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Home My WebLink About02-1069PETITION FOR PROBATE and GRANT OF LETTERS Estate of Jay H. Powell, Jr. also known as Deceased. Social Security No. 201-16-3905 No. 2 ~ - o~ r~g To: Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/~d8 years of age or older an the execut rix named in the last will of the above decedent, dated , 19 and codicil(s) dated none (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h is last family or principal residence at 216 Roxbury Road Shippensburg Borough of Shippensburg (list street, number and muncipality) Decendent, then 77 years of age, died November 8 ,~ 2002 , at 216 Roxbury Road, Shippensburg, PA 17257 _ 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: none Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ 2,000.00 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ 22.000.00 situated as follows: 216 Roxbury Road Shippensburg, Cumberland County, PA WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentarX (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. ,, U (/ ~v Linda K. Klein C'O cd '.^. ~a „ w. 7 ~ C b0 405 Maple Hill Avenue Shippensburg, PA 17257 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF CUMBERLAND 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 truly administer the estate according to law. Sworn to or affirmed and subscribed ~~ /~ /~~~'~- ~ before me this 26th day of Linda K. Klein ~• 1~~_ 1 egister A No. ,2l - O~ - /otp9 Estate of Jay H. Powell, Jr. ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW NOVEMBER 26 , 2002 ~[ 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 1- 7-19 9 8 described therein be admitted to probate and filed of record as the last will of Jay H. Powell, Jr. and Letters Testamentary are hereby granted to Linda K. Klein 1 ~"'7~' Register of Wills '^''""~~ FEES Probate, Letters, Etc. ......... ~ 60.00 Jerry A. Weigle, Esquire i'~01624 Short Certificates( ) .......... ~ 6 . 0 0 ATTORNEY (Sup. Ct. LD. No.) xR~xx.extra..pa.ge~ 1p_cln WEIGLE & ASSOCIATES, P.C. 126 East King Street ] Cp ~ 10.0 0 ADDRESS TOTAL ~ 88'00 Shippensburg, PA 17257 Filed 11-26-200.2 ............... C717) 532-7388 put in pr. oth box PHONE 11-26-2002 LAST WILL AND TESTAMENT v2 ~ - C7 2, - ~ p (o y` I, JAY H. POWELL, JR. of 216 Roxbury Road, Shippensburg, Cumberland County, Pennsylvania, being of sound mind, memory and disposition, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void all wills by me at any time heretofore made. FIRST. I order and direct the payment of all my just debts and funeral. expenses as soon as may bP convenient after my decease. SECOND. I give, devise and bequeath all my estate, real, personal and mixed, whatsoever and wheresoever situate, to my wife, DOROTHY V. POWELL, absolutely. THIlZD. In the event that my said wife should predecease me or is not living on the sixtieth (60th) day following my death, I then give, devise and bequeath my said estate as follows, on a per stirpes distribution basis: A. ONE SHARE to my daughter, LINDA K. KLEIN B. ONE SHARE to my daughter, PATRICIA A. McCLURE C. ONE SHARE to my son, JOHN C. POWELL D. ONE SHARE to my son, RICHARD J. POWELL FOURTH. In the event that any beneficiary of this my Last Will and Testament is under the age of twenty-one (21) years, I then give and bequeath said beneficiary's share to and appoint as Guardian of any property which passes under this Will or otherwise, my daughter, LINDA K. KLEIN, AS GUARDIAN NEVERTHELESS, to invest and re-invest the same until the said ~1 ~~ tr~" ~ (SEAL) MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA. 17257 beneficiary reaches the age of twenty-one (21) years, with the following powers in addition to those presently given by law: A. The power to expend the income towards the health, support and maintenance, and education, including a college (both undergraduate and graduate), trade, business or technical school education, of the said beneficiary; B. The power to expend the principal, within the discretion of the said Guardian, if the income is insufficient, towards the health, support and maintenance, and education, including a college (both undergraduate and graduate), trade, business or technical school education, of the said beneficiary; C. The power to sell any and all real estate, within the discretion of the said Guardian; D. The power and obligation to distribute the balance of principal and interest, if any remaining, when the said beneficiary reaches the age of Twenty-one (21) years, without the necessity of a formal adjudication of the Guardian's account in the Court of Common Pleas of Cumberland County, upon the receipt of a good and valid release; E. The principal of the Guardianship and the income therefrom shall be free from the debts, liabilities, and engagements of those beneficially interested therein, and shall not be subject to assignment by him or her, nor to attachment or execution under any legal, equitable or other process for the enforcement of judgments or claims of any sort against them, either individually or collectively; F. In the event the above-mentioned Guardian is unable to accept the position of Guardian, I then name, constitute and appoint my daughter, PATRICIA A. McCLURE, as Guardian, with the same powers hereinbefore stated. FIFTH. I nominate, constitute and appoint my daughter, LINDA K. KLEIN, to be the Executrix of this my Last Will and Testament; if she be unable to fulfill the duties of Executrix, I then nominate, constitute and appoint my daughter, PATRICIA A. McCLURE, to be the Executrix of this my Last Will and Testament. SIXTH. I direct that my personal representative shall not be required to give bond for the faithful performance of her duties in any jurisdiction. . ~~-~.-~ (SEAL) MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA. 17257 IN WITNESS WHEREOF, I, JAY H. POWELL, JR., have hereunto set my hand and seal to this my Last Will and Testament, written on three pages, the first two pages signed for identification only, this '7 day of January, 1998. t~, ~ (SEAL) This instrument was by the Testator, JAY H. POWELL, JR., on the date hereof, signed, published and declared by him to be his Last Will and Testament, in our presence, who at his request and in his presence and in the presence of each other, we believing him to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. MARK. WEIGLE AND PERKINS - ATTORNEYS AT LAW - 726 EAST KING STREET - SHIPPENSBURG, PA. 17257 _~ ~~. ~~. COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND I, JAY H. POWELL, JR., whose name is signed to the 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. ~~ Sworn or affirmed to and acknowledged before,~/me by JAY H. POWELL, JR., Testator, this - / * day of January, 1998. ...... ~A~Irr41MM~~~~IM~ Mli b~i~ EyMr ~ T MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA. 17257 ...,~.. E ~ ~iot~ ~N~~ COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS. e '~"' `_"~-_ ' ~ ~ and ~~~~ WG~ -`'" l.~ ` ~ W, the witnesses whose names are signed to the fo going instrument, being duly qualified according to law, do depose and say that we were present and saw JAY H. POWELL, JR., Testator, sign and execute the instrument as his Last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the will as witnesses; and that to the best of our knowledge the Testator was at the time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. Sworn or i med to armed s sc e8 before by and .1f 2- _ . witnesses, this `~'~ day of J&~uar~f, 1998 ~~ L Mid 1~N~ ~on n Expires 1wM 1,11N MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 7 26 EAST KING STREET - SHIPPENSBURG, PA. 1 7257 ~E #ww1aM ; il~d~A ~~eli # ! ~ ;.~. ~.~ .: . .,.. ~- -_ x v v m Z m c N m m D m 1 x m A m m 1 b D J N w J ~~ D ~o X _m r m D Z 0 m Z D -i 1 0 A Z m D 1 r D a ~-4 pq 0 r ti 7d ~, ~-z- t~ ~~ ~~ ~# -',.~" tC WEIGLE & ASSOCIATES, P.C. • ATTORNEYS AT LAW 126 EAST KING STREET, SHIPPENSBURG, PA 17257-1397 • TELEPHONE: (717) 532-7388 FAX: (717) 532-6552 IN RE: ES"hA"I'E OF ,IAY H. POWELL, .IR.. late of the Borough of Shippensburg, Cumberland County, Pennsylvania, deceased IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE NUMBER 2I-02-1069 CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name o:f Decedent: Jay H. Powell, Jr. Date of Death: November 8, 2002 ~ Will No. 21-02-1069 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above- ~' captioned estate on November 27, 2002: Dorothy V. Powell 123 East Garfield Street Shippensburg, PA 17257 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except NONE. ~~ I~~ November 27, 2002 ,' ~ ~~ ,~ t ,j " Signature G / ~~~' ~ ~~ '~ Name: Jerry A. We' le, Esquire ; Address: Weigle & Associates, P.C. 126 East King Street Shippensburg, PA 17257 Telephone: (717) 532-7388 Capacity: Personal Representative X Counsel for Personal Representative WEIGLE & ASSOCIATES, P. C. -ATTORNEYS AT LAW - 726 EAST KING STREET - SHIPPENSBURG, F~4 172'.i 7- 1 453" i ~ ~ v• ~ ~ / f f ,~ ~~ j s~r ;t, ', r 1 ~~~~ i ~ ~' ~, ~, a ~ ~ w ~, H3~~ ~' ~ ~ ~ U a ~ ~ O d ao .-, ~ ~, ~ a Q y ~ it Q7~ ~ W ~ ~ ~ b a ~ '" a c. ~ ^~ W `~' 0 U b c~ v U M .-~ ~ O rl p ~--~ ~ Q `'-~ a o .. v ~ ~ ~ •~ o ~ ~ ~ ~ •~ •~+ v ~+ ~ bo +~ ~ ~, ~+ d' U U ~~ ~_ N a a O M M fi t'~ a a r 4 7 Ct" ~y 2v,u~ ~ ~~" ~„~ Vin; ~ y ,~; ~~ ~-~.-~~ -~.~ ~.;k--~~~~ ~ ~~ ~,.~-) ~ ~ ,~,~., ~ f~ ~-~--~ . ~ ,,,,,_ ~CL~'~(~ ~~ X~~ ~.