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ADAIR, S. RUTH I FILE NUMBER 21 - 02 - 00998 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 DESCRIPTION VALUE AT DATE OF NUMBER DEATH I Waypoint Bank, checking account #0090140641 12,004.39 2 First Union Bank, checking account #1000293621499 2,774.96 3 Proceeds from IRA account, beneficiary: estate 29,428.96 4 (2) $50 EE U.S. Savings Bonds, issued 1/92 & 1/89 100.46 5 (3) $100 EE U.S. Savings Bonds, issued 4/88,6/88 & 8/88 332.32 6 Proceeds from public sale of household goods on 11/11102 32,931.75 7 ]{efUnd~carinsurance 278.10 8 Proration of Cumberland County real estate taxes 522.13 9 Sprint, refund 4.83 10 2002 P A income tax refund 50.00 TOTAL (Also enter on Line 5, Recapitulation) 78,427.90 . SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ADAIR, S. RUTH I FILE NUMBER 21 - 02 - 00998 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A Margaret Irene Steele 590 N. Middleton Rd. Carlisle, PA 17013 Cousin JOINTLY OWNED PROPERTY: DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM LETTER DATE Include name of financial institution and bank account number DATE OF DEATH NUMBER FOR JOINT MADE or similar identifying number. Attach deed for jointly-held real VALUE OF ASSET DECD'S VALUE OF TENANT JOINT estate. INTER~ST DECEDENT'S INTEREST I A 09/22/1971 Real estate in Penn Forest Township, Carbon County, 4,100.00 50% 2,050.00 Pennsylvania, parcel #12A-51-MV246. Assessed value of2000 x common level ratio of2.05 TOTAL (Also enter on line 6, Recapitulation) 2,050.00 . SCHEDULEH FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ADAIR, S. RUTH I FILE NUMBER 21 - 02 - 00998 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A FUNERAL EXPENSES: I Hofftnan Roth Funeral Home 9,942.60 2 Rice Memorial Works 1,488.00 3 Rev. Sterlen S. Sheaffer 175.00 4 Ken Walker, organist 75.00 5 Hays Greenhouse, funeral flowers 127.20 6 Thomas J. Sheaffer, funeral expenses 102.75 B. ADMINISTRATIVE COSTS: 16,000.00 1. Personal Representative's Commissions Thomas 1. Sheaffer Virgil E. Gutshall, Sr. Social Security Number(s) I EIN Number of Personal Representative(s): Street Address 1140 Forge Road City Carlisle State PA Zip 17013 - Year(s) Commission paid 2003 2. Attorney's Fees Martson Deardorff Williams & Otto 11,000.00 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, Cumberland County, PA 269.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs I Cumberland Law Journal 75.00 2 The Sentinel 98.69 Total of Continuation Schedule(s) 2,336.57 TOTAL (Also enter on line 9, Recapitulation) 41,689.81 *' Schedule H FlIlE!f'aI Expenses & Adninistraliw Costs CClI1Iiroed COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ADAIR, S. RUTH I FILE NUMBER 21 - 02 - 00998 3 Certified mailing, DPW 4.42 4 Register of Wills, filing fee, inheritance tax return 15.00 5 PPL, electric service pending disposition of real real estate 78.56 6 Agway, furnace repair 16\.95 7 Conoty of Cumberland, I % Realty transfer tax 1,350.00 8 Recorder of Deeds, copies of Deeds, etc. 3.50 9 EVP, stock valuation report \.S5 10 Death Certificates 19.00 11 Register of Wills, short certificates 9.00 12 Postage, mailing of stock certificates 11.43 13 Seaboard Surety Corp., stock replacement fee 182.16 14 500.00 Reserve Page 2 of Schedule H *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF I FILE NUMBER 21 - 02 - 00998 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIOENTDECEDENT ADAIR, S. RUTH Include unreimbursed medical expenses. ITEM NUMBER 1 DESCRIPTION First Union Account # 1000293621499, outstanding check 2 Discover Card, balance due on account AMOUNT 225.00 1,074.87 9,229.84 3,460.32 4,724.60 337.33 48.10 470.70 30.66 37.59 208.00 480.00 1,826.40 1,800.00 1,500.00 1,500.00 350.00 1,500.00 1,030.00 150.00 Total of Continuation Schedule(s) TOTAL (Also enter on Line 10, Recapitulation) 4,926.96 34,910.37 3 GM Mastercard, balance due on account 4 QVC Credit Card, balance due on account 5 Cumberland Crossings, nursing care account payable 6 Alert Pharmacy, account payable 7 West Shore EMS 8 Nancy Sheib1ey, 2002 and 2003 real estate taxes 9 Sprint, telephone service 10 York Waste Disposal, trash II Advance Publications, advertising sale of real estate and personal property 12 Thomas Palm, surveying 13 Virgil E. Gutshall, Sr., sale expenses 14 Thomas J. Sheaffer, sale expenses 15 Sterlen S. Sheaffer, sale expenses 16 Evelyn Sheaffer, sale expenses 17 Beverly Sheaffer, sale expenses 18 JoAnn E. Roberts, sale expenses 19 Patricia A. Gutshall, sale expenses 20 Cindy Bedarf, sale expenses *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS continued ESTATE OF COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ADAIR, S. RUTH Include unreimbursed medical expenses. I FILE NUMBER 21-02-00998 ITEM NUMBER 21 Tony Roberts, sale expenses DESCRIPTION 22 Ann Gutshall, sale expenses AMOUNT 80.00 100.00 100.00 80.00 30.00 30.00 30.00 158.96 600.00 900.00 270.00 143.00 2,405.00 23 David Egolf, sale expenses 24 Timothy Sheaffer, sale expenses 25 Matthew T. Sheaffer, sale expenses 26 Kara M. Sheaffer, sale expenses 27 Luke Sheaffer, sale expenses 28 Evelyn Sheaffer, reimbursement for purchase of personal items at home 29 Virgil E. Gutshall, Sr., administration services prior to death 30 Thomas J. Sheaffer, administration services prior to death 31 Carbon County Real Estate Taxes, 200 I and 2002 32 Mt. Pochantas Property Owners Association, assessment 33 Internal Revenue Service, 2002 income tax Page 2 of Schedule I . REV.1513 EX+ (9-00) *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ADAIR, S. RUTH I FILE NUMBER 21 - 02 - 00998 RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Margaret