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Home My WebLink About01-0510 theron. - ~ U U = U ~- .- en .n_ U'" cc:U c -g.g as';: -;~ "ire... ~o Ci = ClO en PETITION FOR PROBATE and GRANT OF LETTERS Estate of S' iij..:'~ L. Nt:1:~~ No. a\- ~\ - S\l:l also known as __1:" _ I Ai ~ ___::i-II To: . . I Register of Wills for the Deceased. County of C lJ WI ~ in the Social Security No. ;; 0 9 - a g r" .e; 231 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut Ar1c.s in the last will of the above decedent, dated ~ ~ L lif and codicil(s) dated Y1 JY\.JL.-- I named , -. 2.0U ( (state relevant circnmstances, e.g. renunciation, death of executor. etc.) h4 Decendent at death owned property with estimated values as follows: ~.2-. (If domiciled in Pa.) All personal property $ ~ dOV (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in pennSYIVania~ ~' $ situated as follows: _ _ 0"7 L./~ ~ I ~ A:>O (J d 0 /I1,dr .... ?(_( ~ I?o~r' "' WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters tion c.t.a.; administration d.b.n.c.l.a.) 1::. f ~ ;~c.. k- ~ ;~ / :r;,-- ~)U'" \~ '1 ~ ;: /L'uA OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ") sa COUNTY OF Cu~t?aeoLAv./~ - J 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. v, ~. :::t ~ - t: ~ ~ ~ N 21 - 01 -', ~10. o. Estate of S h;r h.4 . L ~e s 4?/ rl( , Deceased' a/k/a. S~RLEY NE'WMITH . DECREE OF PROBATE AND GRAN;T'OF L'ETTERS . .0:. . " . . AND NOW MA Y 30 ~ >Hl 2001',.ih' 'consideration of the petition 'on (be reverse side hereof, ~atisfactory proof having been pr~~ented before me, ' . IT IS DECREED ,that the instrument(s) dated A P R I L, 14' ~ J.2 0 01. described therein be admitted to probate and' filed of record'as the last will of SHIRLEY L NESMITH a/k/a SHIRLEY NESMITH 1t.~IAMENIARY and Letters are hereby granted to ROD NESMITH and KIM MEeK Lof~(!dt).,,~ J{l(~. ~, U Register of Wills . U (/ MARY CLEWIS RICHARD C RUPP ATIORNEY (Sup. Ct. I.D. No.) FEES Probate, Letters, Etc. ......... $ 305.00 Short Certificates( ).......... $ 30.00 Renunciation ................ $ X-Pages $ 15.00 JCP ~.uu TOTAL _ $ 1!:i!:i no Filed .... ~~.X .09.,. .~ QQ) . . . . . . . . . . . . . . . . . 3'55 NORTH 21 ST STREET SU ITE 205 ADDRESS CAMP HILL PA 17011 PHONE r MAILED LETTERS TO ATTORNEY ON 5-30-01 "":' '="'\ ~ r, ''='r. This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local R,egistrar. The original certificate will be forwarded to the State Vital Records Office for permanent liling. WARNING: It is illegal to duplicate this copy by photostat or photograph. No, -I~ r;"L Local Registrar ~ Fee for this certificate, $2,00 p 7386633 J/f7 d ~ ~o I / Date HI 05. l4J Rev 2//17 COMMONWEALTH Of PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH TV PElPRINl IN PERMAIlENT BLACK INK AGE (La -"'Yl UNDER 1 YEAR - o.ya SEX STAlE FilE IOUMllEA SOCIAL SECURITY NUMBfR NAME Of DECEDENT IF.... _. Las, a. Female I. 209- 28 - May 21, 2001 /IlRTHPlXE (CoIy and 3leIe 01 fa_ C""""YI Perry County, PA :=".,,0 Dauphin DECEDeNT'S USUAL C/CCUAlIJ1ON (~"'=:~'::'::::t=r 1\ Sales Manager 1 DECEDENT'S IoWLING ADDRESS(Slr...~. SlaIe. ZtpCOdeI Ie. White ~ DECEDENT EVER IN US ARMED FDACES? VM D Ho [J( o w (/) ::) ~ <C 1'111.Coun Cumberland Did - live .. a -......? 14. 11C.C3<...__.. MAfIlTAL STAruS . ......... N_""",,laCI,_, ~~ Widowed SURVIVING SPOUSE .1_.___, I" FRHER'SNAME(Fir.. _.lHll q07. Wayne Drive Mechanicsburg, Pa. 17055 I'pp",r Allpn "'" C1Iy- 1.. _ORMANT'S NAME (TypalPrinll Frank R. Brownawell DATE PRONOUNCED DEAO(MonIh. Day. Year, 24. al. ~ l21/ 0/ 27. MIlT.; E.....1he __. injuriaa Of c:ompIicaIl,n...llich c:ausaolha daatll Do not ani.. IhlI_ .1 <lying. ._ a. cardiac or resporalOty .".... shock Of hlIllI........ llOl only OM _ OIl_line ../hGTYt-ST'KT7 L $' 1Y1ff~ Ct!lL. c::/tfl~~ DUE 10(011 AS A CONSEOUENCE Of): p.. rdi!'" ?- V IV r; 21. l=="n :--- I I HoCk PART.: 0lIlaI1ignilIcanI_ CIIlIIIIlIluIin III _...... ......-;no in... ~..... giwen in I'IUff I. E WERE AUlOPSY FINlllNGS -.u.a.E PRIOR 10 CC/IIIf'LETION 0# CAUSE 0# DEATH? DUE 10 (OR AS A CONSEOUENCE Of): DUE 10(011 AS A CONSEOUE NCE Of)' IolANHER 0# DEATH DATE Of INJURY (LIon.. Day. 