~-~~ ~t0 ~D ~~~ COMMONWEALTH OF PENNSYLVANIA REV-1162 EX~11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 002095 WEIGLE JERRY A ESQUIRE 126 E KING STREET SHIPPENSBURG, PA 17257 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- ford ---------- -------- ESTATE INFORMATION: SSN: 201-16-3905 FILE NUMBER: 2102-1069 DECEDENT NAME: POWELL JAY H JR DATE OF PAYMENT: 01/27/2003 POSTMARK DATE: 01 /24/2003 couNTY: CUMBERLAND DATE OF DEATH: 1 1 /08/2002 101 ~ $153.64 TOTAL AMOUNT PAID: $153.64 REMARKS: LINDA K KLEIN C/O JERRY A WEIGLE ESQUIRE CHECK#184 INITIALS: CW SEAL RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 002096 WEIGLE JERRY A ESQUIRE 126 E KING STREET SHIPPENSBURG, PA 17257 told ESTATE INFORMATION: ssly: 2oi-is-aso5 FILE NUMBER: 2102-1069 DECEDENT NAME: POWELL JAY H JR DATE OF PAYMENT: 01 /27/2003 POSTMARK DATE: 01 /24/2003 COUNTY: CUMBERLAND DATE OF DEATH: 1 1 /08/2002 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ $153.63 TOTAL AMOUNT PAID: REMARKS: JOHN C POWELL C/O JERRY A WEIGLE ESQUIRE CHECK# 3421 SEAL INITIALS: CW RECEIVED BY: DONNA M. OTTO REGISTER OF WILLS S 153.63 DEPUTY REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX111-96) N0. CD 002097 WEIGLE JERRY A ESQUIRE 126 E KING STREET SHIPPENSBURG, PA 17257-1397 --- fold ESTATE INFORMATION: ssrv: 2o7-i6-3905 FILE NUMBER: 2102-1069 DECEDENT NAME: POWELL JAY H JR DATE OF PAYMENT: 01/27/2003 POSTMARK DATE: 01 /24/2003 couNTY: CUMBERLAND DATE OF DEATH: 1 1 /08/2002 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ S 153.63 TOTAL AMOUNT PAID: REMARKS: RICHARD JAY POWELL C/O JERRY A WEIGLE ESQUIRE CHECK#113 SEAL INITIALS: CW RECEIVED BY: DONNA M. OTTO REGISTER OF WILLS S 153.63 DEPUTY REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX111-96) NO. CD 002098 WEIGLE JERRY A ESQUIRE 126 E KING STREET SHIPPENSBURG, PA 17257-1397 -------- fold ESTATE INFORMATION: SSN: 201-16-3905 FILE NUMBER: 2102- 1 069 DECEDENT NAME: POWELL JAY H JR DATE OF PAYMENT: 01/27/2003 POSTMARK DATE: 01 /24/2003 couNTY: CUMBERLAND DATE OF DEATH: 1 1 /0$/2002 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ S 153.64 TOTAL AMOUNT PAID: REMARKS: PATRICIA A MCCLURE C/O JERRY A WEIGLE ESQUIRE CHECK# 2566 SEAL INITIALS: CW RECEIVED BY: DONNA M. OTTO S 153.64 DEPUTY REGISTER OF WILLS REGISTER OF WILLS REV-1500 EX + (6-00) OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA REV-1500 DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN F1L~ NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 2002 1069 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Powell , Jr., Jav H. 201-16-3905 DECE- DATE OF DEATH (MM-DD-YEAR) -I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 11/08/cr.t 10/05/1925 WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Powell, Do:rothv V. 3. Remainder Return CHECK ~ 1. Original Return ~. Supplemental Return 8 (date ot death prior to 12-13-82) APPRO- 4. Umited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required (date of death after 12-12-82) PRIATE 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 8, Total Number of Safe Deposit Boxes (Attach copy of Will) (Attach a copy of Trust) BLOCKS 9. Utigation Proceeds Received 10. Spousal Poverty Credit(date of death between 0 11. ElectiontotaxunderSec.9113(A) 12-31-91 and 1-1-95) (Attach Sch 0) fnjm~IUMllm.ijl!~.!l!'ilIl___W:edf$.ijjoo.J!ti\Of4!@llM.n~J!!lQIJm~iil_I.!l:t!;!1 NAME COMPLETE MAILING ADDRESS COR- Jerrv A. Weiale, Esauire 126 East King Street RE- FIRM NAME (II Applicable) Shippensburg , PA 17257 SPON DENT Weiale & Ass=iates, P.C. TELEPHONE NUMBER (717) 532-7388 42,500.00 OFFICIAL USE ONLY 1. Real Estete (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) None 3. Closely Held Corporaflon, Partnership or Sole-Proprietorship (3) ~ 8 ::DE? 4. Mortgages & Notes Receivable (Schedule D) (4) wn 5. Cash, Bank Deposits & Miscellaneous PersonaJ r,:,i" {O c~ (,~ :3 :~i~"~~::: Property (Schedule E) (5) 3,218.~0 "" -< 6. Joinny Owned Property (Schedule F) N 0 Separate Billing Requested (6) 14,375.40 UJ , RECA- :::g PITULA- 7. Inter-Vivos Transfers & Miscellaneous c..) TION Non-Probate Property (Schedule G or L) (7) ~.... (,j ~. 0\ 8. Total Gross Assets (total Lines 1-7) (8) 60,093.80 9. Funeral Expenses & Administrative Costs (Schedule H)(9) 6,031.07 10. Debts of Decedent, Mortgage liabilities, & liens (Schedule I) (10) 4,395.44 11. Total Deductions (total Lines 9 & 10) (11) 10,426.51 12. Net Value of Estate (Una 8 minus Una 11) (12) 49,667.29 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax (13) None has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 49,667.29 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a){1.2) 35,292.09 X .0 0 (15) 0.00 TAX 16. Amount of Line 14 taxable at lineal rate 14,375.20 X .0 45 (16) 646.88 - 0.00 COMPU- 17. Amount of Line 14 taxable at sibling rate 0.00 X .12 (17) TATlON 18. Amount o'f Line 14taxable a1. collateral rate 0.00 x.15 (18) 0.00 19. Tax Due (19) 646.88 20. 0 t~l*ij~jWitQ\t;Mi:~'agQ(l~Jl~ii!!~ijpQFA'IO\ij~!l!iAYM~iltl .,:':..""......, ..-,........,...,.,......_,. w.-......',,'.',.,..,':...:'.'i..".'..,.,'.. . ... ... .. . .,........ ..........:.,.,.,.:.,.:.:.,...,-"',;,;.,,:,:,',,.,,~ o PA15001 NTF 29755 '/-1 -71 _ I / - / (/I -1 ifW;ifi!!~$WBI$WQ'l\Iii~Wllffljo;U;'QlI~$ljQIii~tl!'lllJi~i't~l\IiiPl!~i:l!l~MA'I1iHi('t Copyright 2000 Grea.t\andINe\co LP - Forms So'ftware Only c)~~ """:''':;''':''''''''''''''''':''':''''''''''''':':,;""";:";':""'~;:':'::' .............................:.:.,.,...,.,.;.,.:..;,:,,',.-,.,.;...'. Estate of: Jay H. Powell, Jr. SUMVlARY OF ALIDCATICNS TO BENEFICIARIES Taxable at lineal rate Linda K. Klein Patricia A. McClure JOM C. Powell Richard J. Powell 3,567.20 3,593.60 3,620.80 3,593.60 14,375.20 21-2002-1069 PA REV-1500 EX (6-00) D d'C It Add Page 2 ece ent s amPle e ress: STREET ADDRESS 216 Road CI1Y I STATE !ZIP shi PA 17257 Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 646.88 614.54 32.34 Total Credits (A + B + C) (2) 646.88 3. Interest/Penalty If applicable D. Interest E. Penalty TotallnterestJPenalty (D + E) 4. If Une 2 is greater than Line 1 + Line 3, enter the difference. This Is the OVERPAYMENT. Check box on Page 1 Une 20 to request a refund 5. If Une 1 + Une 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax dUB. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. ..................... Make gheck Payable to: RE13ISTER l?F'YIL~,AGENT ...........,. ..........,......... "." :;:::::~:;:::::::::::::: :::::::::;:::::::;:::;:;::::}:::;:3:: ......w_.........._ 'U' :.:.::::~:~:;~:;.:. .:.:.~:... .:.;.;.:.:.;.:..::?;: .......'.... .:.::::::::,.....:.... :::;t~;:: ................, ...:., ~:~:.h}M~N%,: ;:,:;:::::;~~% ...... _.' ;::;::;;~~(:;:::~;:.;:~:: ........:.~,,',,' .................,m":. .....m...." i:;;~I:i:~;~:ti:i:ii~il;~:!i~i:L;;::L':".::::,.:'::. ::: :.:.:.:.:.:.:.:.:.:.;:~:;.~;g.:~~~}L?'~:~:~,:.,.,.:.:':~:~. ;~:;'.<,.:'. :::':':"~:;';"':':. :'::,:. . .... \ii:~::: ":::"~'~:~;~::~{....... .::Ni:~:~;";:;;;;: ..... ..... :'::::;;:;::;':',.. . .<.~~~~~;~~:~~~Hr:::':.~;.:.:. ::.:.:.:.:.:.(::::::::::;::::~r .,::::::::.~:.::t .::::;:;:;:;:~~:::;::::::::?<i:;:;:;;;:;;;;;~; ":':'" PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE SLOCKS 1, Did decedent make a transfer and: a, retain the use or income of the property transferred; ....................................... b. retain the right to designate who shall use the property transferred or its income; ................. c. retain a reversionary interest; or. . . . . . . . . . . , . . . . . . . , . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . , . . . , d. receive the promise for life of either payments, benefits or care? .............................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . , . . . . . , . . . . . . . . , . . . .. D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjul}', I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowfGdge and beUef, it is true, correct and complete. Declaration of preparer other ttlan the personal representative is based on information of which preparer has any knowledae. SIGNATURE OF P . SON RESFgNSI LE FOR FlUNG RETURN DATE ~ (/_ _ - -S'-2'L-(J 1 ADDRESS chedule attached NATU FP PA~~ERT (3) 0.00 (4) (5) 0.00 (SA) 0.00 (5B) 0.00 Yes No ~ I B ~ ~ DATE S 2"Z. _0 3 17257 [12 P.S. Ii 9118 {a)(1.1)(i)}. For dates of death on or after January 1, 1995, the tax rate is imposed on the net value of transfers to (lr for thlt use of the surviving spouse is 0% [72 P.S. Ii 9116 (a)(1.1){ii)). The statute dnp.~ not p.lCp.mDt a transfer to a survIving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on Drafter July 1,2000; Thetaxrate imposad on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% (72 P.S.1i9116(a)(1.2)]. The tax rate imposed on the net value oi transfers to or for the use of the deceDent's lineal beneficiaries is 4.5%, except as noted in 72.P.S. Ii 9116(1.2) [72 P.S.1i 9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. Ii 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. o PA15D02 N"TF 29756 Copyright 2000 GrtlatlandJNelco lP - Forms Software Only Estate of: Jay H. Powell, Jr. 21-2002-1069 'The follCM'ing person(s) are signing the retum. as representative(s) of the estate: Linda K. Klein 405 Maple Hill Avenue Shippensburg, PA 17257 REV-1502 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Jay H. Powell, Jr. SCHEDULE A REAL ESTATE FILE NUMBER 21-2002-1069 All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property Which Is Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 216 Roxbury Road, Borough of Shippensburg, Cuntlerland County, PA - sold 04/28/03 42,500.00 TOTAL (Also en/er on line 1, Ree.oi/ul.tion) $ (If more space is neededl insert additional sheets of the same size) 42,500.00 7 CPA21 NTF 10904 Copyright Forms Software Only, 1997 Nelco,lnc. REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Jay H. PoNell, Jr. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-2002-1069 Include proceeds of litigation & date proceeds wers received by the estate. All prOD. Jolntlv-owned with rlaht of survlvorshlD must be disclosed on Sch. F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 Patriot Federal Credit Union Savings Ac=unt 143.65 2 1992 Chevrolet Blazer - proceeds of sale ll/25/02 3 Erie Insurance Group - autarobile premium refund 12/12/02 4 Sprint - refund at cancellation 01/02/03 2,500.00 296.00 9.95 5 County tax proration at real estate settlerrent 04/28/03 128.97 6 Sch=l tax proration at real estate settlerrent 04/28/03 63.03 7 Nationwide Insurance - homeowner's premium refund received 05/08/03 77.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 3,218.60 7 CPA81 NTF 10908 Copyright Forms Software Only, 1997 Nelco, Inc. REV-1509 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Jay H. J?cr".1ell, Jr. SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 21-2002-1069 If an asset was made lolnt within one year 01 the decedent's date of death, 1t must be reported on Schedule G. SURVIVING JOINT TENANTrSl NAME A Patricia A. McClure ADDRESS RELATIONSHIP TO DECEDENT Daughter B John C. J?cr".1ell Box 56 Doylesburg, PA 17219 8367 Olde Scotland Road Shippensburg, PA 17257 Son C Richard J. J?cr".1ell 236 Lurgan Avenue Shippensburg, PA 17257 Son D Linda K. Klein 405 Maple Hill Avenue Shippensburg, PA 17257 Daughter JOINTLY-OWNED PROPERTY: LETTEA DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR MADE lnclude name of financial institution and bank DATE OF DEATH DECD'S VALUE OF JOINT account number or similar identifying number. NO. TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENTS INTEREST 1 A 1998 U. S. Savings Bonds jointly 7,187.20 50% 3,593.60 owned with patricia A. McClure, daughter 2 B 1998 U. S. Savings Bonds jointly 7,241. 60 50% 3,620.80 owned with John C. J?cr".1ell, son 3 C 1998 U. S. Savings Bonds jointly 7,187.20 50% 3,593.60 owned with Richard J. J?cr".1ell, son 4 D 1998 U. s. Savings Bonds jointly 7,134.40 50% 3,567.20 owned with Linda K. Klein, daughter TOTAL (Also enter on line 6, Recapitulation) $ 14,375.20 7 CPA91 NTF 10909 (If more space is needed, insert additional sheets of the same size) Copyright Forms Software Only, 1997 Nelco, Inc, REV-1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Jay H. Pc:/I;ell, Jr. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-2002-1069 Debts of decedent must be reDorted on Schedule I. ITEM NO. A. FUNERAL EXPENSES: DESCRIPTION AMOUNT 1 Crider's Meats - funeral reception 185.12 2 Fcgelsanger-Bricker Funeral heme 5,374.50 3 News Chronicle - thank you note 4.00 4 Ray's Laminating Se:rvice - copies of obituary 10.60 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representatlve(s} Social Security Number(s}/EIN No. of Personal Representative(s) Street Address 0.00 City State Zip Year(s) Commission Paid: 2. 3. Attorney Fees Family Exemption: (If decedent's address is not the same as claImant's, attach explanation) Claimant Street Address 0.00 0.00 City Relationship of Claimant to Decedent State Zip 4. Probate Fees 88.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 See Schedule attached Total from continuation page (s) 368.85 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of 1he same size) 6,031.07 7 CPA11 NTF 10911 Copyright Forms Software Only, 1997 Nelco, Inc. Estate of: Jay H. Powell, Jr. sc:HEDJLE H, PART B -- Administrative Costs Item No. Description 7 News Chronicle - advertising Letters Testamentary 8 Cumberland Law Journal - advertising Letters Testarrentary 9 News Chronicle - ad to sell autarobile 10 Carlisle Sentinel - ad to sell autanbile 11 Postrraster - certified letter to mw 12 Postrraster - postage for payrrent of bills 13 Sailharrer Real Estate - rrarket analysis fee 14 Register of Wills, CUmberland County -filing PA Inheritance Tax Return 15 Register of Wills, CUmberland County - filing Family Settlement Agreement TOTAL. (Carry forward to main schedule) . . . . . . Page 2 21-2002-1069 Arrount 76.88 75.00 9.75 5.40 4.42 7.40 125.00 15.00 50.00 368.85 REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Jay H. Powell, Jr. Include unreimbursed medical expenses. ITEM NO. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS DESCRIPTION FILE NUMBER 21-2002-1069 AMOUNT 23.28 1 Sprint 2 PPL Gas Utilities 3 Penelec 4 Real Estate settlement expenses (including realtor's carrnission - $2,550.00; realty transfer tax - $425.00; and Borough of Shippensburg final water cut-off billing - $66.75) 5 AT&T 6 Sprint 7 PPL Gas Utilities 8 Penelec 9 PPL Gas Utilities 10 Borough of Shippensburg 11 Penelec 12 PPL Gas Utilities 13 Penelec 14 PPL Gas Utilities 15 Penelec 16 Borough of Shippensburg 17 Lisa L. Helm, Tax Collector 18 C. V. Wenger, Inc. - furnace repair 19 PPL Gas Utilities 20 Louis Larson - winter snow rerroval 21 PPL Gas Utilities Total frcm continuation paqe (s) 68.19 39.35 3,041. 75 0.44 23.47 66.18 25.10 64.05 122.53 22.03 37.78 39.79 37.4 7 10.47 86.53 189.82 376.78 45.37 50.00 14.31 10.75 $ 4,395.44 7 CPA12 NTF 10912 TOTAL (Also enter on line 10, Recaoitulation) (If more space is needed, insert additional sheets o11he same size) Copyright Forms Software Only, 1997 Nelco, Inc. Estate of: Jay H. Powell, Jr. SOiEOOLE I h Debts of Decedent, Mortgage Liabilities and Liens Item NO. Description 22 Penelec TOTAL. (Carry forward to rrein schedule) . . . . . . Page 2 21-2002-1069 Arrount 10.75 10.75 REV-1513 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES Jav H. Powell, Jr. No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distribu~ons) 1 LOrothy V. Powell 123 East Garfield Street Shippensbt.u:g, PA 1.7257 2 Linda K. Klein 405 Maple Hill Averrue Shippensbt.u:g, PA 1.7257 3 Patricia A. McClure Box 56 LOylesburg, PA 17219 4 John C. Powell 8367 Olde S=tland Road Shippensbt.u:g, PA 17257 5 Richard J. Powell 236 Lurgan Avenue Shippensbt.u:g, PA 1.7257 FILE NUMBER RELATIONSHiP TO DECEDENT Do Nolllsl Truslee(s) Surviving spouse Daughter Daughter Son Son 21-2002-1069 AMOUNT OR SHARE OF ESTATE 35,292.09 3,567.20 3,593.60 3,620.80 3,593.60 ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 17 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 None B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS None 7 CPA13 NTF 10913 TOTAL OF PART II -- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ Copyright Forms Software Only, 1997 Nelco, Inc. (If more space is needed, insert additional sheets of the same size) 0.00 LAST WILL AND TESTAMENT I, JAY H. POWELL, JR. of 216 Roxbury Road, Shippensburg, Cumberland County, Pennsylvania, being of sound mind, memory and disposition, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void all wills by me at any time heretofore made. FIRST. I order and direct the payment of all my just debts and funeral expenses as soon as may be convenient after my decease. SECOND. I give, devise and bequeath all my estate, real, personal and mixed, whatsoever and wheresoever situate, to my wife, DOROTHY V. POWELL, absolutely. THIRD. In the event that my said wife should predecease me or is not living on the sixtieth (60th) day following my death, I then give, devise and bequeath my said estate as follows, on a per stirpes distribution basis: A. ONE SHARE to my daughter, LINDA K. KLEIN B. ONE SHARE to my daughter, PATRICIA A. McCLURE C. ONE SHARE to my son, JOHN C. POWELL D. ONE SHARE to my son, RICHARD J. POWELL FOURTH. In the event that any beneficiary of this my Last Will and Testament is under the age of twenty-one (21) years, I then give and bequeath said beneficiary's share to and appoint as Guardian of any property which passes under this Will or otherwise, my daughter, LINDA K. KLEIN, AS GUARDIAN NEVERTHELESS, to invest and re-invest the same until the said (/aj . f;t, e.JJ ~ o ' (SEAL) MARK, WEIGLE AND PERKINS _ ATTORNEYS AT LAW - 126 EAST KING STREET _ SHIPF='ENSBURG. PA. 17257 beneficiary reaches the age of twenty-one (2 I) years, with the following powers in addition to those presently given by law: A. The power to expend the income towards the health, support and maintenance, and education, including a college (both undergraduate and graduate), trade, business or technical school education, of the said beneficiary; B. The power to expend the principal, within the discretion of the said Guardian, if the income is insufficient, towards the health, support and maintenance, and education, including a college (both undergraduate and graduate), trade, business or technical school education, of the said beneficiary; C. The power to sell any and all real estate, within the discretion of the said Guardian; ]'r D. The power and obligation to distribute the balance of principal and interest, if any remaining, when the said beneficiary reaches the age of Twenty-one (21) years, without the necessity of a formal adjudication of the Guardian's account in the Court of Common Pleas of Cumberland County, upon the receipt of a good and valid release; E. The principal of the Guardianship and the income therefrom shall be free from the debts, liabilities, and engagements of those beneficially interested therein, and shall not be subject to assignment by him or her, nor to attachment or execution under any legal, equitable or other process for the enforcement of judgments or claims of any sort against them, either individually or collectively; F. In the event the above-mentioned Guardian is unable to accept the position of Guardian, I then name, constitute and appoint my daughter, PATRlCIA A. McCLURE, as Guardian, with the same powers hereinbefore stated. FIFTH. I nominate, constitute and appoint my daughter, LINDA K. KLEIN, to be the Executrix of this my Last Will and Testament; if she be unable to fulfill the duties of Executrix, I then nominate, constitute and appoint my daughter, P ATRlCIA A. McCLURE, to be the Executrix of this my Last Will and Testament. SIXTH. I direct that my personal representative shall not be required to give bond for the faithful performance of her duties in any jurisdiction. Drvr /;1-. r~ tJ-, (j , (SEAL) MARK, WEIGLE AND PERKINS _ ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA. 17257 IN WITNESS WHEREOF, I, JAYH. POWELL, JR, have hereunto set my hand and seal to this my Last Will and Testament, written on three pages, the first two pages signed for identification only, this 7 day of January, 1998. --f1 ~{~r (SEAL) "j This instrument was by the Testator, JAY H. POWELL, JR, on the date hereof, signed, published and declared by him to be his Last Will and Testament, in our presence, who at his request and in his presence and in the presence of each other, we believing him to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. qj ~~. td~d MARK. WEIGLE AND PERKINS _ ATTORNEYS AT LAW _ 126 EAST KlNG STREET - SHIPPENSBURG, PA. 17257 1 COMMONWEALTH OF PENNSYLVANIA : SS. COUNTY OF CUMBERLAND I, JAY H. POWELL, JR., whose name is signed to the 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. f1 H ~~ Sworn or affIrmed to and acknowledged before me by JAY H. POWELL, JR., Testator, this 1#1. dayofJanuary, 1998. 1/y.;"NA l oI~ ........ ....L......... ==..' . I b;.d..... .. _"___7.. MARK, WEIGl...E AND PERKINS - ATTORNEYS AT LAW _ 126 EAST KING STREET _ SHIPPENSBURG, PA. t7257 r COMMONWEALTH OF PENNSYL VANIA SS. COUNTY OF CUMBERLAND the witnesses whose names are signed to the fo going instrument, being duly qualified according QJ and ~um& ~ .~JLd , to law, do depose and say that we were present and saw JAY H. POWELL, JR, Testator, sign and execute the instrument as his Last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the will as witnesses; and that to the best of our knowledge the Testator was at the time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. C/J. o~ Sworn or before and witnesses, this .......... ..... L...." ....,..... Pin II' J ..fA t , J .. flMIIr MY~ll'IIIJn Ex__J,I. MARK, WEIGLE AND PERKINS _ ATTORNEYS AT LAW - 1 Z6 EAST KING STREET - SHIPPENSBURG, PA. 17257 A Settlement Statement US 0 It t IH ~.'._- -I' non epa men 0 ouslng on" V "Mc N-. 0<n2_no~< ; ~:~ 2. ~~~A 3. DConv, Unins, I 6. File Number T 7. Loan Number 8. Mortgage Insurance Case Number < ,-- O'DWIGHTMARTIN C. Note: This form is furnished 10 give you a slatement of actualllelllemenl cosls. AmOU'lts paid to and by tha settlement agent ere s.OONn. Items maOi,ea "(p.o.c.)" W9f'8 paid oulside the closing; Ihey are shawn here for information purposes and are not included in !he totals. WA~N!NG: It is a aima to ~Iy ,!,ske false stalems.nts to .th..!.,l!nit~. S~ on this ~ ~~Other similar form. Penalties upon D. NAME OF BORROWER: Dwight L. Martin E. NAME OF SELLER: Estate of Jay H. Powell, Jr. 216 Roxbu~">oad "hi~~ensburn PA '7257 F. NAME OF LENDER: G. PROPERTY ADDRESS: 216 Roxbury Road, Shippensburg, PA 17257 Bo'oua" of S"i~~ensbura H. SETTLEMENT AGENT: South Central Home Settlements, Inc., Telephone: 717-532-7387 Fax: 717-532-6552 m ~- -n on~. 12~ EastKinn Street Shi~~ensburo PA 17257 , on~~. 04/78/2003 J. SUMMARY OF BORRnWER'S TRANSACTlnN: K. !':UMMARY OF SEI LER'S TRANSACTION: .00 , 'C FD"" c"RR"'''''D 400 ""T"""" "R' .n. nu~_' 42 500.00 An. 'nri~ 42 500.00 .no .no .