L Steele COUSIn 10% estate residue 590 North Middleton Road, Carlisle, P A 2 Virgil E. Gutshall, Sr. COUSIn 10% estate residue RD. I, Box 896, Blain, PA 3 Patricia A. Gutshall cousin 10% estate residue R.D. 1, Box 896, Blaine, PA 4 Joanne E. Roberts cousin 5% estate residue ION orth Road, Mechanicsburg, P A 5 Virgil E. Gutshall, Jr. cousin 5% estate residue R.D. I, Box 932, Blain, PA 6 Ann L. Gutshall cousin 5% estate residue 37 Fort Street, Lemoyne, PA See Continuation Schedule(s) attached 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 TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS I The First Lutheran Church, Carlisle, P A 16,590.64 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 16,590.64 '* SCHEDULE J BENEFICIARIES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ADAIR, S. RUTH I FILE NUMBER 21 - 02 - 00998 RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT 00 Not List Trustee{sl OF ESTATE I. AXABLE DISTRIBUTIONS {include outright spousal distributions, and transfers under Sec. 9116(8)(1.2)] 7 Rebecca Sue Gutshall cousin 5% estate residue 3141 ErlyRoad, Elliottsburg, PA 8 Lucinda E. Egolf cousm 5% estate residue Box 23, Baker Lane, Landisburg, P A 9 Gabrielle E. Egolf COUSIn 5% estate residue Box 23, Baker Lane, Landisburg, P A 10 WilliamA. Steele cousin 5% estate residue 700 North Middleton Road, Carlisle, P A 11 Cindy E. Roberts cousin 5% estate residue 6207 Elaine A venue, Harrisburg, P A 12 Tony E. Roberts cousin 5% estate residue 322 N. Front St., Apt. 3, Wormleysburg, PA 13 Thomas J. Sheaffer none 5% estate residue 1140 Forge Road, Carlisle, PA 14 Kara M. Sheaffer none 5% estate residue 1140 Forge Road, Carlisle, PA 15 Matthew T. Sheaffer none 5% estate residue 1140 Forge Road, Carlisle, PA Page 2 of Schedule J 01/31/2003 08:55 71 7'37523I3S DARREL DETHLEFS PAGE 02/03 A. Settlement Statement OMS No, 2~02..(J205 u,s, OEJpartmMtDfHou~in'L and Urban De~",lopm!!nt ~ T B TYI=Ill!ofLoan 1. 0 FHA 2 0 FmHA 3. 0' CO"v. Unill' [I File Number '10582-CAAB A 0 VA 5, 0 Conv. Ins. C. NOTE:This form Is furnished to glw you II statement of actual settlement 1:0$'1.$, A1'I'IouI;'\ts paid to and by the sl!ttlem!ln\ agent are shown. Items markea "p.o,c~ were paid outside ofclo$lng; thll!Y ere sl'iOWt1 here for informational pUf1:losas and er@ not ineh.lI::led in the Iota Is, D. NAME! ANO AOtlRESSDF SOFl:ROWER~ L.fN'OY K. SteftnmH ,,,.,. Loan Number 00412415&3 Mortgage Insurance Case Number N/A E'. NAME' AND AOtJReSS OF SELLER' Estate of $, Ruth Adafr 185$1'rfndte Road, Carlisle, PA 171>13 Flt"If/'lrJl1nm HtHrIe LrJln CorptJnHlr:m 681 AndeMCH'llltM, SUitt 42~, PJmbtlrgh, PA "5220 BhlfeofS.RlJthAd:llr 15SS Trllld/e RO#ld, C~rlis/e, F'A 17013 F. NAME: AND AobFleSS OF L.ENDE1=!:: G. PROPERTY 16$5 Trfrrdle RO#ld I.OCATION' Carllsll, PA 17013 H. SEiTl.eMENT AGENT: J:'LACE OF SETTlEMENT: 1W CAPITAi.ARSA ABSTRII1CT 38ti$lJMRKeT STReET, CAMP HILI., piA 11011 ~501lU'16J3 I. SeTTLEMENT DATE:: 01131/iCJOJ RESCISSION OATE~ J. S M AR F BORROWER'S T NSACTION K. SUMMARY 0 SELLE~'S RANSACTIO 100. GROS~ AIIIO,fJffT OU~ FROM,BORROWER: ;400. GROSS AMO~"'rDUE ro SELLeR.: 101. ConlrlCtSales Ptibe .m o a "1l1, COMli*CI Sales Il'l1ce $1E5 MO " 102. parsonl'll Property ~02. PeI'lIonatpropsrty 103. SlIlIleme/'lta. d'larges to I3otrQWer. ~3. (from line 140:0\ 86,.UO. 77 '" .04 HIS. iAO!. ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE: ADJUSTMENTS f"OR HEMS PAID ay SELLER IN AOVANCE: '06.Clty!lo\lh1l~ " 4Q6.C!tI!ltoP.'f1TIl(U " 107, Counlytaxes ro .407, COll"l:yTa~es ro 1~,A~1'trEln\t OJ./3J12a03 . D-S/JO/200J '5.:!~ .13 4'lle.A'Uil!$ftl1SrtlS 01/:31/20/J3 " 06/:10/:2003 $522.13 '" 40a, '" "" '" "" 112. ... 120. G~OS$ AMOUNT DUe FROM BORROWER: $Hl,7i2.90 420. GROSS AMOUNT DUE TO SELLER: $1.35, !522. 13 200.AMOlJNTS PAllO BY O~{N'eEHAiJlOF BOi\t:(OWEft 5(1o.AeOuCTJONSrll4 J1iMOUINTDLIIE TO SEU~~: 201, DepoElit Dr eemnl mo,,(w $S,OOO.OO 501, ~en dl'!OMlt (see In'tr~ctlons\ $5,'000.00 202. Prlnclpalllmount dNiw loIIn(~l $3,30, 9'50. oa, !D:t;setlll/'nllntchsrg~$Io:"il:rlln'l'40ci) $l,JSO,OO 208, ex~ttn910an('}takansubJoolto 503. !;:)d'~r'g losn($) laken sub)Gctto '04. :504,F'avQtt<)fllmmOl'lWr.ltlQn '" 50S. Payoff 01 seeoncl mortglllge loen 206. .,.. '" 507. '" ~(l8, la, 50g, ADJUSTMENTS FOR IT~MS UNf'lAID BY SELLER' ADJUSTMENTS F01=!: ITEMS UNf'lA1D BY SELLER' 2'0,CllyltooMllallQt " S10.C\ti11.0WTI\:l'dI~ " 211.COI.lnlYttlllBS 01/0%/2'003 " 01/31/200.3 $31.96 511, Ccunlyta~" 01/01/2'003 to 01/31/20'03 $31.96 21;tAsst&5ml!lrll$ '0 512. As&eMmenl3 " ~15. ~13, 21;1, 514. 215. !!1S. 216. 61~. 217, SH'. '" 51$. 219. 319. !20. TOTAL PAlO ~YIFOR $135,9Rl.96 520. TOTAL REDUCTIONS BOR~OWeA.: I N AMOUNT DUE TO SEI.I.ER: $6,:381,96 100, CASH AT ~Ein.EMENT FROMfTQ BORROWER: 600. CASllI-AT SE~~NiTOrFROM SEI.LIiiR 101. Gross amQl,lnl due from bQrrower (line 120) $141,'16.:z,90 601. Gro,& amount due to seller (lI~e 420) $:1.35,522.1.3 J02. Lna amollnt P!l~ bylfor botrtimllr (line 220) $13,$,981.9! 002: 'Letsl1ldudlonl in ltrttt. due MlllIor (line 520) ;~,J-S:J.,96 !O3, CASH r 0FROM I ( DTO) eORROWEA; $5,780.94 S03.CASH ( DFROM) ( !'JTOI SELLER.: $U9,14o.1? HUD-1 (3-86) - FlESPA, He 4305.2 5CbI SCH $C.H \\A '\ ',E" IJen.. l? , ''1-1' ,6-7,7 PAGE 1 01/31/2003 08:55 71 79752309 DARREL DETHLEFS PAGE 03/03 HUO.1IR~v.3I8B: L. OMBNo.2502-Q265 SETTLEMENTC~ARGES 700. TOTAL SAlE.S/8~OKER'S COMMISSION MSEOON PRICl;; $135,0~0.00 @ " PAID fROM BORROWER'S fUNDS AT SETTLEMENT PAID FROM SELLER-'S FUNDS AT SETTlE.MENT 701. "" 103. m. 7M,COm",I""I!;I(I~ld9t.~men! 