'MatI TILlE Of INJURY INJURY AT WORK? DESCAHIE HOW INJURY OCCUflflEO No Ox _01 Ox Ac<:odent D SuOClde D Homocode Pendtng Invesllga"'''' o o o PLACE Of INJURY. AI home. ""m. .r.... lactOty. oIIIce M. ~_ISpec..1 _. _ 0 NoD /~/Adj I~ II~t j,21 o Could noI be det.rmlRed 29. ~ o w ~ o II. o ... ~ <C Z o 38. c:wp60lwillslShirley Nesmith LAST WILL AND TESTAMENT OF SHIRLEY NESMITH I, SHIRLEY NESMITH of Mechanicsburg, Cumberland County, Pennsylvania, 17055, being of sound and disposing mind and memory, do hereby make, publish and declare this for and as my Last Will and Testament hereby revoking any and all Wills or Codicils by me at any time heretofore made. ITEM I - I direct my Executors, hereinafter named, to pay all my just and lawful debts and funeral expenses out of my personal estate as soon after my decease as is convenient. ITEM II - I specifically give and bequeath my diamond and wedding band to my granddaughter , HOLLY MECK. ITEM III - I specifically give and bequeath my Family Ring and Birth stone to my granddaughter, KATIE MECK. ITEM IV - I specifically give and bequeath one of my late husband David's wedding bands and class ring to my grandson, BEN MECK. ITEM V - I specifically give and bequeath my late husband David's other wedding band and onyx ring to my grandson, MATTHEW NESMITH. ITEM VI - I specifically give and bequeath all of the rest of my jewelry not otherwise specifically given away hereinabove and my jewelry box to my granddaughters, KATIE MECK and HOLLY MECK. ITEM VII - I give, devise and bequeath all the rest, residue and remainder of my estate, real and personal, and mixed, wherever situate, as follows: Twenty-five percent (25%) to my daughter, KIM MECK, per stirpes; Twenty-five percent (25%) to my son, ROD NESMITH, per stirpes; 2 Fifty percent (50%) to my TRUSTEES, IN TRUST, NEVERTHELESS, for my grandchildren, in accordance with my TRUST PROVISIONS hereinbelow. ITEM VIII - TRUST FOR GRANDCHILDREN: I give, devise and bequeath the above referenced fifty percent share of my rest, residue and remainder of my Estate, real, personal and mixed in ITEM VII, to my Trustees, IN TRUST, for my grandchildren as follows: I direct my Trustee, for the Trust of my grandchildren, to hold, invest, and reinvest the rest, residue and remainder of my estate which is distributed into this Trust, and after paying all the expenses necessary or incidental to the management of the Trust, to pay over or to apply such part or parts of the income and/or principal as in my Trustees' sole discretion, may be necessary or advisable for the maintenance, support, education, health and welfare, of my grandchildren, as follows: (a) Until my oldest grandchild reaches the age of eighteen (18) years, the Trustees shall pay to or apply for the benefit of all of my children, in monthly or other convenient 3 installments, so much of the net income, up to the whole thereof, as the Trustees in their discretion deem advisable for their proper maintenance, support, health, education and welfare. At the end of each year, the Trustees shall accumulate and add the remaining net income to the principal. In the event that the income shall be insufficient to provide my grandchildren with adequate maintenance, support, health, education and welfare, the Trustees may invade the principal of this Trust for these purposes. (b) At the time my oldest grandchild attains the age of eighteen (18) years, said trust shall be divided into equal separate trusts for each respective child then living, each trust to be held and administered as a separate trust for each of my grandchildren, then living. (c) At the time each of my grandchildren attains the age of twenty- five (25) years, all of the remaining balance of principal and interest of said child I s respective Trust shall be then paid to him or her and said child I s respective Trust shall terminate. 