__Mn' D_no~. .no . ..no' 813.50 .no 'M .nA .n< .n< Ad' ~'n, " ""..',.,' , '"v'n~ '0' i..nn. noi" b" .."., in '""'n~ .n. 04128/03-12131103 128.97 onO 04 '28'03.n 12131'-03 128. 9? <nA "nhno' T.v.. 04128103.n 06130/03 63.03 AnA 04/28/03.n 06/30/03 63.03 .n9 AM ..n "n .H A<i ,<0 "0 12n. ~R_M '"',,..nMB 43 505.50 Aon "R . ~~ "~. L"D. 42 692.00 ?M . av "D mJ n~c.., C "C '"-"0 DC'" .....T "CD .n. 500.00 .n. <v_no nonn_" nM n.' . -. <M "'M' 3 041. 75 OM _...." .-..-. ", ,,- <00 <v'."nn 'non'.' <in nM <nA D__H n' ' .n< on< M' .no no. VM OnA <nA oM <nn u fn. "n__ ..nM'" "" "'I .. fn' ".nn. "n""i" "" .."er on v.. ou <u .0< .0< n.. v.o ..7 <" ... <<" ..0 ..0 oon. T"TA' PA'" CYIC"R D"R 500.00 <on. T"T" RC""(,TI~" ...~, 'NT '" '" ""LLCR 3 041.75 OM N~W ^T ~C~ C"C'~ FD"M ~M ".."... !"..nM"~"c on< ",n.. ---,., - " . <on> 43 505.50 <no ",no. ..,n' 42 692.00 .no . "'n. .on> 500.00 OM . -"~, . __n..nO 3 041.75 on. ". "W CD"" 43 005.50 OM "^"4 Tn """ "D 39 650.25 SUBSTITUTE FORM 1099 SELLER STATEMENT: The information contained herein Is important tax information and is being furnished to the lmemal Revenue Ser\lice. If youare reQuired 10 file a return, ~n~6rr~:c:,~~O::e S;:~~~J::a ~:~~iS item is required 10 be reported and the IRS determines that it has not bean reported. The Contract Sales pnce deSCflbed on SELLER INSTRUCTIONS: If this real estale wall your principal residence, file Form 2119, Sale or Exchange of Principal Residence, for any gain, with your Income lax relum; for other transactions, complete the applicable parts of Fonn 4797, Form 6252 and/or Schedule D (Form 1040). You are required by law to provida the settlement agent (Fed. Tax to No: ) with your correct taxpayer identification rwmber. If you do not provide your correct taxpayer identification number, you may be subject to civil or criminal pena\tia6 impO&ed by law. Under pananl9ll of parjl.M)', J certify that the number shown on this statement is my correct taxpayer idenliflCStion number. TIN: SEllER(S} SrGNATURE(S): SfllER(S) NEW MAILING ADDRESS TitleExpress Settlement System Printed 04/28/2003 at 13:32 REV. HUD-l (3186) l.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT File Number: 03DWIGHTMARTIN P'O~ , PAID FROM PAID FROM 00. TOTAL "AI ""'B">l'K .,,,,,,,,,,, 0~42 500.00 . 6.000 = 2 550.00 BORROWER'S SELLER'S nivi.lnn nf FUNDS AT FUNDS AT 701. . M SETTLEMENT SETTLEMENT 7n? . 2 550.00 .n SailhlUller Real Estate 7n' .n.'" o' 2 550.00 800. ITEMS . ~ 'OJ""N .n.., R01 I nan n.' i . Rn? I n~ % An. ",- RO' Rn< I on"._. , ,.. AnA 807. R08 ono 810 R11 onn ' nD"n BY I "'NDFR TO 1"" AnVA"''''' on, Inlo.... '~m In "". ..... 002. ,.. 'n 00. H.,.," I , 1M In on. on, "'''''''''''''''V'''' "tonTI<' '"'''' ,on, HA7.'" In'nrAnr~ mn __ 'mn ,nn? -. 'm. 1003 ~... Omn.... T.v.. mn __ 15.82 .-. 1004 r:anntv X" mn __ Imn ,nn. m. _. 29.96 .- 1009. 1100TITI 11n' In South Central Home Settlements Inc. 225.00 11"' 'n South Central. Home SettleUL8nts Inc. 125.00 110' WI' TiI'.' o hin"", 11n' 11M 11n7 ...... . '",,,.. . N,' I 110R Trrlo nn"',,".. .Nn' , 1109. 0- '"0 ~ 42 500.00 - 1111 1"7 1113 1700 N HA""''''' 17n' ,n..H 38.50 0- .- n 38.50 1202. n..H425.00 425.00 120' n..H 425.00 425.00 ,?o. 170< 1300 I ""TTI ""ENT ""'A""''''' 1301 ",~~ 13n? 13n. Rn'n"nh." tn Fi.nal Water 66.75 1304 13"' 13nA ',"7 130R 1400. T"TAI ..n'..M "n.. ,n. """,'nn' .UM 813.50 3 041.75 HUD CERTIFICATION OF BUYER AND SELLER e ~C:i:~ent and 10 ~~~ ~~r~::s~::':rt~lief, II fs a true and aCCl1lllle stalement of all receipts and disbursements made on my account or by me ?O/TVJU/ J 71~ . E"".~J.YHrz{J./r: /(' ~ WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TinE 18: U.S_ CODE SECTlDN 1001 AND SECTION 1010. repared is a true and accurata account of this transection. rsed in accordanca wi this statement 8y -0Qd'/M TitleExpress Settlement System Printed 04/28/2003 at 13:32 REV. HUD-I (3/86) PO. Box 778 Chambersburg, PA 1720 1'{)778 717-2634444 717-762-8555 ;'~i-,:c'u',)n'r:- \~~lbjblZ\';:\'1;:'F,1.1Zi 'l~:'f)t..JL:LI '. J!"~V 1. U DtJf ;."j(".rTE P~~J 1\11,; :Cr:'i"~[ :r ~"'! T [: P t'::: f,\ 'r D~;~no:::-:i t rii(~ t (] l:::q:~ J t,1E SHi41'~E' ;~CC:CH..Jt\lT ';1" :~::C Ql, I(:J~~l ::)lli~;("l:c\ i~ividp.nt.1 OFFICE LOCATIONS: 800 Wayne Avenue 247 Overcash Avenue Chambersburg, PA Chambersburg, PA 140 S. Federal Street 10933 Buchanan Trail E. Chambersburg, PA Waynesboro, PA Eff~:(. t ~ 1~::~/i?lC,/'IZli:~~ i')G,:~;;t ~ J.;::~/I:'JC/~Iil:~ 'I'll FI:::I.c', l?,(H. (H\!CF T nnhi !:)MDU1\n Pl 'p.~' Ei r:t 1 ~ () ~ (i)~:: J /,- :.:~ ~ ~~; 9 ~ /, ..:, :: I;';:. .\. .,..,,_.~ L}._, 1,/1, ~:?b It" E~G r;l)mllll?fl"i; fOl" !')RII'tlE: Grh~~:~F: f~CC':JUNT \lllll 14,."'''1 Fcu.ned (..J i 'I:; j"ldr',:.;..IJJ,:'tl 0121 fl'olll PHIt<lL ::,HPm': ncclJI.Jrrl i '..:-...," b~:';'- el~ Qllc.~ elf-,::?.',! r,L'!) #2.{t,(:i~"(. rll"~PV P6:\I:: 0. (~0 1. l-i':~:~ 6:; 1~01~ 11~/01/02 to 12/05/02 #34098 k~. i.Mlt 11.~ 3. t;~:J """_"_"_ .....'~ ... .._..____.m._..____._... <._,_..._._._..-.,...~. ,,~,__-".~'''-''-''-'''__. .-.-.---' ._-.._._...~._.. 14:3, E,5-- Ct,st:k Disbllrsed 45 ;:::~r::J~Y;)9j:;1 ESTnTE OF ~r(.~y H PDW[LL.. .JP (il..lthDl-,,,,,d by' ._._.,. ......_._.__._.__...._,._K'_._..__..._....._~"__._...,.._..._.__..--._,~..~,_,_~_"~___,."..._,.._. -, .-.-. #3Jj.0{~J9 ~'l:l,:~ tht~ ~':'~~I:.j,son fOt", 9ivin[~I~ Help locDl nCIs\ci';/ f,-;itliiJi,:.:'~:'" Thl~ '3f..\1'la.t::i(Jn HI-"'fijY 1'-~ co:;,lpc"(.'in~l r'lon....p.:.~t"i.~':\l~I.a.blii.,: foud i.tf~m~:;" ~J(:~i..'i:'~~Dj\ l..-Ji'f"i:.,:J(I'c<:, i~. c~ol;.\:~ct:tnl~) lJSi=C; L(~'J p~~OD0S and acressot~ies lo ~2rlefit dome~tic vi0]0n::~p agencies. C(111ec~iun boxes have baei\ pl~c@ci if! ~].l offlces. J rw Pc/WEt t. (;:1.6 ROXBUHY f;'f'I" f1HIPPENSBLiRG oq '7257..1124 www.patriotfcu.org MEMBER'S copy .........I..".....""'"."otI....C'.,.dltUni""Adm'"~..tiOD PO. Box 778 Chambersburg, P A 17201-0778 (717) 263-4444 (717) 762-8555 ,aunt 0000212610 POWELL, JiW Ie receipt for reference) 'pose of check: SHARE WITHDRAWAL 295999 Effect: 12/06/02 Post: 12/06/02 Tlr: 0634 ~ ~ J:- IC::~ t.5 0000295999 / / " .,...tIOT FEDERAL CREDIT UNION PO BOX 778 800 WAYNE AVENUE CHAMBERSBURG, PA 17201-0778 NOTICE: See reverse side of page 1 for important information regarding your rights to dispute billing errors and erectronic fund transfer errors. >5# 201-/(,,- 3<1or 004562 >1725711240< ,JAY POWELL 216 ROXBURY RD. SHIPPENSBURG PA 17257-1124 AS PART OF OUR ANNUAL AUDIT, PLEASE COMPARE THIS STATEMENT WITH YOUR RECORDS PLEASE REPORT DISCREPANCIES TO OUR AUDITORS: SCHREINERL LEGGE & COMPANY POBOX 553 SPRING.'IELD VA 22150-0553 CELEBRATE INTERNATIONAL CREDIT UNION WEEK OCTOBER 13-19! STOP BY OUR OFFICES AND JOIN IN THE CELEBRATION. SHOW YOUR CREDIT UNION PRIDE! Sh2."e accounts ere NON-TRANSFERAAI E exCApt on the books of this credit unior!. .. Debits: New Loans. Refinanced Loans. Add-ens, PrincipaJ Reversal or Share Withdrawals _f'~~tW 0... 1'lo......11...... IJ........ ......'V'Vn. "-'............ ---- _ lteUe)' Blue Book The Trusted Resource . . kbbcom New car Pricing Build a Car Incentives My Car's Value Used Car Retail Free Price Quote Buy a Used Car Sell Your Car Motorcydes financing Insurance Le man Check Warranties Accessories Car Reviews Car Previews Decision Guides Advi ce Aboutkbb Home Blue Book Private Party Report Pennsylvania' November 15, 2002 1992 Chevrolet 510 Blazer Sport Utility 20 Buy a New Car Buy a Used Car List Your Car For Sale Online Free Lemon Check Auto Loans As Low As 4.50% APR Insurance Quote Warranty Quote Print "For Sale" Sign Payment Calculator c' -- Shop likl with a r Blan k CI how mud ~ rPEOf. ~IlH::I,';t... :IIA:"'.l:'~' http://www.kbb.comlkb/ki.dIlIkw.kc.ur?kbb.PA;914732;PA055&17201;p&723;Chevrolet;I...IIII 5/02 Engine: V6 4.3L High Output Trans: Automatic Drive: 4 Wheel Drive Mileage: 26,200 Equipment Air Conditioning Power Steering Cruise Control AM/FM Stereo ABS (4-Wheel) Consumer Rated Condition: Fair "Fair" condition means that the vehicle probably has some mechanical or cosmetic defects, but is still in safe running condition. The paint, body and/or interior need work to be performed by a professional in order to be sold. The tires need to be replaced. There may be some repairable rust damage. The value of cars in this category may vary widely. A clean title history is assumed. Even after significant reconditioning this vehicle may not qualify for the Blue Book Suggested Retail value. Private Party Value . $2,805 Private Party value represents what you might expect to pay for a used car when purchasing from a private party. It may also represent the value you might expect to receive when selling your own used car to another private party. CI...~-;..,.":'1; 'k . bJ'l'''' ''- /~ :";",.,.r". . "; :..aK!,;~~~,~...t.,~:~ Get a LI~_c;I_!,:;:rrTB'IJ;te::I!lY!3.)u....e: Get Invoice & MSRP on New Cars ~~!.~.f'_~r5g!l_J() _Per~on Auto Loan ":' ..:a.._ ::._ - ~._.--:_. '"' ,~ -. ._,.',"' I' "h"'~'_W""" t.,. I ~ 'a'_.'.; '~-';~''I''<''''''''''''~~r''.:..-_...U''.''''--'--'''~~'''-'''' .-~. ....- ----. ... . . - .. '-. I 'W.lliJ Iil)'~JlJI.illl~~~~(!I..M,~ 711 ~g'NfmJSI}\1lwu..(.1H14'U1 .' .. '. ' . ".1 ir,: 1 t'""'':~;,', ri7 REDEEMED SAVINbS BONDS - SSN.,..OOOOOOOOO FACE VALUE MM YY SERIES $1000.00 12 EE $1000.00 12 EE $1000.00 12 EE $1000.00 12 EE $0.00 0 SUB TOTAL REDEMPTION...... SUB TOTAL 5T EARNED. AL REDEMPTION....~. TOTAL. INTEREST EARNED. i ,..;" .' ' . ~-..', '., .:1 REDMP VAL $595.20 $595.20 $627.20 $627.20 $0.00 $2444.BO Wf4.80 $2444.BO $444.BO ..1..,..,:.., ,_- ! V:'_- _-t' , I I II , ' SERIES EE\ . . lfilTE.JtCST CEAses 80 YeA'"~ t , "JtOM ISBUI: DATI: ' , .' llllil.ID lWfffiJC..llJ~~~(W~:A1tenlfM.i. @Th'~'Nf~.1g:;~\1lH>l!-(il'JmM:51 ,>,' . ~l ,,: 20 ,Ioo},~",~,~05 l';r. '7J(i;I'\~' 7" JAY H. POWELL JR t;~~i ('~lr ~ I.i." .. fit ,.~~,~:::t~216 ROXBURY RD Ii';:' ""~'" .'~F,:SHIPPENSBURG ') :PA 17257-1124 ,_, ~~J.ii.!. ~1U; \:i; 1..;IIl...I..IIIIIIIII"II~.,i.III..II..I.I.I"II.IIII.II~...II.I "I' . fl':J1 "") ORI PATRICIA A"MCCLURE', .I~, " I RDSlA~43000261-00000000000 010499 025 n072021721 "ri;;:i~ '; III, iU t,' . n ;'~'"~JiILli ~; ;Ml2021121EE ." 1:0000900071:07 8900720 2lo? 2 loll' [121 ~, ' ISSUE DJI,TE , [i;,?~ ,FRB PItT. : 01- 06- 99, . : 'llllU""i"QI::Il-rt. ~ , ' , DA"..G.'.......,. 'I I "'\I tol , _- ! v:_- _-t . ,""',: ~ I I' _ ___ __H__'___ llllil~ ~q;~l~~~~~ill!lOO'~~.~Jm!b. (!~!UJ 'illW!W2\!.~!!)!!I~I'J14\!lS1 201 16 3905 I',,} SERIES,EE ". I~Tlt"J:.T Cl!:ASlI:S 30 YI:A". \ ""-Olr! I.sue O"TlI: I ; , ,. ., ! 12: \_199_~' .." : I ~:; ~; I 'J. n J r E lV..,,~ 7' JAY H POWELL JR 'l , .~, - ~RB PITT l;f[f- :01-0<;-96',; ~~\4., ". , .. :' ,bu'''l~l:n ~. ~J,"" .' ~~~P~~~~~~~GRD , PA 17257-1124._ .."