'CO DIVISION OF COMMISSION (1,INE 700) AS fOLLOWS; " " " " 800. I EMS PAY ONNECTION WITH LOAN 601 LM~/l"i~ln8U~nrH \.l. 10 First HorizOll HOllIe ~;eI", C~..t.i eO:? Loan <liOOO!Jrlt 'If, ~~ !'irat kor.t..oD. HOlM Loa'" Co orillti ~n~'81i1ol1f...t~; First Hori;ron H(lIrIe .L~ Co rllt.:.on &)4 Orndttret>ortto First Horit.:m J'lcme .r."SI1 CO ;eltion e()!;,l8IOolfl~tII'\n.a COlIli:Il.1tl1lmlt: he ~o First liori~rm HOIlI~ .Loan CozpoJt4ticll'l eo6.Mortgagalnelnncoapplk:alIMr..\o'l'aJt li~rT.iCfJ Ft'!Io!! to Tots.! Mortgllg'e Sol~t:io.D;" ~7A801JmPlklflf"" tlndenr.iUng Fee to First Hor.:l.,zan Ht:IIq Lo,.D; CorporaUotl 1lCA. Mort:./Sillge .l'l.rol:-er ~ ~o tiom.tt:Ow.rl- HOr .~ Jhuotlrc"..., tnc. !09. Application .F.. to HaftetO'lnl )fQEtg~ Besonrv"'8', .mo. atO, Brllur pr~... ft<!II to HQUletown Moz;t.gag.>. lteso=.s, J;ne. 811. Floocl' PlPU.Cll.i.JUltio.tl. Fl!le to Feder8'l 1"loocr 900. IT R UIREO BY LEND!;:R TO BE PAID IN DV 1lO1.\n\e'llttfrcm OJj,31!2003 to 02101.12003 0 $,23 19/~ty 9O:l, ~Ie~g, InM~nli8 premliXllfor mo" 10 1Jr.l3 Ha:m,d;nlurSI\ClI!I"...",I(.Il1ft1r 1.00J""ll.ll> .All$tat. rn"~"nae $36000 I'.O,C) eDol, Flood;n!uo'll....&pr~mloJ'" Ig/ Y"'.IO 905, 1"und1ng .1'"".. to Fir"t HoriNft Ho:mEl Loan C01Jl"rati,,"" $iOJ. &9 $1.50.00 $90.00 $250.00 $1,.309.SCJ $350.00 $250,00 $24.00 $23.19 $20.00 1 DO.R S p IT WITH \.ENOE 3.00rTlOl\u\!1 ~thil@ -~. 12, OOIn<ln!h$~ "'OI1l""llIl -'" S.o-O_lll!@ m.",,@ E:~crow Mjustl1l"nt $3. OCJlf''''OI\I~ $i04.?GI'tlt'rI'IMIII I'llrrl'lontt1 $3240"",,"\""th w_ pftrrl'lMtIl $:105..18$1'me<'tlh $9.00 100l, HII%~rd l....ur.1'IOl 1002.Ma<'tI1"~I1".,,,g"~.. l00~.Cllyl'rQpliPl'tytllllN lOO4,C",m!yprlllX'fll'lI:l.91 l00~. Annulll Mlo...lrflElntll l005Floodlnlur8nct 1007, 8.:bo01 raxe.!l $388. SO $1141,41 '00' l00Q A9greq~te Acccuntinq 1100, TI LE HARGES: 1'01. S*,,~~Otc<ollngfHIO (:A;IrAL AJlSA AaS'Z'lUCT, 1102 AbltrBCforUltlMtl""to jlIJ3.T1UoUlmin_l~ po9'mM~l ($339.60) INC. 11(M.TlUel~C&tll_1Il 11OS,DooJM8nlpr~liMlo 1tOll, ~/fIo~\Q Mic:b4..J. J. Pykosl1., ~8quiU 1"07 MomwaNallo rlnelU(le&o~eihl""N\nlb"", 11~ T\hil'l&\l~to S.~rity X.1tlo!"/Cap.1tlll (I""tud~' ~b<><t91l8m9 Nu~llr8' Basic- - 3 ~nd. 11m, LOnd~""~~'IflI'II8 ltl0,o-~.0Q""IIli'O 1111. Closi7.l'1 Se.rr~(:e Zetter he to s.c~r.:Lt:y 111~ 1113, $6.ao , ( :ritle $1.:;0 9so 00 $i.35,000, 00 Ar.-a JLbllltr=et, 7'ne. 1200, G VEA, ENT ECORDING A ,.., lWI.R_dt""Ill"" 1202. CrtylCOUI1!y ta)(/"M\~~ t203.StIl!918lt101Il111p. 120~ 1205. 0.... 0,.. TRANSFER CHARG $4".50.MCt'liOQR $70.50 $1,3.50.00; ...".,rtg~9n $1,J5il.oa',~.\I'!> :RBfuae& $.1ll 00 $1,350 00 $1,350,00 1300 OOIT\QNAL E. EMENT CHARGE l001,S!rvII\o'10 1302. PlIIt 1I''Ip8lll101l to ljoo oYe.t'n.J.qbt h. to lOa". o~rin. o~ Daz-,re,11 C. ~t1Ue!'lI ('lJPS) 1~ It.1z-e r... to Cllpita1: Area Ab.!ltract, Inc. 1305. "CO "" $15.00 $:lO.OO 1400, TOTAL SETTLEMENT CHARGES $6,240.77 $1,350.00 I ~a\te carllfully r~vleweclll'lll .HUD-1 Senlemenl Statement and to the best Ol m., l<O<;lWle~ aI'lO~, \1 Is a jn;~ Imd lJoC(:uratll statemenl 01 all reoolpta aM diaburaernents I"\i'Ide Oil ""/ ;oetOVn\ crby me In Itll8 tran~on I fuMer certIFy ll'Iat I hove receivtd a copy 01 1M MUD-l Senllmsnl Stalement ac~' Leroy K. Stehman Sel\erOl" Dllt,,; ___ Agent. Thoma$ J. ShNffer, Executor D~le: F.I0IrOWE!r. o.~' Sl!lleror Agllnt Dall'! Virgil E. Gut!.ha/', Sr., Executor ::;.~ ~~D~:~~;el'!l Slammenl Which I haye pIIlP9'e,:l Is IIlrullllnd aCCllrale S<;lCOUr'l1 ofir>l, traMa!ctkm I hlVIl es.ui>ed CIWiIl ceuse thll fund, \0 btI diBb"rUi:lln lll.corctllMCll Dalll" Senle/!',entAget'lt' DElte. WARNING' II j nrl k Michael J. PykO$h, esqoir~ . s a me 10 nO'l/,Ojngly make wtse !.\M0<t\lIr.\s 1,,\he Llnll,ell Slale, on Iniol; or any otnllr similar form, "'en~ltiM UPQn ClllwtdiQJ1 c;ll\ i>'lClud .a r.n _~ I men/. FordeWds ace; TIlle 18 U.S, Ccr.rt SE!Ctlc1"I1001 and Secriorr 1010 Q ,e 8,... mprlson. Y'l Way~qifl~ LOOK FOR US, WE'll GET YOU THERE 11114/2002 MDW & 0 10 E HIGH ST CARLISLE PA 17013 Th inti . e. onnati.on which you requested on the account(s) of S RUTH ADAIR (SoCIal Secunty Number 174-20-4939) is/are as follows: Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownersbip SOLE Name of Joint Owner, if any Date Ownership Was Established 90140641 CHECKING 1lI18/02 12004.14 .25 12004.39 Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name ofJoint Owner, if any Date Ownership Was Established 5CH ''E'',J:.fe,."c.../ ~cere1Y LIn rr&~~6~ SENIOR SERVICES REP. Additional Information Requested P.O. Box 1711. HARRISBURG, PENNSYLVANIA 17105-1711 Toll FrEe 1_866-WAYPOlNT (1_866-929-7646)' IN YORK AREA 717/815-4500 . www.waypointbank.com f~N' WACHOVIA Reference ID: 460852 First Union/Wachovia Attn: Balance Confinnation Services POBox 40028 Roanoke VA 24022-7313 November 15, 2002 MARTSON DEARDORFF WILLIAMS & OTTO TEN EAST HIGH STREET CARLISLE, PA 17013 SUBJECT: Vetification I Confirmation of Account and Balance Information provided for: Cnstomer: S RUTH ADAIR (SSN# 174-20-4939) Date of Death: November 4, 2002 DeDosit Acconnt Information Account Type Account Number Date of Death Balance Average Balance'" Date Opened Maturity Interest Accrued YTD Date Date Rate Interest Interest Paid Closed CHECKING LEGAL TITLE: S. RUTH ADAIR THOMAS J. SHEAFFER, POA OR VIRGIL E. GUTSHALL, SR., POA 1000293621499 $2,774.96 8/3/1990 NA ... Due to system limitations, we can only provide a twelve month average balance on depository accounts. No Safe Deposit Box found fOf customer. '" Date of death balance does not include accrued interest. ... If date of death occurrs on a weekend or a holiday, date of death balance does not include any transactions that were ~de during that time period. .~ Ii. Sorrells November 15,2002 (540)563-7323 Servicenter Associate Phone Number abs; tb sCH \\c".~ Z- 000671 FIFlLESIDA T AFILEIWILLS\4050. WIL LAST WILL AND TESTAMENT I, S. RUTH ADAIR, of Middlesex Township, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. 