4 (e) After each of my grandchildren attains the age of twenty-two (22) years, each child shall receive the net income from his or her respective Trust, at least quarter annually. The Trustee shall continue to have sole discretion with respect to the application of principal for each grandchild's maintenance, support, education, health and welfare. (f) If one of my grandchildren should predecease me or die during the term of his or her TRUST, then I give, devise and bequeath said deceased grandchild's share of the rest, residue and remainder of my Estate or the remaining balance of principal and interest in his or her respective TRUST to my Trustee, IN TRUST, for the benefit of my remaining grandchildren then living, to be held and administered in accordance with the provisions of This Will and Trust. 5 ITEM IX - I nominate and appoint my children, ROD NESMITH AND KIM MEeK, or the survivor of them, be to be the Executors of this, my Last Will and Testament AND Trustees of any Trust or Trusts established herein. IN WITNESS WHEREOF, I have hereunto set my hand and seal this /,1 day of ~ , 2001. ~~' i'J/l c~ _ '" _~d/n~____(SEAL) S IRLEY SMITH Witnesses: /~ .~~C ~--.) residingat III'J' c: /Y'r~~;4odYl(~.;tJ4" , , ' / ~\S- ~ ,o/~ residing at t;'Or/;~~'itJ4/ldik~t#l.)~fl 6 21 - 01 - 510 REGISTER OF WILLS OF l(/ vw ~........a.. COUNTY OATH OF SUBSCRIBING WITNESS ~1t.E.~ :T ~~Sw-\lTH eoliiiil >(i!fadJ.) a subscribing witness to the will presented herewith, )(~m being duly qualified according to law, depose(s) and say(s) that S ""'--~ L....\A's present and saw Sh \R\.~ Ne.Q\'~.'HTIo1 the testate:>>&. , sign the same and that f)L.. signed as a witness at the request of testat~ in h eJl presence and (in the presence of each other) (in the presence of the :~:::::S:i::::::n::::~scribed before / / ~~ /~~ me this 29TH day of ame) /j/g> E. ,L/.s6tchU Aad h1~. /l4 / /()~- (Address) (Name) (Address) REGISTER OF WILLS OF COUNTY OATH OF NON-SUBSCRIBING WITNESS " " ~'" "'" .-//', (each) a subscriber hereto, (each) "Qeing duly qualified according tq..Aa'w:'depose(s) and say(s) that --- familiar with the signatur~/of'/ . // codicil testat_ of (one of the sUbscribing",\\,itn~~ses-t'o) the will presented herewith and /'.... codicil that ,"uelieves.tpe signature on the will is in the handwriting of " /'/ ,/ ", ''"' "'"" ,.,,~ " to the best of .)dl~wledge and belief. _",r' Sworn to or affirme me this (Name) / ./ (Address) Register (Name) (Address) 21 - 01 - 510 REGISTER OF WILLS OF CUMBERI ANn COUNTY OATH OF SUBSCRIBING WITNESS Th\lLd fl\~ codicil X~~<<) a subscribing witness to the will presented herewith, i>>~bO being duly qualified according to law, depose(s) and say(s) that he... WAS present and saw SHIRLEY NESMITH a/k/a SHIRLEY L NESMITH the testatc:al'l.. , sign the same and that he! signed as a witness at the request of testat~ in h .It presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this 29TH day of ~ 2 1 ~~~ (Nam ) ., j(j .a:l )7(VCi ~41aAr"'() ot.{.()Lt./. ~~(f,/lC($-;I"1'T VI /. (Address) (Name) (Address) REGISTER OF WILLS OF COUNTY OATH OF NON-SUBSCRIBING WITNESS "''''' ,/,/,-~/"// - (each) a subscriber hereto, (each) being duly qualified according to 'law, depose(s) and say(s) that familiar ,with the signature of codicil testat_ of (one of the subscribing wlt~sses to) the will presented herewith and " codicil that believes the'sjgnature on the will is in the handwriting of to the best of knowledge and belief. " "', Sworn to or affirmed and subscribed before me this day of 19_ ~ (~ " '. -,,/ (Address) Register (Name) (Address) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT RUPP RICHARD C POBOX 395 355 NORTH 21 ST ST SUITE 205 CAMP Hill, PA 17011 n_nn_ fold ESTATE INFORMATION: SSN: 209-28-9239 FILE NUMBER: 21 - 2001 - 051 0 DECEDENT NAME: NESMITH SHIRLEY DA TE OF PAYMENT: 08/21/2001 POSTMARK DATE: 08/20/2001 COUNTY: CUMBERLAND DATE OF DEATH: OS/21/2001 NO. CD 000176 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $15,000.