...".. ~i.,,: ','.1".11I",1,,111111111,,11,,111,,111,,1.111,,111I1.1.11..,,11.1 '.. /, :J.;". ,',' OR !PATRICIA A MC CLURE, c, j J r\', "', .,' . - ',' ! RDSlA 043000261-0000 0000000 010296 015 , 0010167362 ~ %i \ I I .' ". .. .. ., '1 \ I \ ""'" "''';;;''', .;"" ~ ~I I I I ,." " ~~0,< ~..l.l' "llMlOlb 13b2EE ~',,\:, I:OOOOCJ00071:07. .aDOm?O-~~3b ~II' w:_-_-. tl~ : " ~~mfill>~~~OO~.!~llff?A~ SERIES EE. UWtll11JIOJrtil\).\1l!!)IUtlUIJ!.\!151 ,......, c..... 3D ..... \ 1~'O.I"3U'I'''~__1 '. ." . ,20116 3905 'r~t ,12,1997. iiN,'Iw." "', ~bJAY ~"'~'~:~~'L JR ~,';1 ",SF l>ftH i ~ ". '" FRB PITT " , :01-06-96'. : ,.UI'1...0lNl'. " ~, '."" :::'::216 ROXBURY RD ; I "J I ': , ,\"1' 'SHIPPENSBURG 'I PA 17257-1124 ..,,".m., J ',f ~ L:;',~;I"IIII".I"I.I,I,I,I".I."II...II"I.I.I"I".II.III11.II.1 " " ,:' /"\I'.jOR:'PAtRICIAA'MC'CLURE',I',l" II" ' "",' ~, ' I RDS0A 043000261- 0000 0000000 010296 015 ' , 0010167363 I 'n P I'" I II II " . U ~ ~ 1 1 \ ."'... I i'.' 'e I Ii" "11 I J "' c., "'~"...s'di.,W' "W10lb l3b3EE ; ~, '.' 1:0000900071:07 8900 ~O'~~~7~3 b 311' , . ""'",__u "" :.,. ,-- '.' , \. ~1;;o! ~1"4',ii/;;;;;("'~Yj?,~:1ft"'% lid ,~,,'t ;;~j" ;I ill~~ '>r, ~~ J,::'ri.t-"~ $"~ ~ 711 REDEEMED SAV INGS BONDS {)JJllJ) ~. ,n ',,' ''', '~~~~~;J~~~~~$~<<~I FACES~:LU~.O~~O~~O~~RIES RE[~ V~0i "!I" 'llW'!';"\~' (!~i!ll~\~wool $1000.00 08 EE $903.20 \1 , , $1000.01) 08 EE $903.20 ..vrf 201 16 3905 i" 1 $1060.00;, 09 EE $742.40 "", I' $1000.00 09 EE $742.40~' l. "l/et-. I $0.00 0 $0.00 "- \ .' .', 7hJ A Y H POW El L J N I , 't;>, -- ( SUB TOTAL REDEMPTION...... $3291.20 ~\>\ ~', . c. ~,~~~ TOT~rNTEREST EARNED. $1291.20., ;":~ ," ,'216 Rex au R Y R 0 ,,"',..'fOTALREDEMPTION.... ..$3291.20' . ~'.,':," ;'.;\SH IPPENSBURG, . ' PA. ,1J '. TOTAL INTEREST EARN~D. $12,91.20 . " ~t::(,OR PATR1CIA A, MC CLURE " ,'.,'. , '. ~~0<'l ,;1'!031 ~ Oq8 2,1-0~OO;)08 3JiU (J02r024 R ~~-A If:: {'.' j,:' ;1l0:iJtl21827 I,J, ""';';"'.', "\,,,'1 :::::" r II' ,: ~~ ll,'-' Pd ~I-l-I'~"""-"" f '- I",', ,-',.', t~~''':'\\'''_.c'- ..~"l. "".'~'1 ,(1"-,-11'~I'M51b218271EE ,~.l....: 1 ~ "'_1 ~..." ' IW....'Y-'...~-) ~ '. (\~C,-~' \~\ \ "I:OOOOq00071:07 m oOOs~bnB27n" I:' i,',< tJ . "" 1lI:-i I .: "':.. _-;"-, ~ .: = I ,.. 'llllil~ W~!!Ij!!~~~ID!M!J<<!IJ~:!.f~~IUM.l ~~i!ll'~\IU~1(15\!>}(WOO1IM'US\ SEIUES EEl IM'I;'U.ST CEA.f:iI '10 .,......". ""'OM IS sur; OAT' 201 16 3905 : lj I, i 081 i 19921 I... ,J L ',! ,. rE 7h JAY H POW E LL J R 216 ROXBURY RO SHIPPENSeURG, OR PATR1CIA A 031300821-0000 I , P~ 17257 IIC (LURE 0831.92 002 024 File PGII'. '09-02-92\ :' "''3'00'0'" " " O...Tr/olQ.,....... : --- ReS-II 'OO~162182 ., I! i 'I ' .~;~~tt~t~~- 2 ~.~~- :~ ~r~.~.~:.~.~~~ I:OOOOqOOO 71:0 7 "''', .'"'' ,.,,,,. ,Hi},;I:"" "," "#;""""/>UI"1fti> '\\1'1 ,,~" "'w':,j'i'i(~~";y'~r{i"S:~s] '!,",("~~,' ,ll,iIl~,"~, ~~!ffi, ~~I\iii,~ to, '.:. "~\\\\":'~...~..dllf~r.u'''''' .'I~ff:",'t _,'f"." .,:."....".~..,.....,......,'.,....'. ........... ., ........' . ._li. ",. ...0' _ _",'H" _ .._...., ....... __ ,,__,....,""'_ ;()'\1111D: .. ." ,. 11I.!l1Jlli~~lj~;IlJ~.1~!.11lli~I!lJ~:!11~_mlli!).l SEIUES EE ~'(~):'-" "~\'~:'~ ;~;~,.'''''i:!'':' <<1)~Il"'J'U(IHI'S~~\~IJI)'l~(J)I'IL.~'PS~ INTUUT CUSES '10 YUlut . i'!!t! /~l,~j~:!;' '\v - . _~~ !.1~~ l ~ ~ ~, '"0104 ISSUE o....u ;;.' 201 16 3905 09 1994; li,JAY H POWELL JR 216 ROXBURY RO SHIPPENSBURG PA 17257-1124 1...111...1..1,1.1.1.1...1...11...11..1.1.1..1...11.11....11.1 OR PATRICIA A HC ClURE RDS-A 043000261-0000 0000000 092694 014 'I I! ! ' ~~" Mb3l03085EE 1:0000 qOOO ?I:O 7 . I) 2D~li~ 37~~~~!~ 5111.. uu ,'r<<r'., L " FRB PITT .D9-28-94" 15Il"f~QrNT'. D.."NO.T.....,. 006370308! , i .. I II '" :-i' ..: . ~ 'i.I: _- -; . --I "'- -:- , , II' l1!!i1'll ~~~lIj~~~~ID~<<!Ij'I).:!~lmm..l ~~i!ll11IU~J(~\)'~!!l ~(~I'IL)"USI SERIES EE INTe.II'I:ST CIU.... ao ...111. ',II'OM ..SUI;: DAT. 201 16 3905 , . , .09 , 199' ~JAY H POWELL JR 216 ROXBURY RD SHIPPENSBURG PA 17257-1124 1...111...1..1.1.1.1.1...1,..11...11..1.1.1..1...11.11....11.1 OR PATRICIA A HC ClURE :RDS-A 043000261-0000 0000000 092694 014 , . , I I:OOOO~'O~O ?r:O? ..~~i~.~.~^~:~:..:.~~.~~..~.~8bE FRB PItT :09-28-94'. . 1.."''1...01:IIIT-. D"TlIIIO.T"'''''' 00637030 " "'1',', ;,'" . "..:i. ,'_'__,-, "';1', :'t,_ i I I I -"~., ~->~~\ I 711 REDEEMED SAVINGS BONDS. ..::; ',;$0 9SN....000000000 FACE VALUE MM YY SERIES REDMP VAL $1000.00 12 EE $725.60 $1000.00 12 EE $725.60 $0.00 0""'0".'00 $0.00 0 $0.00 $0.00 0 $0.00 SUB TOTAL REDEMPTION...... $1451.20 SUB TOTAL INTEREST EARNED. $451.20 TOTAL REDEMPTION...... $1451.20, TOTAL INTERE9T EARNED. $451.20" , 11 '. ww:,,>> \I: _- _-~ t, '~!.!lI1: li~~!J!!~ ~}}..\!l~.~;(!llj, ~~i!l:.il~\\~i!!lW~~ '''1 ~.! r.r -;' . \, H! . I '!" f ~ \;:~ ': .~ ~,,- ~ ,. " I' , ; "/~ . f I' ~~~"",'.:"'h'''''...n. ,~....~~iIT"'1' '.,.. _~, _. _ ,. "," g\.",-, ,?Jl'~,,:\..\..- "",'1:,1,.( "I'I"~' t~"'t!~':'f.:t::tl!I.~11"..~\<:\,it 11,- '. W '" :.. I K_- Y \!: lJ: _- _-: . ,", t".: ~ , '.) f" lU'~:'''';;~' ,\ "~""i;"'I. ,11.~.fl<-" ~ ",' :', I I : ~. ", ~." . . . .. . . ". ',i~,tUJJJ}) '. .. .tll!Jli:I~~~(f!I~J.!J~jJ~lliw~;cm'~.!\!(!ifJY1~;,. ,.w~ .~~!!j' i:l~;;i:;: ,,\,~.~.., (~);IUJ ~m.!i:!.~J\\~W Q,U In,~~ ' ,- \,~,;.;,(:,.' , ---', --- '-"'--.... SERIES EE ll--ltll'lCSt C["SUI -10 yr....... '..0... 1.!fUr. D"TlE 201 16 3905 12 1994; , . ; I 10 JAY H POWELL JR 216 ROXBURY RD SHIPPEHSBURG PA 17257-1124 1,.,111..,1"1,1,1.1,1,.,',,.'1...11..1.'.1..',..11.11....11.1 OR PATRICIA A MC CLURE RDS-A 043000261-0000 0000000 122794 058 FRB PITT '12-29-94'. , ,~.u''''l''("'''''''. . O...fI~':' ST....~ 0064341226 ."4:?'/.:~--s- ' ,~-..""...",)...... ~ ~ ':0000'10007':07 6 00010[, 3[, ~ 2 21011' '~i..~m:"M~"";""'~"-'~"'>'~"~~<:Y:' ,~, "'0 ,. , ~~, =~~ .~IU~~""''''-'t>. >....~"'~" . Mblf31f122bEE ~~ II '. lJ '" :., I ..: ,"'-\I: _- .....! ~ I -..... ~ _-' & I ~lli1!; ~!IDI.IDi~~.Jal(!lJ~ 1 ~ I ~rn'l\lf(UllStW!!lUJ~Jma'US\ -..... REDEEMED SAVINGS BONDS' SSN....090000000 FACE VALUE MM YY SERIES S1000.00 12 EE S1000.00 12 EE S1000.00 12 EE S1000.00 12 EE SO.OO 0 SUB TOTAL .REDEMPTION...... SUB TOTAL INTEREST EARNED. REDMP VAL S595.20 S595.20 S627.20 S627.20 SO.OO S2444.80 S444.80 711 . . -.JOc....'; ...~ ..~ .;i, . j,;l , '-'-'j' .201 16 3905 7" JAY H POWELL JR f'\-~;il " !/' /' ~ t 1 , ....._..~_.._.'--,_."' ..-..........-..--.-.,.-.-... '-".' ---.-. II 'W\I:". _-' l \1:...- _-. ~ "'-_- : I .. 'll!ill:M!lI.lfID;~$~~~j~~.l. ~Jru'l\lft~ll~I).\'KUl~(~llnA\j:SI SERIES EE, . 'IHTc,utST CCA!U:S .,0 'f.....tS ~ '''ON '.SUI: O"TII "'."';',",''-,,,'''' J:;] 12 j-- \ i 19911 , . .201 16 3905 1'_;:: ,:f_ : ....IF. H JAY H POWELL JR FRB PITT " 01-06-99', . J55"''''1.''~II!:''T'. 216 ROXBURY RD SHIPPENSBURG ,PA 17257-1124 ..,.',.1...111..010.1.1010101...1...11,..11..1.1.1..1...11.11....11.1 " ; OR I JOHN C POWEL l i ," .' , · ,j .' , RDS-A 043000261-0000 0000000 010499 025 0072021725 i ::;,;~ ill " :.' I , ;-~L,!)~!JX:; ;Ml2021l25EE 1:0000 "1000 '11:0'1 :8 200 ?~;~2-;'i' 25"' 0#\"100 IT"..,. 'P:l' II, ' III !" :~ I ~,,"'~ ~, ~ ,t _- ";'-~. I.',+' -._-,,",; I ;' f _ _..___.m ,,__u___ '[ll ..,,\~~, '~lli1!; \!~~J~m..~~..w~1~(!IJ~.'!)!l!9J"]!)..l. @~@~\\..W!!lWUll"\..\IlSI -- - -. . ~ SERIES EE. 'HTE"r;ST CEASES 1I0 'fl...... nlO'" ISSUI[ DATlE L-.r#r "'t,' '? 70 JAY H POWELL JR c" TL , '1f1\ .:.. . ,FRB P{TT ~f\!' 216 ROXBURY RD ;' 0,},;;'.~.~.;.~8" ~'~ :.: SHIPPENSBURG ,PA 17257-1124 ',........... : ~~..,i ",' 1".III."I"lolololol".I."II...II..I.I.I"I".II.II~...II.1 '.. I,",.' , . OR jJOHN C POWEll . ," . Ij , I,. .... .' _~ : \ RD~ ,A,. 1?~3000261-000,0, OOOOOpO ~~0298 O~~, , . " ' 0070167358 ,...."":,.. > r~.""" II II I". '7',J.U.J2'~!lMlOlb1358EE "I. 1:0000 [WOO ?I:~? .. 1.00 ;-oJ~~? j 58u" 201 16 3905 " i' , :' ,.1! I 12' ,_.,... '1' I 199( w \,;... - . : -- -- ;'" , .- , :r ." '201 16 3905: }'~1 112\ \19911, ~<.f:' ""'''"''''''1 1 . '.'0 '" ,,: '~, ff~;';,;~~;;~~:~~' ii:}. nm-"'< i~~~~,~,~t ~"~,;,,,~ f/'~'I".!II".I:.I.I.I.I.I".I.~.I!.".II"I.I.I"I...II~"II.~..II.1 IJ "." ' '<MoR ']JOfiN C POWELL " .' 1'. f! ,j " '. '-. . .' . . I . 'RDS A 043000261-0000 0000000 010298 015 ! 0010167359 .;;'..;o~.',:~' t i::~~'; III r~ I' ,f :J 117',J)~\l.!i!:::MlOlb1359EE , '\ '\'; '.;0000"1000;1:01' .SOO;"O,~..t7:lSgll' ~.m ~mnm)~j1.$R.Jal{!U~~llI-mIM~ ~fll~~fj)lM~llll\.\IlS\ SERlES EE . ItfTIlIU.8T C-IlASlla so ...c"". \ ""()M .ssue O..TI '. ^,.,-." ""-"",'o,,,,,.."'m'.~,"'<"-_'w,,,,_ ..., ." ... .., ..' 711 :'I..V{r;4""\\..'~'>.'ll~;'~I;""~/.~i.,;,:,~~'''iI'!~:~~!:1$ ~ ~'~\~'''\ II " \,4 W l't, _~ Il't lJ: _- ..: ~ . ,'" , ~';;..,-:,>-", ',>' .'.'.,;....,':.1 ~~#,::_;"'''',, '_.' .'-.J, ' .. . '. .'i~J.1J1Jl' n ... . - 11!!ll.t mnilJ!ll~lEf~miC!l.M,: '9{W' :!!i','!" ')'\~ 1i!. ~!1:T\U~~llJ;!\);"'Wl!mu~ ,'.t'. e'! 1 ,201 16 3905 ! ):;1: I .5" Hc..,..~ ," "'0 r t.' 1. r ...., ' ;.< 7bJAY HPOWEll JR I , iilif,t, _ . I t' n t \ ~1~ '::.:216 ROX8URY RD 1T)I' \ ~ ~;i\~ 'T;;:;~\~P P E NS8 U RGL..J It;;r~ 72.1 ! ,1;,: t"I"OR , J~HN C POWELl. .. c''''''h". ~~;' :'~\O!31Ja~821~.aOl)Oi;<, 041ftft ft)(ji2,lt(. J" "".;',,~, tJ4I~,!,86~381 '. . >: ". . f. *....,iR.JT;1.,\:J":I. 'j . ". oJ I;+~ II II !I !,,~...,-:'"'\1) ') .1....~i...-'-i.,. I. " '. L, "'li.l\J'l~U., :",>1,_ "'Jl!I]'L \ U:.!'-" ~ 1, ~--- - -( ;I'-',!i'l',.'i. ". '" ,.",.\ '.... ".:.,.-;......... .' .-'-....'-"'.JI' .~~. ~~' 'Wt98b9381EE.; .!....;.~.,.\,~.\",. ,'. ,'~"t""o'~c''''','".'',...,...., ,.~~"-- , , ',''''",'l 1 ;">"1:0000'1000'1'1:0'1' ,.. BOOl,Q8\;'H81.u" 1 (,' '.----'- _.' - - - - ---- -- -- _.' ---.--.-- REDEEMED SAVINGS BONDS SSN . , . .000000000 FACE VALUE MH YY SERIES $1000.00 04 EE $1000.00 04 EE $1000.00 09 EE $1000.00 09 EE $0.00 0 SUB TOTAL REDEMPTION.,.... SUB TOTAL INTEREST EARNED. TOTAL REDEMPTION..,... TOTAL INTEREST EARNED. ~ REDMP VAL $930,40 $930.40 $742,40 $742.40 '0.00 $3345,60 $1345.60 $3345.60 $1345.60 o ~-~-""''''-' .,.."'........_.. .~.~..~_._"'_~__ - _.'"u ,. . . I 11I~:"f _- . W:_-...~ '. -- I " , ll!ffil~l{flOOl~W!)cm'4>~ q~!!1l1\1~~~j!.S\lo.~lllW~llJL1'USI ) 2a~iC~'~".~~,05 ;'1\~1 IbJAY H POWELL JR . SERIES EE IfIlTl:JU::ST ee:"'I5I[~ ~o 'JE-"'. ,.RO.... ISSUE 0.111<< 1'041 i 1992 I ! FR8 PGH :04-21-92.. . "'30 CJD" , , 1:1' PA 17257 ~~ - ,OR JOHN C POWELL , . 1'031~Op821~ooaO;041.,6?l :'002[\019 IiDS~A):, "0049M9382 I "';l '''' I I '1 f. J,' .... \'1 ~ 1 I I ' "Ii II " .' "... 'I ~ I, .~i~o;:7.i';..:~)\'" 'M't98b9382EE ':0000'1000 '1'1:0 '1'.'1OOI,.'~ab'1 38211" ~216 ROX8URY RD --- O...f1..a.T.....l' . l , ~~......_...," ,'''' ,.".,..r.,"'W"'" " ::I.V.~""'~~.l:,;:.. ...,;"..,."''''.'7~,,.\:~~"V;t;!f,~tll.~~,lfJ."I.'',~P\,\ u,. W \I:>l 'A'~ 'O'~ \I. _ _: 'l.... . - . I . ~ I .~: ~i'.:;~:..-_ ',~\l.\,,\,~,.,\~.' .Il~f~"";,;'.~ff' :"', .,n :,'~ _ _ I',. .... " ....-,.' ' '" ,. ,...' , , . . !~DJ.lLtJj~: .. ....... . 'Ullllj;t!lli~(~\UI.~~!Y1{11U~(~U'1)~!il.l~J:U~~" '?~"'.'!!f'" :';h;;j:", -\~~~,,~,., (:!~!!t 'm..:H~~~\,)l!!!!-l !t{!!.I'll.lli.="jj , 'l;'~..~:,,;,:, ~\\\\~~~,,~j~tf~ ~ ~~\'\\~~~' SEHIES EE ".