1. I direct that all my just debts, funeral expenses, testamentary expenses and all inheritance taxes (whether such taxes may be payable by my estate or by any recipient of any property) shall be paid from my residuary estate as soon as practicable after my decease and as part of the administration of my estate. My Executors shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. I further direct my Executors to convert all of my estate into cash and distribute the same as herein set forth. 2. I give, devise and bequeath ten percent (10%) of the residue of my estate unto MARGARET IRENE STEELE; however, in the event she shall predecease me, this legacy shall lapse and be paid to THE FIRST LUTHERAN CHURCH, East High and South Bedford Streets, Carlisle, Pennsylvania. 3. I give, devise and bequeath ten percent (10%) of the residue of my estate to VIRGIL E. GUTSHALL, SR.; however, in the event he shall predecease me, this legacy shall lapse and be paid to PATRICIA A. GUTSHALL. 4. I give, devise and bequeath ten percent (10%) of the residue of my estate to PATRICIA A. GUTSHALL; however, in the event she shall predecease me, this legacy shall lapse and be paid to VIRGIL E. GUTSHALL, SR. 5. I give, devise and bequeath five percent (5%) of the residue of my estate to JOANNE E. r 0'); '/,t \ ..J S.R.A. Page 1 of 5 Pages . ROBERTS; however, in the event she shall predecease me, this legacy shall be paid, in equal shares, to her children. 6. a. I give, devise and bequeath five percent (5%) of the residue of my estate to VIRGIL E. GUTSHALL, JR.; b. I give, devise and bequeath five percent (5%) of the residue of my estate to ANN LOUISE GUTSHALL; c. I give, devise and bequeath five percent (5%) of the residue of my estate to REBECCA SUE GUTSHALL; d. I give, devise and bequeath five percent (5%) of the residue of my estate to LUCINDA EILEEN EGOLF; e. I give, devise and bequeath five percent (5%) of the residue of my estate to GABRIELLE ELIZABETH EGOLF; f. If any of the legatees in this paragraph shall predecease me, his or her share shall be divided equally among the survivors named in this paragraph. 7. I give, devise and bequeath five percent (5%) of the residue of my estate to WILLIAM A. STEELE; however, in the event he shall predecease me, this legacy shall lapse and shall be paid to THE FIRST LUTHERAN CHURCH, East High and South Bedford Streets, Carlisle, Pennsylvania. 8. I give, devise and bequeath five percent (5%) of the residue of my estate to CINDY ELIZABETH ROBERTS. 9. I give, devise and bequeath five percent (5%) of the residue of my estate toTONY EGUENE ROBERTS. 10. I give, devise and bequeath ten percent (10%) of the residue of my estate to THE FIRST LUTHERAN CHURCH, East High and South Bedford Streets, Carlisle, Pennsylvania. ') , I{/I S.R.A, Page 2 of 5 Pages II. I give, devise and bequeath five percent (5%) of the residue of my estate to THOMAS J. SHEAFFER; however, in the event he shall predecease me, this legacy shall be added to his children's shares equally. 12. I give, devise and bequeath five percent (5%) of the residue of my estate to each ofKARA MARIE SHEAFFER and MATTHEW THOMAS SHEAFFER. These shares shall be held by THOMAS 1. SHEAFFER for the benefit of the legatees until each attains the age of twenty-one (21) years; however, the income and principal may be applied for their secondary education. In the event THOMAS J. SHEAFFER is unable to serve, REV. STERLEN S. SHEAFFER shall serve. 13. In the event both VIRGIL E. GUTSHALL, SR. and PARTICIA A. GUTSHALL shall predecease or fail to survive me, I direct that their share aforesaid shall pass to their children in equal shares. In the event any part of my estate shall pass to any person who shall be a minor, I direct that said share shall be paid to the parent or parents of said minor child to oe held for the benefit of such minor child until they shall attain legal age. Such fund shall be applied toward the cost of secondary education of such children if it shall be their intention to pursue same. If not, then the parent may distribute such sum. 14. I nominate, constitute and appoint VIRGIL E. GUTSHALL, SR. and THOMAS J. SHEAFFER as Executors of my estate. 15. I direct that my Executors shall not be required to file a bond to secure the faithful performance of their duties in any jurisdiction. 16. I authorize and empower my Executors, in their sole and absolute discretion, to purchase or otherwise acquire and retain any investments of which I die seized or any real or personal property ~, 'i 2/ S.R.A. Page 3 of 5 Pages . of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in regard to any or all property of any kind forming a part of my estate for such terms and such prices as they may deem advisable; to borrow money for any purposes connected with the protection and preservation of my estate; to mortgage or pledge any real or personal property forming a part of my estate or to join in or secure the partition of same; to compromise any claims or demands of my estate against others or of others against my estate; to make distribution in kind and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share; to employ agents, attorneys and proxies and to delegate to them such power as my personal representatives consider desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys and proxies; and to execute and deliver such instruments as may be necessary to carry out any of these powers. In addition, I direct that my personal representatives shall have the power to conduct an inventory of any safe deposit box necessary to the administration of my estate. IN WITNESS WHEREOF I have hereunto set my hand and seal this ~ \.:>+ day of -.lu.