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: ROD NESMITH C/O RICHARD RUPP ESQUIRE CHECK# 096 SEAL INITIALS: VZ RECEIVED BY: $15,000.00 MARY C. lEWIS REGISTER OF WillS REGISTER OF WILLS "\ E- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Shirley L. Nesmith Date of Death: May 21 , 2001 will No. Admin. No. 21-01-0510 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on August 20, 2001: Name Address Rod Nesmith, 1118 E. Lisburn Road, Mechanicsburq, PA 17055 Rod Nesmith, Trustee, 1118 E. Lisburn Road, Mechanicsburq, PA 17055 Rod Nesmtih, natural quardian for Matthew Nesmith, 1118 E. Lisburn Road, Mechanicsburq, PA 17055 Kim Meek, 440 Cabin Hollow Road, Dillsburq, PA 17019 Kim Meek, Trustee, 440 Cabin Hollow Road, Dillsburq, PA 17019 Kim Meek, natural quardian for Ben Meek, 440 Cabin Hollow Road, Dillsburq, PA 17019 Kim Meek, natural quardian for Holly Meek, 440 Cabin Hollow Road, Dillsburq, PA 17019 Kim Meek, natural quardian for Katie Meek, 440 Cabin Hollow Road, Dillsburq, PA 17019 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None Ri hard C. Rupp, Esquire 355 N. 21st St., Suite 205 Camp Hill, PA 17011 Telephone (717) 761-3459 Date: August 20, 2001 Name Address Capacity: x Personal Representative Counsel for Personal Representative ~ .C..3li:'.."'." ...... '-"", II""" ' Li""1 l.,.,,.. . ,.j- C:) l,r'J t--:) i''1.." I:JC t.-..l .,...,' _:~ ~ 8 . I:I."'J.. "_.1. 0 it:.~; <tj;' fG ,,f~-~'i~... 6 . :' t . l.J."" ff J~. tj..~ f.a 'II:' 1!\.1.;. ...1.....J ~~.~ ~ .$\o-*mn c.:~ ~ . .in .~:~; ~~::~ +: <i ~~. Ch r~'J .,... .~.. ~:;""'" f"'.~. !()": a:l ril U 10004 ~ o ~ ~ ~ ~z ~ ~ ~ ~ ~ ~ g ~ ll. 10 t- = al ~ o C') ~ 0 ~ ~ ..... ~ a:l "' Z ~ 0 ~ ..-l a.i ~ =3 ~ ~ =: "'. ~ c.. ....= ):J "'. ll. < .... < U ~ ~ (~ ili \ ---- ~ 00 ...... ~ C+-t Q) o ;g ~ 0 ..........t::: CIlt:: .~ ;::S ~ 0 ~ ~uC'j OO&M ~~r./J,...., ;::S ~ Q) 0 OOCllt- uu;::s,...., ""eJ""eJ.8< ~at::~ C'j...... ;::S '" "i:: ~ 0 ~ Q)....,u 00 ..0 ..0 . _ S S Q) "i:: .-t ~ = C'j uuou ~ ". ;; ; ::t "~: ...... ~ ... : ....... ....... - ... ! - - ! -= 1.'1 C) N tt' r' i'] K ~ ort " ,... ~ "'; . . J-d-:2Q_~ b ~ O:.;J COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE * BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION w DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLOMANCE OR DISALLOMANCE OF DEDUCTION5, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1548 EX AFP (01-02) 'U,2 '"i. L) 7 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 07-22-2002 NESMITH 05-21-2001 21 01-0510 CUMBERLAND 209-28-9239 01137848 SHIRLEY L KIMBERLY A MECK 410 CABIN HOLLOW RD DI LLSBURG PA""170 19 Ct Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1548 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-22-2002 ESTATE OF NESMITH SHIRLEY L DATE OF DEATH 05-21-2001 COUNTY CUMBERLAND FILE NO. 21 01-0510 TAX RETURN WAS: S.S/D.C. NO. 209-28-9239 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01137848 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 82662-05 TYPE OF ACCOUNT: DATE ESTABLISHED {X> SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE 07-14-1997 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due x 81,108.75 0.166 13,518.40 .00 13,518.40 .45 608.33 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." x TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) INTEREST IS CHARGED THROUGH 07-30-2002 TOTAL TAX CREDIT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 608.33 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 15.86 TOTAL DUE 624.19 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. * ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) ~/'{,"- ~ -~-3 - ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION . DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLONANCE OR DISALLONANCE OF DEDUCTION5, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1548 EX AFP (01-02) 'U~ L.LJ ~ iJ .. ~ 1"..' .'U DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 07-22-2002 NESMITH 05-21-2001 21 01-0510 CUMBERLAND 209-28-9239 01137847 SHIRLEY L RODNEY L NESMITH 1118 E LISBURN RD MECHANICSBURG PA 17055 Cl Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-Y=is4-i-EX--AFP--coi-:02J------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-22-2002 ESTATE OF NESMITH SHIRLEY L DATE OF DEATH 05-21-2001 COUNTY CUMBERLAND FILE NO. 21 01-0510 TAX RETURN WAS: S.S/D.C. NO. 209-28-9239 ex) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01137847 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 82662-11 TYPE OF ACCOUNT: DATE ESTABLISHED ( ) SAVINGS (X> CHECKING ( ) TRUST ( ) TIME CERTIFICATE 07-14-1997 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due x 2,415.89 0.166 402.66 .00 402.66 .45 18.12 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." x TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) INTEREST IS CHARGED THROUGH 07-30-2002 TOTAL TAX CREDIT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 18.12 REVERSE SIDE OF THIS FORM INTEREST AND PEN. .47 TOTAL DUE 18.59 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. * ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. } \'/0- ~~ - ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION . DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLONANCE OR DISALLONANCE OF DEDUCTION5, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1548 EX AFP (01-02) 'U2 :i(J DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 07-22-2002 NESMITH 05-21-2001 21 01-0510 CUMBERLAND 209-28-9239 01137849 SHIRLEY L RODNEY L NESMITH 1118 E LISBURN RD \,J MECHANICSBURG PA(\7:055 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1548 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-22-2002 ESTATE OF NESMITH SHIRLEY L DATE OF DEATH 05-21-2001 COUNTY CUMBERLAND FILE NO. 21 01-0510 TAX RETURN WAS: S.S/D.C. NO. 209-28-9239 ex) ACCEPTED AS FILED e) CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01137849 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 82662-05 TYPE OF ACCOUNT: DATE ESTABLISHED e)() SAVINGS e ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE 07-14-1997 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due x 81,108.75 0.166 13,518.40 .00 13,518.40 .45 608.33 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." X TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) INTEREST IS CHARGED THROUGH 07-30-2002 TOTAL TAX CREDIT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 608.33 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 15.86 TOTAL DUE 624.19 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. * ( IF TOTAL DUE IS LESS THAN *1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) \'/6.-~33-~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION , DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE * NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLONANCE OR DISALLONANCE OF DEDUCTION5, AND ASSESS"ENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1548 EX AFP (01-02> .O? 23 b DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 07-22-2002 NESMITH 05-21-2001 21 01-0510 CUMBERLAND 209-28-9239 01137846 SHIRLEY L KIMBERLY A MECK 410 CABIN HOLLOW RD DI LLSBURG PA 1 V.O 19 (':\ Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1548 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-22-2002 ESTATE OF NESMITH SHIRLEY L DATE OF DEATH 05-21-2001 COUNTY CUMBERLAND FILE NO. 21 01-0510 TAX RETURN WAS: S.S/D.C. NO. 209-28-9239 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01137846 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 82662-11 TYPE OF ACCOUNT: DATE ESTABLISHED ( ) SAVINGS ()() CHECKING ( ) TRUST ( ) TIME CERTIFICATE 07-14-1997 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due x 2,415.89 0.166 402.66 .00 402.66 .45 18.12 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." x TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) INTEREST IS CHARGED THROUGH 07-30-2002 TOTAL TAX CREDIT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 18.12 REVERSE SIDE OF THIS FORM INTEREST AND PEN. .47 TOTAL DUE 18.59 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. * ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) ~ /6- c:J3-$ -~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLOHANCE OR DISALLOHANCE OF DEDUCTION5, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1548 EX AFP (01-02) .0.2 Z3 DATE ESTATE OF DATE OF DEATH FILE NUMBER ;3 COUNTY SSN/DC ACN 07-22-2002 NESMITH 05-21-2001 21 01-0510 CUMBERLAND 209-28-9239 01137851 SHIRLEY L RODNEY L NESMITH 1118 E LISBURN RD MECHANICSBURG PA 11-055 (~:' t ; Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1548 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-22-2002 