-rUlES"'! l:.EA!n::S:!lI)'1fi"". r..ow ISSUI; D....TI[ 09 1994' 201 16 3905 1;,JAY H POWELL JR '-' FR8 P lTT .09-28-94' """"1 "C;rl<T" ' , - 216 ROXBURY RD SHIPPENSBURG PA 17257-1124 1",111."',.1,1.1.1,1,,,'..,11...11..1.1.1..1,..11.11,.,,11.1 OR JOHN C POWELL RDS'A 043000261'0000 0000000 092694 014 ':0000 qOOO ":0' .~~fr;';088" .-. .. . D~"..a n~"" 0063703088 Mb3103088EE ,\ l " \,," -':"-~ ,,"-_-11 It 'I "" W:" I _- SERIES EE 1100 ~~~Jll!!~~~!!lIM!l(PJ~!!ilium~J. ~!!!1l~\~\'\OWOOIll,,\,"tS\ '""."'1:91' et....s!;' SD .,r...llI. '''014 IS.Ut PAT. 1994' 09 201 16 3905 ~JAY H POWELL JR FRB PITT .09-28-94" . ",u'T"'"'''''' ' 216 ROXBURY RO SHIPPENSBURG PA 17257-1124 1...111...1..1.1.1.1.1.,.1.,.11,.,11,.1,1,1..1...11,11...,11,I ,OR ~OHN C POWELL ,RDS-A 043000261'0000 0000000 092694 014 i. . ;', II I ~~~~E' Mb3103081EE 1:0000'1000 ?I:O '1' &~,'?~,:"~:!:w~~^~.~~~~-^..^ l)""~O."'''''''' 00r>3703087 ., " ',~,; i , \ .. , -.~,,'~"'. K~utEMED SAVINGS BONDS _, SSN....OOOOOOOOO fACE VALUE MM YY SERIES REDHP VAL "j'."..,,-...""....~"'l """.00 "" "",'" l,!;:ml"illillW",-\-:t;WlUillHL>l $1000.00 12 EE $725.60 $0.00 0 $0.00 . 201 16 3905 'I ;;1, $0.00 0 $0.00 ,. .oi .,. '"'" .., $0.00 0 $0.00 . I .,' I SUB TOTAL REDEMPTION...... $1451 ryo " 7b.JAV H POWELL JR . . I SUB TOTALll'UEREST EARIlED. $451:;0 \~~~':' . -.i:216 ROXBURV RO \ ..1 17' ~Ut!~~~~~~O~ARNED: $;:;~:;~ ~~ ''''SHIPPENSBURG, ,PA 1 '~ ~~(~ j~~:I...III",I"I,I,I,I,I",I".\lI..\III,I.III,"\l,lI..u.._. . 'I, ,J '~;"'-ij~~OR":lJOHH C POWEll?;; ~". F' ~ ~ . II :, : .:.. "-, . .t, L.' (. RDSJ{.. 6430002.~1-0~0~ .01!\l00~Oft1~2194 ~S~. i...,' , 0064341229, \~r ~. .1:;1 ~::;!-\..IJ.Lu \,...~_I' .~I!..I~1IqIlMbtt3tt122qEE: ~GI,\J \ ;\.,:-\;~\"\ -F - - ""," ~v~__~:-.,.,..." . '~~~~::{f~'.'t\..!\:, ,:OOOOGooo 'j'1:0 'j' ~ ,00bl.. "",I. ~ n" IJ.J. it~ . ~ w'w:... , __" Vi. l.I: _- ";.:f ~ 'I" .. .= 'q~~1:\ ~!. '. v '\r ~~) ~ ~ ,,: -- ..: ~ ,.~...,. 'if'- -= : , 'l1!!i1J: ~~~Jum~~I.!!~mlb~.!l.N,~!lIJ.@~c. ~~g '!llliWk!\~W!W ~@.IHLM~.sl --".---- ...-...- SERIES EE . -;......--~-'"..-."...,;...-.- ,"T1UI:f.S" CI>\515 to '1'....". ""0" ISSUe:: DA1'I 12 I , 1994, 201 16 3905 Ji, JAY H POWEll JR FRB PITT , 12-29-94-. . '.....'..lM..."". 216 ROXBURV RO . SHIPPENSBURG PA 17257-1124 .1."111,,.1,.1.1.\,1.1...1..,11,.,11,.1.1.1..1...\1,"....".1 OR 'JOHN C POWELL RDS-A 043000261-0000 0000000 122794 058 '. I' ' ' .-4i!?"~t::'" ,..., . ':D~.DO~OOO?~~?'j'""",,, 6 ",OOb..:I... i!,:l9"" - Q",,"O.,....... 0064341230 Mb't3't1230EE " "., . ~ ~.'- .. 'll00l ~~JllIDJJ~~!!l~(!Ij*- (!!f~~I}.~W Jom '1':.1 t'.l '. ")~"s": ("" H' '.n r r" .;~^ ~fJ'\\t,' To JAY .H POWELL JR r--} \ (~ll11:';"';".~j'216 ROXBURY RO i'i ii' . '11 .~"- r,;r';',ISHIPPENSBURG '\' PA 1 , ~'.. )'ttdt,~;.l~i~I.';\ 111.,.1..,.1,1.1.,.,..1...,1...11..\.1.\.. .I..!I.I.!!, .JP';;d'>^OR'LRtCHARD J POWElL'~ II.' '.'.'. ' k ~.i R~~.~~0,43000~61-00,~Or~!I1)oooo 0\ 'I" ,. '''''',\;,(:1.,1'' I"'.' 1.I,j II r." I" ~ 11 a, ,CUI" .I,~l,h~,h"TI..~ ,.---- ~ ",,-,:: --.--?"J I"\~C " ~'';,>~' I:OOOO"lOOO?I:O? m :WOl ~ - - - . - ~~ - L ~~~ 1 -,..-....-...-...------"....;.--...-...-'-- "-...-,..;.----'-,,~........;,; 201 16 3905, \ REDEEMED SAVINGS BONDS SSN....OOOOOOOOO fACE VALUE MM YY SERIES .1000.00 12 EE .1000.00 12 EE $1000.00 12 EE $1000.00 12 EE $0.00 0 SUB TOTAL REDEMPTION...... SUB TOTAL INTEREST EARNED. TOTAL REDEMPTION...... TOTAL INTEREST EARNED. 711 tJ :... _- III _-_ II ~.IDlWlmR.J!J~Jjl<<m' ,. qwgj~~W9>lYtJiMi.1Sl - ., . ... REDMP VAL $595.20 $595.20 $627.20 $627.20 $o.OQ .2444.60 $444.80 $2444.BO $444.80 ~; ....''''1' .f.."..,., '/ -"uC.U1GJJ::.lJ::.l;': IHTlE"IUT CItA"lES .0 ......,,~ \ "tIoOM ,.aue. ~"T' \ ~""I [12\ [1-~9~ '201 16 3905: . g'~ ~(c 'Me 'C, ,.( To JAY H POWELL JR I ~", c.1.1 E n~, T EO , , ,FRB PiTT " 01-06-9~, " 'S.U""'l"G.NT'. " '216 ROXBURY RO ,_ SHIPPEHSBURG PA 17257-1124 "'\,I.III".I..I.I.I.I.I...I...II111II,.I.I.I"I".II.II'lllll,1 ,';; OR 1 Rr'CHARD J POWELL ", ',.; , -- i RDS A ~43000261-0000 0000000 010499 025 0072021727 ';::':;'1 I! I:!' '.\2'.JsJ~i,,,-0;:M12021121EE 1:0000"l000 71:0? 81.00 ?~;~~~? 2711' t -,,, ., _-".. l , ," ., ~~~"'''~.'''j*,> { ~\ilt~~ _...- .--- SERIES EE " ~\" ",",W:.J' ....- Vi. . , . '.. ~.' ," .. . - _: 'lltlJl.ID \!~@l@)~J).jl~(!IJ~.!1Jl!!OOM-,). (!~!!1: '1\lftil:!lj:S\\'~.w MI\It,~USI OIoTlNO."..... '~ i Il</TJ;:IU,!IT CEASE. 3Q '!'lEA". ""OM ,alllUf; O"'T! 12' i 1991.. . . ...,~J 201 16 3905 7;' JAY H POWELL JR , ~. ':J ~ {; i T L FRB PITT ,'Ol-~"-Q8" . ,A",," "~U.tT'" '." ; ~ ' 216 ROXBURY RD !! I i SHIPPEHSBURG PA 17257-1124 .. 1...\III..I"I.I.I.I.I...I...II...II..I,I,I"lllllI,IIIU.II.1 " ': OR . :RICHARO J POWELL,:'. ;, ( i1 'I , \ RD5."A 0~3000261-000000QOO!l0 010298 015, ' 001ii167364 1";;';1 III r' ';; ;'~J,ttll:;:;M10lb13bltEE I:OOOO"lOOO 71:0? &1.00 ?'O-~~? :lbl.Il' '" - , . I , \ :- D"'TIHO.TA.... J , II W :... _- W:_-_' ,,""': .- SERIES EE ' ''''ITlElIlEST CE....E. .0 y."". ' "...0.. ,..ut DATa \}2\ .~ln~:WmI@J~Ml<<m~:A!L~,). ~~1\lmlyg~~Dl)U!'III~i.lSI i <;:":!i. ( 201 16 3905! ,:~"j; 'i':r' ';',c)c',,'Ec'ic,'.;-'nt.;" I. .. ;' fJ~~~:':\., 7bJAY, H POWELL JR ,i",'7, ';;~E ;'~~~ ., ,.' 1.' 'I' \,.' :01-Q6-28' , (~', _ 0';"':';)'<216 ROXBURY RO '.1 :' ".'''1'''.'' ": ~ ,~":-'SHIPPENSBURG, ' i- PA 11257-1124 , ........... : ., ,"1,,\ , ~~" ::/" 1..,\11,,,1,,1,1.1,1.1,,,1,,,11,,,11,,1,1,1,,111,11.11,,..11.1 .....- , ..r~J~ I OR :IRICHARD J POWELL, ,1, ",j ~ q, , "'" .-"" " l "~'RDSJA b43000261-0000 0000000 010298 015 ' 0070167365 , , , . '" "' I I f' II I "I ~ \' \ \ ) ,,'. "' , ''''.''''" :~; ..n,", I "H '-~.&d~"W~IJM:'Olb13b5EE \ " ", " ,~ ,', '\:,\ I:OOOO"lOOO ?I:O? &000 ?~O"if,?-:lb SII. \~1~9~ . - . - -"' . '-" ilTI"'T",]) -, ,. 1!!!lI~W~JJ~!i~~~9J!1~(!Il~'lI~ ~J),JJ _~, -'. ..lfltlll"lf"il~"\\\~'" -,' II Itlr,,",.,J - - ',-' \,\1,/:" .' _,' (!!~dr~\U~.:WS~~Wlli!J~ .~ L ,l 1- ,,\ 'l\I>~'-:;" ',C~.' 20'.'6 3905: ,;,r_,.:1. I ,! ,,!./ (l ,/,'. .. ", t '0<. "'C,l"'~'" ~o .. ~/ /1(,:, 'i~<;'JAY H POWElL JR, ! :;' (~dl'..o \.,~(l;~ ~ 6 ROXBUR Y R D ",' I';' ~' ~~':1 ,t1~;~~H}PPENSBUR~ _ P,~~~,5 ~\W, $i,; .',011 RICllARD J POWelL ' ;':i ...,;~t -:;t'tO_~l?_~p8,,:'_-0"OCCl Q6~r.il2 L:002J O~ :., . ',,,, 1;\ 11'11' {f'{'tiII rliT-c ~nll'rl \~ 'i,'~,.,.'....t~.,'.~. ,~,.,t;-..:\.~'..'\'., (.\ ;."', I...~ ~.!! ! _'1. - - --:.....' .~L<<.4 oj! ,\""'-\C;J'~~:i.o.4)-,'I"'\'\~,--1 . - .co'" '"'''' ,~.....,,"'~ . '\{,L\~n\";'(~\~~',\ 1:0000 ''lQOO. 71:07.. 8 b..D. D. 5. D.J ; - . ... .-""--~---:---.- -. . 1. . "'--. , . ~'.' REDEEMED SAVINGS BONDS SSN....OOOOOOOOO FACE VALUE MM YY SERIES $1000.00 06 EE $1000.00 06 EE $1000.00 09 EE $1000.00 09 EE $0.00 0 SUB TOTAL REDEMPTION...... SUB TOTAL INTEREST EARNED. TOTAL REDEMPTION...... TOTAL INTEREST EARNED. 711 , - ~ , , REDMP VAL $903.20 $903.20 $742.40 $742.40 $0.00 $3291.20 $1291.20 $3291.20 $1291.20 ,--.----.. -.-----~-----------. ",: 1 "c.nl.r;;'-~rJ :I' "H.R~.T CI:...IIII' '3110 Y~A". t ""ON ISIIUE bATI! ' " 201 16 3905' r 06) [1992[ i. " " #r:~-.. ~;l, :0 Jle, . .... i ~,'1(~:. :- !~i:, ~~'\.. :- ""~::.;,f' $0>< $(" ""~ ., ,--' 'j ,~ : ,-' !,. I.' 1 f-: 7;,JAT H POWELL JR 'FIlB PGH :06-30-92, '"31)00''' ' I',' ,216 ROXBURY RD 'SHIPPENSBURG; . PA 17<',57 OR RICHARD J POWELL . '031300821-0000 062692 iDOl' 025 , I " ,r --- D.-TlH".''''''''' RDS-A! "Ql)5068Z621 ,.. ';: 'I 1 I I f' ,. :~.L!~~, J,I,,,I ',;,', 'MSOb82b21EE I:DDOOgODO 71:0 7 . 7~-6'5'~-~a~b 2 ~II' SERlEsEE ''''",I':"1:5T (:1["'511:11 30 YIEA"'. ntoM 'SSUE OATil 201 16 3905 09 1994 l;,JAY H POWELL JR FRB PITT . 09-28-94' \lS'''1 ~"n.-rs . 216 ROXBURY RD SHIPPENSBURG PA 17257-1124 '""1,,,,',,1,1,1,1,1..,1...11...11..1.1.1.,1,.,11,11,.,,11,I OR RICHARD J POWELL .RDS-A 043000261-0DDO 0000000 092694 014 A 4",&-~ Q .OO~l'?'030al.lI' "..."..<:I.u.... 0063703084 Mb3l0308LfEE ':0000 gOOD 71:0 7 '. 0 ~ II '1I"':~.I,...._-'i1i: V:_- _ l ,-,~--_",': I '1 1!!!iI1: lf~IJlj!i~ ~_IJ}..ID~(!Il'I}:!)~lJ.ID~~ ~';\'~ 1\umt~l,l11l'!!llli~m~)',u;s1 SERIES EE INTI:I'tESY CI:AIU:. 310 YI:AJtIl '''ON IS SUr: DATI: 201 16 3905 09 1994 r__ II'! ,'I \ ' ';.. 'r'itfi - \V'l' . ,l\.~,... ~,~ ~JAY H POWELL JR FRB PITT .09-28-94', l.su'T...or;'H.. ' 216 ROXBURY RD SHIPPENSBURG PA 17257-1124 '",11""",'",1,1,1",'",1",.11,.",1,1,.1",11.,1,...11.' 'OR RICHARD J POWELL , iRDS-A 043000261-0000 0000000 092694 014 1,,;,,;'111!': ~' i ~~-".".~:.~~.9"?~~"~,o",.?,~.:"~~?,,,~.i~,~I~~~~~'~~:M:'~;~;~'~~.~'~.~.~'~"" D...".....T....... 0063703091 I.,. . . 'j ..;,'t -4 ,. w:,,:~ " "ii~'I:"''''''''' '-/.:;. ,~tl " '. 1I'W'~" l .: ~ V t -- .:: ,-. ~ . ~~'-- .. ~ ",'t-dll . ~ '~J i. 'fl ~ 1';Jl: . ~~{i.i~1(lJ!U!>~j).!!\!b'!JQl.M.:J)1 .~~~l\il~"'\~ .' . (!~llli~.J.\il'!!I'OOmL~" g {'(y. \0, " I I ~".,;,I..::,c.:1 ,", 201 16 3905 .... .,Ht." .1'.' ..... .1 '~L I l :-...\. .ne ~". ,...~ ,D "" " " ~;f :~f!::'l~t...:..- ?n,JAY H POWELL JR '" \ 711 SSN.~:~~~~~~o~~~INGS BONDS .; ~"~'~ < . '. \ FACE VALUE MM YY SERIES REDMP VAL ',~' <':!. 216 ROXBURY RD : j , 7 5 60 ~. f;;"'SHIPPENSBURG~" PA 11257\ '1000.00 12 EE . 2 . '.' ,i';", I 11III I II II III I IIII III HOOO 00 12 EE '725.60 ~.~ !?1l'fl",J,I...I..... I II' II' ... It.. II III , U" , \ . 0 $0.00 . ~~?;'f~10R"'IRltHARO J F'OWEL'L . ~, l1 I ~ '0.00 '0.00 l' .'{ t..1 RDSL(4 043000261-0000 0000000 122794 .0.0000 00 .0.00 . "t, ',",~,,:; ,Illl'll .1:IJ' W 11111";'" ~ r. Ii M\ '0. \&l ~ .' l\. '" .~.,. IT!~f.!.LD_'.l :,,' ','_" ~--' SUI< TOTAL REDEMPTION...... H451.20 \Zlbr'\t'"L~I;, ~.~\"i ..' , . ".. ",. . v~"-"'" SUB TOTAL INTEREST EARNED. .451.20 'I'~,i('r.t, .t~\>'~ :'.1:0000900071:o? = J,om;....:l. TOTAL REIlEMPTION...... U451.20 .' ... -j TOTAL INTEREST EARNED. $451.20 \ \ .... ~,..~,.,..~,,, , .. ~t .~WI. .. SERIES EE IttTI:"'f:5'f C:I:"SCS '0 'I'll""". 'I'JtOM I"UI!: DATil 201 16 3905 12 1994: ji, JAY H POWELL JR 216 ROXBURY RD SHIPPENSBURG PA 17257-1124 1...111,.,1..1.1.1.1.1...1...11...11..1.1.1..1...11.11....11.1 OR RICHARD J POWELL RDS-A 043000261-0000 0000000 122794 058 , , ~ ".:~.,; &~-c::: . ,:0000900071:0? .2,~O ~-~-i'~~ 2 2811' FRB PITT '12-29-94', ,ssu'''l""un.. " D~~'''O .,"'.... li064341228 Mblt3Lf1228EE ".l""f',~:'.J""(I'U' "..~. 1"'1']' '~'. ~ ......, -- "'.~...~: _- ..-" . t" I ~ I I I 'JlIU~: ~OOi1.tiJ~~~'OO*~j , . #'~\W!' ""\~ "" ~~~*\F!!lJ)jun~).'I~ 'C L ." ~ ~, f! L . ' ,q~' K ;',; 201163905;r:;11 '( . '/~" , . I ,," ;"".,," '.0' ..-;!",-;: I ~'~"l"',~, 7b JAY H POWEll JR \;-:/ ' \ , \~;~' l.... '.:' '" "p,' I I~" ;,.\>-~'216 ROXBURY RD \ I I I' . i :-;- ^., i<~~;'S~IPPENSBURG :.i PA 1,12\1 , ~~l,tl~j' ,J"lllIlI.I..I.I.I.l.I.!.I.IIII!!.III1I".llIIIIJI.II.illl ..",,' 't ~OR 'lL1!NDA K KLEIN 1\ I 1~ ?l, ~ 1 ~ . .( . " '. \.,: :, RDS. A~0'i;S000261-0000'[OOboooo 010 " \.:" il...... ) \ t___ " 'c, i _ ,'";"''', .'c l. . :. ~ , J . 1 ~l U ]' II II il I I " I!. I. II ' : (: "'.' \,;. ,"\ '\,' <.;S~-,---- - . '" -4... ":t:' \::')\:\)~!\1:(:";~~~~'~i:~'OOOqOO~";;';~'1: . Wo";-; ....... --:'... """,. -."" 711 REDEEHED SAVINGS BONDS SSN....OOOOOOOOO FACE VALUE HH YY SERIES $1000.00. 