\~ ,1997. j/ )2' . Y ..... ./cIl. S: Ruth Adair ", !, C(l~"(.>'7/ (SEAL) SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, have hereunto subscribed om .=" m Wi"'''~~ "" p""'" of"'" mid ;"",,"i' ,nd of =h 0,"& d~A';1L'iJ. . ~f _ )/;(ify;-/p )i{ -13At1,t di- Page 4 of 5 Pages COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) I, S. Ruth Adair, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. f.,) I /,' y'. (1;1'/1'7., ((L.a', L.' S. Ruth Adair Sworn or affirmed to and acknowledged before me by S. Ruth Adair, the Testatrix, this oJ \51 day of .J"u.. \ y , 1997. l~j~V6Q,'Lzr Notary Public Notar'lal Seal . Tricia l. Bailey, Notary Public Carli"'le Boro, Cumberland County My comrnisl)Cn Expires Nov. 24, 1997 \....~--,~ ..^~'^ ,..-....-,.- ....-'-.- COMMONWEAL TH OF PENNSYL VANIA ) : SS, ) Mot Ni(~h(Jle L. bra.ndi COUNTY OF CUMBERLAND We,~ {) 2JlMJ~ the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw S. Ruth Adair, the Testatrix, sign and execute the instrument as her Last Will; that the Testatrix signed willingly and that the Testatrix executed it as her free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the Testatrix, signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Cii:.f' ~~ ./f-/:J: 1:1 /l df ;; '-~' if I k. lid;. '/ ~zp: ::; i .~ It\r" 1<,' /4 /7Ct.,S Sworn or affirmed to and subscribed before me this ~\ day of :J;:. \~ ' 1997. \. ~~\.f9o.; &~_ N~ary Public /ltchu--& Address Notarial Seal . Trii;!,;l L Bailey, Notary Public C:3nlsle Bam, CUI~?erland C~U~~97 i'.,,,," ~>)qi:n,:~~;iU;1 C..plles Nov 2 , ._._~,.,,~e'~'>_"_"_' Page 5 of 5 Pages BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 MARK A DENLINGER MARTSON ETAL 10 E HIGH ST CARLISLE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 ER ~FP (R1-03) ~.• DATE 07-07-2003 ESTATE OF ADAIR S R DATE OF DEATH 11-04-2002 FILE NUMBER 21 02-0998 !-'- -' COUNTY CUMBERLAND ESQ ACN 101 Amount Remitted PA 17013 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 ADAIR S R FILE N0. 21 02-0998 ACN 101 DATE 07-07-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 135, 000.00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) 27 , 028.72 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 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) 7 8, 427.9 0 tax payment. 6. Jointly Owned Property (Schedule F) (6) 2, 050.00 7. Transfers (Schedule G) (7) .00 8. Total Assets (g) 242, 506.62 APPROVED DEDUCTIONS AND EXEMPTIONS: 41,689.81 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 3 4, 9 10.37 11. Total Deductions (11) 76.600.18 12. Net Value of Tax Return (1P) 165,906.44 13. Charitable/Governmental Bequests; Non-elected 9113 Tru sts (Schedule J) (13) 16,59 0.64 14. Net Value of Estate Subject to Tax (14) 149,315.80 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. Amount of Line 14 at Spousal rate (15) . 0 0 X 0 0 _ . 0 0 16. Amount of Line 14 taxable at Lineal/Class A rate (16) .00 X 045 . .00 17. Amount of Line 14 at Sibling rate (17) • 00 X 12 - . 00 18. Amount of Line 14 taxable at Collateral/Class B ra te (18) 149,315.80 X 15 - 22,397.37 19. Principal Tax Due (19). 22,397.37 DATE I NUMBER I INTEREST/PEN PAID (-) I AMOUNT PAID n~-n4_~nnz rnnn~I~~ i nc~ cz ~n nnn nn PAYMENT MUST BE MADE BY 08-04-2003*. ^ IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT 21,052.63 BALANCE OF TAX DUE 1,344.74 INTEREST AND PEN. .00 TOTAL DUE 1,344.74 ( 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 THTS FnRM FoR TNSTRIIrTTnIJC i COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 71 28-060 7 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 002830 DELINGER MARK A ESQUIRE TEN EAST HIGH STREET CARLISLE, PA 17013 -------- fold ESTATE INFORMATION: ssN: 174-20-4939 FILE NUMBER: 2102-0998 DECEDENT NAME: ADAIR S RUTH DATE OF PAYMENT: 07/22/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 1 /04/2002 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ S 1,344.74 TOTAL AMOUNT PAID: REMARKS: THOMAS J SHEAFFER C/O MARK A DENLINGER ESQUIRE CHECK#1052 SEAL INITIALS: AC RECEIVED BY: DONNA M. OTTO REV-1162 EX(11-96) $1, 344.74 DEPUTY REGISTER OF WILLS REGISTER OF WILLS F: \FILES\DATAFILE\ES TATES\4050- I . ffa. frm IN RE: ESTATE OF S. RUTH ADAIR, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO.2002-0998 FIRST AND FINAL ACCOUNT OF THOMAS J. SHEAFFER and VIRGIL E. GUTSHALL, SR., EXECUTORS OF THE ESTATE OF S. RUTH ADAIR, LATE OF MIDDLESEX TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA Date of Death: Letters Testamentary Granted: Letters Advertised: Sentinel - Cumberland Law Journal - Account Stated to November 4, 2002 November 7, 2002 November 12, 19 & 26, 2002 November 22, 29 & December 6, 2002 July 14, 2003 SUMMARY PRINCIPAL Receipts Conversions (Gain) or (Loss) $ 240,456.62 ~ 1,486.68 241,943.30 Less Disbursements Balance Before Distributions Distributions to Beneficiaries Principal Balance Remaining INCOME Receipts Less Disbursements Balance Before Distributions Distributions to Beneficiaries ~ -95,969.51 $ 145,973.79 ~ 0.00 $ 1,006.59 $ 0.00 1,006.59 ~ 0.00 $ 145,973.79 Income Balance Remaining $ 1 006.59 COMBINED BALANCE REMAINING $ 146,980.38 RECEIPTS OF PRINCIPAL Real estate at 1655 Trindle Road, Carlisle, PA $ 135,000.00 Real estate tax proration Proceeds from public sale of household goods $ 522.13 $ 32,931.75 Waypoint Bank checking account # 90140641, $ 12 First Union Bank account # 1000293621499 ,004.39 , $ 2,774.96 Fidelity & Guaranty IRA policy # 1404354 $ 2 9,428.96 1561 shares Waypoint Financial Services, $ 2 6,872.62 Waypoint Financial Services, accrued dividend $ 156.10 (2) $50 U.S. Savings Bonds, issued 1/92 & 1/89 $ 100.46 (3) $100 U.S. Savings Bonds, issued 4/88, 6/88 & 8/88 $ 332.32 Refund, car insurance $ 2 78.10 Refund, 2002 PA income tax $ 50.00 Refund, Sprint $ 4.83 TOTAL $ 240,456.62 PRINCIPAL CONVERSIONS TO CASH GAIN/LOSS 1561 shares, Waypoint Financial Services $ 1,486.68 Inventoried at: $26,872.62 Sale proceeds: 28,359.30 DISBURSEMENTS OF PRINCIPAL 11 /04/02 Outstanding check at date of death on First Unio n account $ 225.00 11/22/02 Cumberland Crossings, account payable $ 4,319.60 11/22/02 Alert Pharmacy, balance due $ 337.33 11/22/02 Nancy Sheibley, 2002 real estate taxes $ 438.74 11/22/02 Discover Card, balance due $ 1,074.87 11/22/02 Sprint, account payable $ 30.66 11/27/02 GM Card, balance due $ 9,229.84 11/27/02 West Shore EMS, account payable $ 48.10 11/27/02 Sterlen Sheaffer, funeral expenses $ 175.00 11/27/02 Kenneth Walker, funeral expenses $ 75.00 11/27/02 Thomas J. Sheaffer, funeral expenses $ 102.75 -2- 11/27/02 Hoffman Roth Funeral Home $ 9,942.60 11/27/02 Rice Memorial Works, grave marker $ 1,488.00 11/27/02 Advance Publications, sale bills $ 208.00 11/27/02 Thomas Palm, surveying $ 480.00 11/27/02 Virgil E. Gutshall, Sr., sale expenses $ 226.40 11/28/02 Evelyn Sheaffer, reimbursement for supplies purchased $ 158.96 11/28/02 Sterlen Sheaffer, sale expense $ 1,500.00 11/28/02 Evelyn Sheaffer, sale expense $ 1,500.00 11/29/02 Beverly Sheaffer, sale expense $ 350.00 11/29/02 Joanne Roberts, sale expense $ 1,500.00 11/29/02 Patricia Gutshall, sale expense $ 1,030.00 11/29/02 Cindy Bedorf, sale expense $ 150.00 11/29/02 Tony Roberts, sale expense $ 80.00 11/29/02 Ann Gutshall, sale expense $ 100.00 11/29/02 David Egolf, sale expense $ 100.00 11 /29/02 Timothy Sheaffer, sale expense $ 80.00 11/29/03 Kara Sheaffer, sale expense $ 30.00 11/29/02 Matthew Sheaffer, sale expense $ 30.00 11/29/02 Luke Sheaffer, sale expense $ 30.00 11/29/02 Virgil E. Gutshall, Sr., sale expense $ 1,600.00 11/29/02 Virgil E. Gutshall, Sr., administration prior to death $ 600.00 11/29/02 Thomas J. Sheaffer, sale expense $ 1,800.00 11/29/02 Thomas J. Sheaffer, administration prior to death $ 900.00 12/14/02 Hoys Greenhouse, account payable $ 127.20 12/14/02 QVC Card, balance due $ 3,460.32 12/14/02 York Waste Disposal, account payable $ 37.59 12/14/02 Cumberland Crossings, balance due $ 405.00 01/02/03 Carbon County real estate taxes, balance due $ 67.65 O 1 /02/03 Mt. Pocahontas Property Owners Assn. $ 143.00 O1 /02/03 Agway, furnace repair $ 161.95 01/23/03 Carbon County Tax Claim Bureau, past due real estate tax $ 152.21 01/23/03 Register of Wills, PA Inheritance Tax, partial payment $ 20,000.00 01/23/03 Seaboard Surety, stock replacement fee $ 182.16 01/23/03 U.S. Treasury, 2002 individual income tax $ 2,405.00 -3- 01/31/03 Cumberland County realty transfer tax $ 1 350.00 01/31/03 Nancy Sheibley, 2003 real estate tax, account payable $ 31.96 04/30/03 Central Penn Medical, account payable $ 11.48 05/30/03 Pecks Septic Service, account payable $ 196.25 05/30/03 Martson Deardorff Williams & Otto, partial attorney's fees $ 4,826.00 05/30/03 Martson Deardorff Williams & Otto, partial disbursements $ 491.59 Probate fee: 269.00 Cumberland Law Journal, advertising: Letters Testamentary: 75.00 The Sentinel, advertising Letters Testamentary: 98.69 Recorder of Deeds, copies: 3.50 EVP, stock valuation report: 1.55 Death Certificates: 9.00 Short Certificates: 9.00 Postage: 15.85 various PPL, accounts payable $ 78.56 various Bank fees $ 6.00 Reserved Martson Deardorff Williams & Otto, balance attorney fees $ 4,000.00 Reserved Martson Deardorff Williams & Otto, disbursements advanced $ 50.00 Reserved Martsolr~Deardorff Williams& Otto, reserved for filing fees and misce an $ 500.00 Reserved eous expenses Register of Wills, Agent, Pa Inheritance Tax balance due $ 1,344.74 Reserved Virgil E. Gutshall, Sr., and Thomas J. Sheaffer, Executors' $ 16,000.00 commission TOTAL $ 95,969.51 RECEIPTS OF INCOME Waypoint Bank stock dividends $ 187.32 Waypoint Bank Account # 90140641, interest from date of death through $ 3.97 First Union Money Market account # 2000003213902, interest through $ 810.62 U.S. Savings Bonds, interest through closing $ 4.68 TOTAL $ 1 006 59 `^-•~r~ ~~1~-~t~ Virgi E. Gutshall, Sr., Executor ,~ /~ ' Thomas J. Sh~fer, Exec~d~ -4- COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND Thomas J. Sheaffer and Virgil E. Gutshall, Sr., Executors of the Estate of S. Ruth Adair, being duly sworn according to law, depose and say that the Account as stated is true and correct, and that the Grant of Letters Testamentary and the first complete advertisement thereof occurred more than four (4) months before the filing of the Account. -~7 Thomas J. Shearer, Executo SLR Virg~l E. Gutshall, Sr., Executor Sworn and subscribed to before me this ~1~C day of apa3 . No ary Public NOTARIAL SEAL CORRINE L. MYERS, NOTARY PUBLIC CARLISLE BORO, COUNTY OF CUMBERLAND MY COMMISSION IXPIRES MAY 27, 2007 -5- SCHEDULE OF PROPOSED DISTRIBUTION Thomas J. Sheaffer and Virgil E. Gutshall, Sr., Executors of the Last Will and Testament of S. Ruth Adair, deceased, propose to distribute the balance in Their hands, to wit: $146,980.38, in accordance with the said Last Will and Testament as heretofore filed in the Office of the Register of Wills of Cumberland County, Pennsylvania, as follows: TO: Margaret Irene Steele, per Item 2 of said Will: Cash: $ 14,698.04 TO: Vrigil E. Gutshall, Sr., per Item 3 of said Will: Cash: $ 14,698.03 TO: Patricia A. Gutshall, per Item 4 of said Will: Cash: $ 14,698.03 TO: Joanne E. Roberts, per Item 5 of said Will: Cash: $ 7,349.02 TO: Virgil E. Gutshall, Jr., per Item 6 of said Will: Cash: $ 7,349.02 