12 EE $1000.00 12 EE $1000.00 12 EE $1000.00 12 EE $0.00 0 SUB TOTAL REDEHPTION...... SUB TOTAL INTEREST EARNED. TOTAL REDEMPTION...... TOTAL INTEREST EARNED. REDHP VAL $595.20 $595.20 $627.20 $627.20 $0.00 $2444.aO $444.aO $2444.80 $444.80 . ------.-.-'"--..- .. , .-- If t \I \I :-t J..- l w: _... _ I ' ~ __ r- l . llI..rn:~ml~~~OO'~"'tlifltl~i ~~',lIU.~lffiS~\1i!!lUl~Jllli).~lSI M-:SERIEsMEE\ IN TEll EST CE,/l.SIES al) YllA'lIt 1 '..0.. ...U. DATil 112) [- , 19!.!! '. ~r- . 20 ~cc_;~c~~P'i~,~.051 t_~{;l, ~ti, :i~, .7;' JAY H POWEll JR \~-1 fi~ ':'";216 ROXBURY RD ;T :[ :S'~>. ',.:.SHIPPENSBURG I'" PA 11251-1124 _, . .~. J ...i}.... :'.r '",'I...III...I..I.I.I.I.I.ul...II,"II..I.,.,..I...II.IIII"II.1 .' ...,.."... . ,'tl ... i. OR lUNDA K KLEIN' ," ,~. ,I , ~" ~ '.' . ( RDS-A '043000261-0000 0000000 010499 025 0072021723 '. i,;; ~: 'I I i I :i I :., l-i>'"~.i~~~;': ;M12021123EE I:OOOOQOOO 11:0 1 8DOO? 20 2 ~ 12 :1/1' IS <.; (I E l) I. r E .~RB PITT.' " 01-06-99, . ",u"'i~ctHr. " ,"',,:.., ",,-' Vi",: _- _- ~ ,'. "'. ; _- & I .- " ,.. . SERIES EE '!!l!lIlJ li~lm!!tiJ$f~!l~~m*:JlllilljJO~.l ~~Ml'4\I!ml/:ll).~filB.(~111~).'nSI 201 16 3905 INTIll'U:ST CE"lIr:S so 'I'IlA". FROM ISSIJE O"TI: I ~ 12 i 199~. ," C 7;' JAY H POWEll JR FRB PITT " 0'-1l,,-Q8' ,,^u"'l,,lt'I:HTC ~. f ,. '. :" I' " \. ." 216 ROXBURY RD SHIPPENSBURG PA 11257-1124 " 1...111...1..1.1.1.1.1...1.,,11...11..1.1.1..111.11.11....11.1 : i OR lUNDA K KLEIN " "I! ,[ "" ...' \R~~l,A" ~~300026t.-?000 0000000, 010F981 O~~, : '~ 0010167360 I, "," I I I I' , ' \2"....sh.~' '''M10lb 13bOEE ':00001100011:0 1 .~00 ?()-~~_:lbO/l'" O"T'''Io.IT...",.. ',' . . ",.:... - . : _- _ t ....- -- I ..~ '!l.!!R~!llj~~~!l~~OO'~:Jl!mJmA\ (!~~'l\lt'~1ffil\\.~D>w-nllli).'I1SI ----SERiES-EE INTItIlIUT Clt....i:. :10 yaA.. . ....OM IS_',IlE DATlE '. i 'T(' il'! 'I. . ; ,,, ~ To JAY H POWELL JR (.idl.~ -':"216 ROXBURY RD 1 I ' ~" ;. ;:"'SHIPPENSBURG. I PA 11257-1124 ~'~"i'\"'I'''III'llll.I.I.I.llI.I'"Il".II"I.I.I"I".II.II"IlIl.1 ','1 ' .r.):;1 OR IIUNDA K KLEIN' ", i' ,~ ,~ '. . , i . !RDS"JA 1'9~3000261,~00~ OOOOO~O 0~0298 01,5, . . ',' r. 0070167361 " f,:;:~~l III; t" d r,\2"&I",I~'}L:P'M10lb13blEE " 1:0000'100011:01 ..??~!~~~~~7~:lb ~II' ,201 16 3905: 'r::l 12 \ , 11991) , ~"c 'c, C 1;"" ". '. , !: ) : FRB PITT ,'01- 06- 98', ;' 15.1.",AOJNl'. " , OAT'NQ.T"Ol" C""""";":' is......"../.... l~""".t ' ,,-,,,,,.- "~ .'~'lIJ;z. ~N.." ....~""..~".... 'U' . .;....,.... ........ N'r. H~" . .' ..." ~~'., ~\~',JI !'\\~ ,{Hi!);"":' ?'-::!:!. J f';~f \'Sir~ II 'I W \,I :>t I _~ VI." \,I t ._- _- ~ ' ',' t'"..: .,tfl~'fl'tJl' , ~J!!I!t ~~-Ill~tll~~!M!JM~llim1 > : ~\.,' , ~!!.1l~~\\l:UiU.l~llIL)..U;S1 i "\.:!.it., ,i,'<; , ' ", I I ~bflil;;'''' '{,,:;,' ,201,,',~;~,}"~005 )~j'. i ,y ~.>~.:. 7bJAYH POWELL JR"., \ , '1~('I:i .. ,;j,~'216ROXBURY RD ! I ii' , ~~\ ,~t%,SHIPPENSBURG\ '.' i" PA 17.257-! " ". .\ti~~I~!~!}IIlII,,'I,I,I,I,IIl,JIIIII..!I!"I.I.1111II1I11I111I11 ! ','i~'lOR !~lNDA K KLEIN' ~ '. "l, ~. ~ \" I ....,..l~...l,. R. DS ~l\d04. 30Q02~1-.00 00 0000000 122794 I " ", (\'t',' , ' · · J · HJ. " ("'J; W L1 11 (." il ~ Y Lll 1 1 ;;}, "';;+1<, ,., J",\.:"j;' .'~ J.t~T"!.!". h-' J: I,:" -C:-:':':J_ :..::.A 'j~ q'\k';~~tX.'lt'.tl ! ,',' ,,"""''''''"' ~~~'-i~~ ., ~~~;~~.:\:'~:\~I;OOOO 'iOOO ?1:O'?n.~ I I I , : '.- , "'-- , " "'.:--............. '" REDEEMED SAVIN~S BONDS SSN....OOOOOOOOO FACE VALUE MM YY SERIES $1000.00 12 EE $1000.00 12 EE $1000.00 09 EE $1000,00 09 EE $0.00 0 SUB TOTAL REDEMPTION.,.... SUB TOTAL INTEREST EARNED. TOTAL REDEMPTION...... TOTAL INTEREST EARNED. 711 REDMP VAL $725.60 $725.60 l742.40 $742.40 $0.00 $2936.00 $936.00 $2936.00 $936.00 ~, t , I , ' " '.1 V' ( ,. ~,' , i I> I ;- ':" ~:,', . '~'\" \ , ' If '" w:". , Ill: _ _ t ' . .: 1100: ~flIJIDj)~ji).91~~~:Mmn ~~!!.1l11I:I~~.W;;\1'\';\J!!>m~lHt1'U;S1 I 201 16 3905 ,. ,1 I , T 12. . l i'J'J~[ .' 7;,JAY H POWELL JR '.1)- 1 :: '216 ROXBURY RD ;1, SHIPPENSBURG PA 17257-1124 ,1..,111",1.,1,1,1,1,1",1",11,.,11,,1.1.1..1.,.11,11,..,11,1 ": OR 'LINDA K KLEIN .RDS-A 043000261-0000 0000000 122794 058 " ' I I . 'I .' . """.\" ~~~I'"'''' 1:0000"l000 ?I:O? &"lOO~~~-i~~ 2 21,11" FRB PITT : 12-29-94' : 's.u'..l...G.....nl 't , '. , : O...TI..ClI'.....~ '0064341224 Mblf31f122lfEE 1:10J. "'. ""W:"I .. ". _- Vi. \I!"":" ',-t! ~ I-, ,,- - _- , I "(,. ~~~lSfi~~ ~ - --- - -~- SERIES EE '~!!Ij; 1i~~J~!!!ijJ'EW.~~~WJ*:!lt~_mm!),~ ~~!!l'~~":l(WOO"'L).'U~ IHTEIU5T c:[...5($ :10 YE"'''. 'ROM ISSUE DATI: 201 16 3905 09 1994 ~JAY H POWELL JR FRB PITT 09-28-94', , ',"u"I''''OE''''1 216 ROXBURY RD SHIPPENSBURG PA 17257-1124 1..,111..,1,,1.1,1,1,1...1,.,11..,11,.1.1.1.,1...11,11....11., OR LINDA K KLEIN . ,RDS-A 043000261-0000 0000000 092694 014 0063703089 i, '!,,'" "_ ! , I '.. ." \ I! I' ~~. Mb3l03089EE ':0000 'i000 ?I:O ?&bOO b 3 ?O 30B "lll" n.."..<> $.,...... -..- SERIES EE INTrl'trST cl~.t:. so TIlA". ""OM ,SSUl DATI 201 16 3905 09 1994\ ~JAY H POWELL JR .FRB PITT ,09-26-94' ",u,'7 ",OUoT. . 216 ROXBURY RD SHIPPENSBURG PA 17257-1124 '1."111,,,1,,1.1,1,1.1.,.1,..11.,.11,.1.1.1.,1,.,11.11,,"11.1 , ,OR LINDA K KLEIN RDS-A 043000261-0000 0000000 092694 014 , ' A %'i~:;;;-; 1:0,000'i0^00 ?':~,,?, 6?00l; 3?0 30CJOU" g..T...O.''''.... 0063703090 Mb3l03090EE , I I "-j '. -... .I '. . ,! --<:!;"'j I ; 'j ., I ", ,-j -: -, .':. ",1 . J :"c,:' "1: " ,- ",. '. , .;'.:) ....-.'. ':<..:. , .'- ,- . - , . '~'.:/ ., . Will:... _- ~ w:...- _-; ,-." --_ . ., -~--~ -- -,. - - -~. ~ -".- ~,----- --..----.... ".-- ".-.. ...., . ,-.' .... .,~ REDEEMED SAVINGS BONDS SSN....OOOOOOOOO FACE VALUE MM YY SERIES $1000.00 12 EE $1000.00 12 EE $0.00 0 $0.00 0 $0.00 0 . SUB TOTAL REDEMPTION...... }$1753.60 SUB TOTAL INTEREST EARNED. $753.60 TOTAL REDEMPTION...... I $1753.60 $753.60 711 REDMP V~ $876.80'- $876.80 $0.00 $0.00 $0.00 TOTAL INTEREST EARNED. II . W W :... _- . \I:... _: ' ----.-...- --~----- .~~""""~-"_.- -~'.'--",--,-'.~,,-,- -_. ~t, "":,t 7iJ JAY H POWELL JR t.. t i~ri, ~ ,"f ,~~ ":':}~~p~~~~~~~GRD 1; >!~A 17257 - ~~'!::";18~1i3bp~~~-~6~bE'Mo5~3 ;'~02: 018 RDS-A! . ?i.' t, .', ~ ;" I I I" '1 l' Ii,' .,' c, ., I I' i '," ," " ,.",,,W" !, ","" 1. ' 1.--<-Z..L, q ,~" " . " ,. ':OOOOtjOOO'i'I:O'i' &3~~~M~'~iH 2 ~bll' , ~IU4i lliW_.ill~~!l~tW.;}..!rn.~.l ~lll...\n~.;lffil~'"'l'!!l!!.(un~lo.'usl r,~ , 1"'.'" , ' . , ' . ~:' ,201 16 3905' " ,.' .oc He E,... '" ~(' SERIES EE ' '"TEREST CI:,tl,.1:8 :10 va,,". \ '"0'" ..SUI[ DA.TIl f- i I 12' , J . , 1'99~ --,." !::; 1.1 E t, I. r .rRa PGfL : 01-07-93. I..~.' --- D..'I....TAY" '!)055.l!0321 M5580321bEE ~! i-/o y y BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 JERRY A WEIGLE ESQ WEIGLE & ASSOCS 126 E KING ST SHIPPENSBURG PA COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 E% ~FP (O1-OS) ~ ~, , DATE 07-07-2003 ESTATE OF POWELL JR JAY H DATE OF DEATH 11-08-2002 •~-_; FILE NUMBER 21 02-1069 I! I_ _~~ - .7 ~- • L~OUNTY CUMBERLAND ACN 101 Amount Remitted 17257 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER POR_TION_ 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 POWELL JR JAY H FILE N0. 21 02-1069 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) - 42,500.00 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) .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) 3,218.6 0 tax payment. 6. Jointly Owned Property (Schedule F) (6) 14,375.20 7. Transfers (Schedule G) (7) .00 8. Total assets (81 60, 093.80 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ade. Costs/Misc. Expenses (Schedule H) (91 6,031.07 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 4.395.44 11. Total Deductions 12. Net Value of Tax Return (11) ) 0 .4 6 . S1 49 667 29 (121 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) , . .00 14. Net Value of Estate Subject to Tax 49 667 (141 , .29 NOTE: If an assessment was issued previously, lines 14, reflect figures that include th t 15 andior 16, 17, 18 and 19 will e otal of ALL returns assessed to date ASSESSMENT OF TAX: . 15. Amount of Line 14 at Spousal rate (151 35,292.09 00 _ 00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) X 14,375.20 X 045 . . 646.88 17. Amount of Line 14 at Sibling rate (171 .00 X 12 - 00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 . _ 00 19. Principal Tax Due . TAX CREDITS: (191 = 646.88 DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 01-24-2003 01-24-2003 CD002095 CD002096 8.09 153.64 01-24-2003 CD002097 8.09 8 09 153.63 01-24-2003 CD002098 . 8 07 153.63 . 153.64 ~ IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT 646.88 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ( 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.) RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 Section 9140]. PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check ar money order payable to: REGISTER OF NILLS~ AGENT REFUND CCRI: A refund of a tax credit, which was not requested on the Tax Return, nay be requested by completing an ^Application for Refund of Pennsylvania Inheritance and Estate Tax^ CREV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour answering service for farms ordering: 1-800-362-2050; services for taxpayers with special hearing and / ar speaking needs: 1-800-447-3020 CTT only). OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, ar disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (607 days of receipt of this Notice by: OR --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Ccurt. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department o avenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent^ (REV-1501) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three C3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the sane manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9l months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20% .000548 1987 9% .000247 1999 7% .000192 1983 16% .000438 1988-1991 11% .000301 2000 8% .000219 1984 11% .000301 1992 9% .000247 2001 9% .000247 1985 13% .000356 1993-1994 7% .000192 2002 6% .000164 1986 10% .000274 1995-1998 9% .000247 2003 5% .