TO: Ann Louise Gutshall, per Item 6 of said Will: Cash: $ 7,349.02 TO: Rebecca Sue Gutshall, per Item 6 of said Will: Cash: $ 7,349.02 TO: Lucinda Eileen Egolf, per Item 6 of said Will: Cash: $ 7,349.02 TO: Gabrielle Elizabeth Egolf, per Item 6 of said Will: Cash: $ 7,349.02 TO: William A. Steele, per Item 7 of said Will: Cash: $ 7,349.02 TO: Cindy Elizabeth Roberts, per Item 8 of said Will: Cash: $ 7,349.02 TO: Tony Eugene Roberts, per Item 9 of said Will: Cash: $ 7,349.02 TO: The First Lutheran Chruch, Carlisle, PA, per Item 10 of said Will: Cash: $ 14,698.04 TO: Thomas J. Sheaffer, per Item 11 of said Will: Cash: $ 7,349.00 TO: Kara Marie Sheaffer, per Item 12 of said Will: Cash: $ 7,349.02 TO: Matthew Thomas Sheaffer, per Item 12 of said Will: Cash: $ 7,349.02 Total $ 1 46,980.38 TOTAL BALANCE FOR DISTRIBUTION $ 146,980.38 -6- STATEMENT OF THE REASONS FOR THE PROPOSED DISTRIBUTION The above distribution is proposed in accordance with the Last Will and Testament of S. Ruth Adair. Thomas J. Sheaff , Executo ~~ ~. Virgil E. Gutshall,Sr., Executor COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS. Thomas J. Sheaffer and Virgil E. Gutshall, Sr., Executors of the Estate of S. Ruth Adair, being duly sworn according to law, depose and say that the facts set forth in the Statement of the Reasons for the Proposed Distribution are true and correct. C•/ rLtG.~ --~ Thomas J. Sheaf , Execut Vi it E. Gutshall, Sr., Executor Sworn and subscribed to before me this ~?~ day of ~ o ~. ~ti Notary Pu lic NOTARIAL SEAL CORRINE L. MYERS, NOTARY PUBLIC CARLISLE BORO, COUNTY OF CUMBERLAND MY COMMISSION EXPIRES MAY 27, 2007 -7- F.\FILES\DATAFILE\W]LLS\4050. WIL ~s ~.#:.H ~ ,.~,~~ sr R LAST WILL AND TESTAMENT I, S. RUTH ADAIR, of Middlesex Township, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. 1. I direct that all my just debts, funeral expenses, testamentary expenses and all inheritance s:.~~ .. . ~, .. taxes (whether such taxes may be payable by my estate or by any recipient of any property) shall be paid from my residuary estate as soon as practicable after my decease and as part of the administration of my estate. My Executors shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. I further direct my Executors to convert all of my estate into cash and distribute the same as herein set forth. 2. I give, devise and bequeath ten percent (10%) of the residue of my estate unto MARGARET IRENE STEELE; however, in the event she shall predecease me, this legacy shall lapse and be paid to THE FIRST LUTHERAN CHURCH, East High and South Bedford Streets, Carlisle, Pennsylvania. 3. I give, devise and bequeath ten percent (10%) of the residue of my estate to VIRGIL E. GUTSHALL, SR.; however, in the event he shall predecease me, this legacy shall lapse and be paid to PA T RiCIA A. GUTSHALL. 4. I give, devise and bequeath ten percent (10%) of the residue of my estate to PATRICIA A. GUTSHALL; however, in the event she shall predecease me, this legacy shall lapse and be paid to VIRGIL E. GUTSHALL, SR. 5. I give, devise and bequeath five percent (5%) of the residue of my estate to JOANNE E. S.R.A. Page 1 of 5 Pages ROBERTS; however, in the event she shall predecease me, this legacy shall be paid, in equal shares, to her children. 6. a. I give, devise and bequeath five percent (5%) of the residue of my estate to VIRGIL E. GUTSHALL, JR.; b. I give, devise and bequeath five percent (5%) of the residue of my estate to ANN LOUISE GUTSHALL; c. I give, devise and bequeath five percent (5%) of the residue of my estate to REBECCA SUE GUTSHALL; d. I give, devise and bequeath five percent (5%) of the residue of my estate to LUCINDA EILEEN EGOLF; e. I give, devise and bequeath five percent (5%) of the residue of my estate to GABRIELLE ELIZABETH EGOLF; £ If any of the legatees in this paragraph shall predecease me, his or her share shall be divided equally among the survivors named in this paragraph. 7. I give, devise and bequeath five percent (5%) of the residue of my estate to WILLIAM A. STEELS; however, in the event he shall predecease me, this legacy shall lapse and shall be paid to THE FIRST LUTHERAN CHURCH, East High and South Bedford Streets, Carlisle, Pennsylvania. 8. I give, devise and bequeath five percent (5%) of the residue of my estate to CINDY ELIZABETH ROBERTS. 9. I give, devise and bequeath five percent (5%) of the residue of my estate toTONY EGUENE ROBERTS. 10. I give, devise and bequeath ten percent (10%) of the residue of my estate to THE FIRST LUTHERAN CHURCH, East High and South Bedford Streets, Carlisle, Pennsylvania. S.R.A. Page 2 of 5 Pages 11. I give, devise and bequeath five percent (5%) of the residue of my estate to THOMAS J. SHEAFFER; however, in the event he shall predecease me, this legacy shall be added to his children's shares equally. 12. I give, devise and bequeath five percent (5%) of the residue of my estate to each of KARA MARIE SHEAFFER and MATTHEW THOMAS SHEAFFER. These shares shall be held by THOMAS J. SHEAFFER for the benefit of the legatees until each attains the age of twenty-one (21) years; however, the income and principal may be applied for their secondary education. In the event THOMAS J. SHEAFFER is unable to serve, REV. STERLEN S. SHEAFFER shall serve. 13 In the event both VIRGIL E. GUTSHALL, SR. and PARTICIA A. GUTSHALL shall predecease or fail to survive me, I direct that their share aforesaid shall pass to their children in equal shares. In the event any part of my estate shall pass to any person who shall be a minor, I direct that said share shall be paid to the parent or parents of said minor child to be held for the benefit of such minor child until they shall attain legal age. Such fund shall be applied toward the cost of secondary education of such children if it shall be their intention to pursue same. If not, then the parent may distribute such sum. 14. I nominate, constitute and appoint VIRGIL E. GUTSHALL, SR. and THOMAS J. SHEAFFER as Executors of my estate. 15. I direct that my Executors shall not be required to file a bond to secure the faithful performance of their duties in any jurisdiction. 16. I authorize and empower my Executors, in their sole and absolute discretion, to purchase or otherwise acquire and retain any investments of which I die seized or any real or personal property j S.R.A. Page 3 of 5 Pages of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in regard to any or all property of any kind forming a part of my estate for such terms and such prices as they may deem advisable; to borrow money for any purposes connected with the protection and preservation of my estate; to mortgage or pledge any real or personal property forming a part of my estate or to join in or secure the partition of same; to compromise any claims or demands of my estate against others or of others against my estate; to make distribution in kind and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share; to employ agents, attorneys and proxies and to delegate to them such power as my personal representatives consider desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys and proxies; and to execute and deliver such instruments as may be necessary to carry out any of these powers. In addition, I direct that my personal representatives shall have the power to conduct an inventory of any safe deposit box necessary to the administration of my estate. IN WITNESS WHEREOF I have hereunto set my hand and seal this ~ Igo da of Y Juts , 1997. ;, ~, r - (SEAL) S. Ruth Adair SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, have hereunto subscribed our names as witnesses thereto, in the presence of the said Testatrix and of each other. Page 4 of 5 Pages COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) I, S. Ruth Adair, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. __ , -_ { S. Ruth Adair Sworn or affirmed to and acknowledged before me by S. Ruth Adair, the Testatrix, this `~ day of ~U,~ ~J , 1997. I Q~ Notarial Seal °Cricia ~. E3ailey, Notary Public Notar Public Carlisle Porn, Cumberland County y ~y t.omn~+l~~`si';n. ~-x~ires Nov. 2A, 1997 COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) we,~~+;.- ~D ~~ owl ~ I~; Chole ~ . ~rand~ the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw S. Ruth Adair, the Testatrix, sign and execute the instrument as her Last Will; that the Testatrix signed willingly and that the Testatrix executed it as her free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the Testatrix, signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. ., • ~ ~ j '~~... Address r ~l ~ i ~~, ,, ;~ ~ ~ ~.'.-,~ A r~ ~ d ~f' ~4 s~ ~ ~ L Address /' °~r~r~~ ~`~:',. / `t f r + , ,~~ Sworn or affirmed to and subscribed before me this o~ day of ~ ~~ , 1997. ~~ ,~- ~. {~{«t~ri;~l Saal ~ ~;;,, ;_ ~;~;i~y, Notary Public Notary Public ~ ~r~ l~u+rh8ri~rd!~OU~t~1 n u es N= _ 2A. ~ Page 5 of 5 Pages ~ T C» ? z D ~ ~ ~ x ` ~ ~~~~ R '~ ~ ~.5 G ~' G~ n x ~' ~ d~ C~ ~ ~ '-~ ~ x z z 1, rn ;~= x K y ~ ~ ~ ~,~~ a ~ ~ [' ~o C~ ~y O r ri Sao z ~ ~ ~ ~ ~ D = ~ - J ~ ~ ~g ~ ~~5.~ ~~ ~~ OZ ~ d ~ ~ ~ z~d~ O~c~'-~ v ~ z `" c z ~ ~' ~ ~5~~ _ Y ~ ~ ~ n ~ ~ N 00 o ~ W Vo ~» ? ' ~ ~ Q~ ~ ~ a a ~ _ ~ •~ ~ ~ rx ~ ~ ~~ o ~ n 170 9 ~ ~ ~ °y ~' Y ~ o ~ ~ ~ ~dt~ p ~~a' ~ ~~ ~~ O z Z ~ O ~~~'~~~ ~°' ~Y ~z Zrm ~ ~ ~~ ~~ y [ ~ ~~ _ S • ~ ~ ~ ~ z z0 ~ ~ ~ ~~w D O A O • ~ •+~ n C _~~~ ~ a ~ ~ ~ .~ _,~ ~ g} a ~~ ~a a ~ c a Q w ~ 4. an ~ ~ ~a'~ ~~ ~~~~~ ~.~_ ~ ~ , - ~ ,~ ~ ~.' ~$~~ ~ ~ ~~- ~'9 ~ COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 INHERITANCE TAX HARRISBURG, PA 17128-0601 STATEMENT OF ACCOUNT REV-16 D7 E% -FP (01-031 DATE 08-04-2003 ESTATE OF ADAIR S R DATE OF DEATH 11-04-2002 FILE NUMBER 21 02-0998 ~_ i.r COU[~TY CUMBERLAND MARK A DENLINGER ESQ ACN 101 MARTSON ETAL Amount Remitted 10 E HIGH ST - CARLISLE PA 17013 ~~ 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 (O1-03) *** INHERITANCE TAX STATEMENT OF ACCOUNT ~*~ ESTATE OF ADAIR S R FILE N0. 21 02-0998 ACN 101 DATE 08-04-2003 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: 07-07-2003 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 22,397.37 PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 02-04-2003 CD002125 1,052.63 20,000.00 07-22-2003 CD002830 .00 1,344.74 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. * IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( 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. ) 22,397.37 .00 .00 .00 ~~ ~ k' G" :~ ~- C~~ ~, . REGISTER OF WILLS OF CUMBERLAND COUNTY STATUS REPORT UNDER RULE 6.12 (For Resident Decedents Dying After July 1,1992) Name of Decedent: S. Ruth Adair Date of Death: November 4, 2002 File No.: 21-02-0998 Social Security No.: 174-20-4939 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes x No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following.• a. Did the personal representative file a final account with the Court? Yes x No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes No d. Copies of receipts, releases, joinders and approvals offormal or informal accounts may be filed with the Clerk of the Orphans' C rt and may be attached to this report. Date: Janua 12 2004 Signature: ~~~ ~u~~ ry , Name: Carl C. Risch, Esquire Address: MARTSON DEARDORFF WIL,LIAMS & OTTO Ten East High Street Carlisle, PA 17013 (717) 243-3341 Counsel for personal representative F:\FILES\DATAFILE\ESTATES\4050-1. srep