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (157 days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. ESTATE OF JAY H. POWELL, JR. File No. 21-02-1069 FAMILY SETTLEMENT AGREEMENT ,~ THIS AGREEMENT made this ~ ~ ~ day of ~ , 2003, BETWEEN: DOROTHY V. POWELL, being the legatee under the Last Will and Testament of Jay H. Powell, Jr., late of the Borough of Shippensburg, Cumberland County, Pennsylvania; and LINDA K. KLEIN, PATRICIA A. MC CLURE, JOHN C. POWELL, and RICHARD J. POWELL; AND LINDA K. KLEIN, Executrix of the Estate under the Last Will and Testament of Jay H. Powell, Jr., deceased, WHEREAS, Jay H. Powell, Jr., died November 8, 2002, testate, and under his Will left his estate to the parties herein; and WHEREAS, Letters Testamentary were granted to Linda K. Klein on November 26, 2002, by the Register of Wills of Cumberland County, Pennsylvania; and WHEREAS, all assets of the late Jay H. Powell, Jr. have been liquidated or distributed and all his debts paid in full, and further the period of four months having been terminated since the first advertisement of the issuance of Letters to the said Executrix, the said parties hereto desire to waive the duty of the Executrix to file a WEIGLE 6c ASSOCIATES, P.C. -ATTORNEYS AT LAW - 726 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 First and Final Account with Proposed Schedule of Distribution for purposes of confirmation by the Court of Common Pleas of Cumberland County, Orphan's Court Division, AND FURTHER desire that a Family Settlement Agreement be executed, which Family Settlement will be duly recorded among the deed records in and for Cumberland County. NOW, THEREFORE, WITNESSETH, that the parties hereto, in consideration of the premises above stated, and of the Accounting and Proposed Schedule of Distribution attached hereto and made a part hereof, and the receipt of their distributive shares as therein shown, do mutually bind themselves to the said Distribution and Accounting as set forth and further release Linda K. Klein, Executrix, from all claims and demands whatsoever arising out of settlement of the Estate of Jay H. Powell, Jr. The parties hereto do further agree that should any liability come due to the estate of the said decedent after the signing of this agreement, we do hereby covenant and agree with the aforesaid personal representative that we will contribute pro rata our share of the estate to satisfy any and all claims, demands, suits, or causes of action which may be successfully prosecuted against the said estate or the aforesaid personal representative after the signing, sealing and delivery of this family settlement agreement and final release. WEIGLE & ASSOCIATES, P. C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 IN WITNESS WHEREOF, the parties have hereunto set their hands and seals the day and year first above written. ,/ ~~G^L~ (SEAL) Dorot V. owell .._~ ~ `~ (SEAL) Linda K. Klein / 1 ~ ,~.~.~'~ .~1' L~ • / ~L[:. (~, t (SEAL) Patricia A. McClure (SEAL) Jo C. Powell " ~ "^,1~/ SEAL _ ~ ( ) Richard J. Powell WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 172 57-73 97 WTTNF.R4~ COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND C! On this, the ~~ day of ~ ~ 2003, before me, the undersigned officer, personally appeared DOROTHY V. POWELL, LINDA K. KLEIN, PATRICIA A. MC CLURE, JOHN C. POWELL, and RICHARD J. POWELL, known to me (or satisfactorily proven) to be the persons whose names are subscribed to the within instrument, and acknowledged that they executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. 9 (~~'-~~ ~ 7 (SEAL) Notarial ea! Rhonda R. Ytiofford, Notary Public hippensburg E~oro, Cumberland Cou M Commission Expires Jan. 20, 2005 WEIGLE 6c ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 EXECUTRIX'S ACCOUNT FIRST AND FINAL ACCOUNT OF LINDA K. KLEIN, EXECUTRIX FOR ESTATE OF JAY H. POWELL, JR., DECEASED Date of Death: Date of Executrix's Appointment: Dates of Advertisement of Letters: News Chronicle Cumberland Law Journal Accounting for the Period: November 8, 2002 November 26, 2002 December 6, 13, 20, 2002 December 6, 13, 20, 2002 November 26, 2002, to July 24, 2003 Purpose of Account: Linda K. Klein, Executrix, offers this account to acquaint interested parties with the transactions that have occurred during her administration. The account also indicates the proposed distribution of the estate. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with: Jerry A. Weigle, Esquire Weigle & Associates, P.C. 126 East King Street Shippensburg, PA 17257 717-532-7388 WEIGLE & ASSOCIATES. P.C. -ATTORNEYS AT LAW - 726 EAST KING STREET - SHIPPENSBURG, PA 77257-1397 S[JDM9ARY OF ACCC~UN'I' Estate of Jay H. Powell, Jr. For Period 11/08/01 Through 7/24/03 Principal Receipts Net Gain (or T1JSS) on Sales or Other Dispositions Other Receipts Less Disbursements: Ac~iinistration Expenses (Prin) Funeral Expenses (Prin) Other E~enses (Prin) Balance before Distributions Distributions to Beneficiaries Principal Balance on Hand Income Receipts Less Disbursements Balance before Distributions Distributions to Beneficiaries Income Balance on Hand Combined Balance on Hand Page 1-2 3 3 3-4 $1,066.39 5,574.22 4,395.44 5 Fiduciary Acquisition Value $81,936.70 0.00 0.00 $81,936.70 11,036.05 $70,900.65 70,900.65 $ 0.00 $ 0.00 0.00 $ 0.00 0.00 $ 0.00 $ 0.00 RECEIPTS OF PRINCIPAL Page 1 Estate of Jay H. Powell, Jr. As of 7/24/03 Fiduciary Assets Listed in Inventory Acquisition (Valued as of date of death) Value SaV1ngS ACCOUntS Patriot Federal Credit Union Savings Account $ 143.65 Federal Notes and Bonds U. S. Savings Bonds jointly owned with Patricia A. McClure, daughter $ 7,187.20 10 Units U. S. Savings Bonds jointly owned with John C. Powell, son 7,241.60 10 Units U. S. Savings Bonds jointly cx~med with Richard J. Powell, son 7,187.20 10 Units U. S. Savings Bonds jointly awned with Linda K. Klein, daughter 7,134.40 10 Units 28,750.40 Residences 216 Roxbury Road, Borough of Shippensburg, Cumberland County, PA - sold 04/28/03 42,500.00 Misc. Personal Property 1992 Chevrolet Blazer - proceeds of sale 11/25/02 2,500.00 Refunds Erie Insurance Group - automobile premium refund 12/12/02 $ 296.00 Sprint - refund at cancellation 01/02/03 9.95 County tax proration at real estate settlement 04/28/03 128.97 School tax proration at real estate settlement 04/28/03 63.03 RECEIPTS OF PRINCIPAL Estate of Jay H. Powell, Jr. AS of 7/24/03 Assets Listed in Inventory (Valued as of date of death) Nationwide Insurance - homeowner's premium refund received 05/08/03 Miscellaneous Property Contribution from Linda K. Klein to pay PA inheritance tax on joint asset 01/18/03 Contribution from Patricia A. McClure to pay PA inheritance tax on joint asset 01/18/03 Contribution from John C. Powell to pay PA inheritance tax on joint asset 01/18/03 Contribution from Richard J. Powell to pay PA inheritance tax on joint asset 01/18/03 Contribution from Dorothy V. Powell for payment of debts from 11/09/02 - 07/24/03 'InTAL INVEN'IC~RY $ 77.00 $ 153.64 153.64 153.63 153.63 6,853.16 Page 2 Fiduciary Acquisition Value $ 574.95 7,467.70 $ 81,936.70 DISBURSEMENTS OF PRINCIPAL Page 3 Estate of Jay H. Powell, Jr. For Period 11/08/01 Through 7/24/03 Administration Expenses (Prin) 11/15/02 Postmaster - postage for payment of bills $ 7.40 11/20/02 News Chronicle - ad to sell automobile 9.75 11/22/02 Carlisle Sentinel - ad to sell autombile 5.40 11/26/02 Register of Wills, Cumberland County - Letters Testamentary and Short Certificates 88.00 11/27/02 Cumberland Law Journal - advertising Letters Testamentary 75.00 12/03/02 Postmaster - certified letter to DPW 4.42 01/20/03 Sailhamer Real Estate - market analysis fee 125.00 01/27/03 Register of Wills, Cumberland County - PA inheritance tax at discount 614.54 01/30/03 News Chronicle - advertising Letters Testamentary 76.88 05/09/03 Register of Wills, Cumberland County - filing PA Inheritance Tax Return 10.00 07/24/03 Register of Wills, Cumberland County - filing Family Settlement Agreement 50.00 $ 1,066.39 Funeral Expenses (Prin) 11/12/02 Crider's Meats - funeral reception $ 185.12 11/18/02 News Chronicle - thank you note 4.00 11/19/02 Ray's Laminating Service - copies of obituary 10.60 11/21/02 Fogelsanger-Bricker Funeral home 5,374.50 5,574.22 Other Expenses (Prin) 11/12/02 Sprint 11/21/02 PPL Gas Utilities $ 23.28 68.19 DISBURSII~NTS OF PRINCIPAL Estate of Jay H. Powell, Jr. For Period 11/08/01 Through 7/24/03 12/03/02 Penelec 12/09/02 A T & T 12/17/02 Sprint 12/20/02 PPL Gas Utilities 01/04/03 Penelec 01/10/03 Borough of Shippensbung 01/23/03 PPL Gas Utilities 02/05/03 Penelec 02/21/03 PPL Gas Utilities 03/03/03 Penelec 03/23/03 PPL Gas Utilities 04/03/03 PeneleC 04/14/03 Borough of Shippensburg 04/14/03 Lisa L. Helm, Tax Collector 04/17/03 C. V. Wenger, Inc. - furnace repair 04/18/03 PPL Gas Utilities 04/18/03 Louis Larson - winter snow removal 04/28/03 Real Estate settlement expez~.ses (including realtor's commission - $2,550.00; realty transfer tax - $425.00; and Borough of Shippensbung final water cut-off billing - $66.75) 05/08/03 PPL Gas Utilities 05/09/03 Penelec 'I17TAL DISBURSII~fE~7TS OF PRINCIPAL $ 39.35 0.44 23.47 66.18 25.10 122.53 64.05 22.03 37.78 39.79 37.47 10.47 86.53 189.82 376.78 45.37 50.00 3,041.75 14.31 10.75 Page 4 $ 4,395.44 $ 11,036.05 DISTRIBUTIONS OF PRINCIPAL 'IO BENEFICIARIES Estate of Jay H. Powell, Jr. For Period 11/08/01 Through 7/24/03 To: Dorothy V. Powell Cash 11/25/02 Cash 04/29/03 Cash Total for Dorothy V. Pawell To: Linda K. Klein U. S. Savings Bonds jointly owned 11/25/02 U. S. Savings Bonds jointly owned 10 Units To: Patricia A. McClure U. S. Savings Bonds jointly awned 11/25/02 U. S. Savings Bonds jointly cn~med 10 Units To: John C. Powell U. S. Savings Bonds jointly owned 11/25/02 U. S. Savings Bonds jointly owned 10 Units To: RichaYrl J. Powell U. S. Savings Bonds jointly owned 11/25/02 U. S. Savings Bonds jointly owned 10 Units TOTAL DISTRIBUTIONS OF PRINCIPAL ~ BENEFICIARIES $ 2,500.00 39,650.25 Page 5 $ 42,150.25 7,134.40 7,187.20 7,241.60 7,187.20 $ 70,900.65 LINDA K. KLEIN, Executrix of the Estate of Jay H. Powell, Jr., deceased, hereby declares under oath (penalties of perjury) that she has fully and faithfully discharged the duties of her office; that the foregoing First and Final Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the estate have been paid in full; that, to her knowledge, there are no claims now outstanding against the estate; and that all taxes presently due from the estate have been paid. Linda K. Klein, Executrix Subscribed and sworn to by LINDA K. KLEIN, before me this ~ i~ day of 2003. ~~~ Notarial seai Rhonda R l":'p!~-,rr: Notary Public hippensbur~ Ei;:~; ,';~:,-r~e~and Cou M Commissicn__.'--~cs'Jan. 20, 2005 WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 ~ t~ w cn ~ a ~ ~ z ~ ~ H O ~ ~ r o ~ ~ ~ O ~ `i' x 0 ~ t e Y O R y w ~ ~ C~ y O H ~ ~ ` ~ N W H+ ~ v ~ ~ J ' 'b ~ ~ . n t~ z a H /~ REGISTER OF WILLS, CIIAiBERLAND COUNTY STATUS REPORT UNDER RULE 6.12 Name of Decedent: Jay H. Powell, Jr. Date of Death: November 8, 2002 Will No. 21-02-1069 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 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 No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes x No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be-filed with th Cerk of the Orphans' Court and my-~p-fie attached to this r por _. / Date : ~/- Z S ~ ~-~ ,~ . ~~~~ 03 5~tgnatur$ Jerry A. Wei\gle, Esquire Name (Please type or print) WEIGLE & ASSOCIATES, P.C. 126 East King Street Address Shippensburg, PA 17257 ~ 717) 532-7388 Tel. No. • Capacity: Personal Representative R Counsel for personal representative (MAH:rmf/AM3)