ESTATE OF NESMITH SHIRLEY L DATE OF DEATH 05-21-2001 COUNTY CUMBERLAND FILE NO. 21 01-0510 TAX RETURN WAS: S.S/D.C. NO. 209-28-9239 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01137851 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 82662-40 TYPE OF ACCOUNT: DATE ESTABLISHED ( ) SAVINGS ( ) CHECKING ( ) TRUST ()() TIME CERTIFICATE 07-14-1997 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due x 14,068.22 0.166 2,344.75 .00 2,344.75 .45 105.51 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." x TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) INTEREST IS CHARGED THROUGH 07-30-2002 TOTAL TAX CREDIT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 105.51 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 2.75 TOTAL DUE 108.26 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. * ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J \, /b -r.233 - ~/ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION v DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLONANCE OR DISALLONANCE OF DEDUCTION5, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1S48 EX AFP (01-02) 'DZ .- " .") i...) ":\ 8 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 07-22-2002 NESMITH 05-21-2001 21 01-0510 CUMBERLAND 209-28-9239 01137850 SHIRLEY L KIMBERLY A MECK 410 CABIN HOLLOW RD DILLSBURG PA tt019 C~ \. Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1548 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-22-2002 ESTATE OF NESMITH SHIRLEY L DATE OF DEATH 05-21-2001 COUNTY CUMBERLAND FILE NO. 21 01-0510 TAX RETURN WAS: S.S/D.C. NO. 209-28-9239 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01137850 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 82662-40 TYPE OF ACCOUNT: DATE ESTABLISHED ( ) SAVINGS ( ) CHECKING ( ) TRUST ()() TIME CERTIFICATE 07-14-1997 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due x 14,068.22 0.166 2,344.75 .00 2,344.75 .45 105.51 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." X TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) INTEREST IS CHARGED THROUGH 07-30-2002 TOTAL TAX CREDIT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 105.51 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 2.75 TOTAL DUE 108.26 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. * ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) STATUS REPORT UNDER RULE 6.12 v C; O~ A:\6.12F .. Name of Decedent: SHIRLEY NESMITH Date of Death: May 21, 2001 Will No.: 2001-00510 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 No X 2. If the answer is No, state when the personal representative reasonably believes the administration will be complete: May 14, 2003 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 is: c. Did the personal representative state an account informally to the parties in interest? Yes No X d. Copies of receipts, releases, joinders and approvals of form or informal accounts may be filed with the Clerk of the Orphans' Court and ma IS repo . Previously filed on Date: 4/15/03 Name (Please type or print) 355 N 21 st St., Ste. 205, Camp Hill, P A 17011 Address 717-761-3459 Telephone Number Capacity: Personal Representative x Counsel for personal representative - Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/09/2003 NESMITH ROD 1118 EAST LISBURN ROAD MECHANICSBURG, PA 17055 RE: Estate of NESMITH SHIRLEY File Number: 2001-00510 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 5/21/2003 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, DONNA M. OTTO DEPUTY REGISTER OF WILLS cc: /File Counsel Judge \ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/15/2005 MECK KIM 410 CABIN HOLLOW RD DILLSBURG, PA 17019 RE: Estate of NESMITH SHIRLEY File Number: 2001-00510 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 5/21/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~~&U~ -./ GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Counsel Judge ~ 8 -rJl 2 e- o ~ ...... !..l-'. o -to.:e CI) ~G ~ ~C6cf)~ ~:E.~~ cf)~';J""", ~'7,g4. ~b~~ \;M~8'tii tIi~ ~ ~ "6'0 ~ (<i CI) ~.ou 6..... ~ ~ '0 o ~ ~ cC '\;a 0 ~~~o ~~~~~ cC~-~~ o'$ffi".Jo ~'Ocg~u.. """~~ffi~ " ~~~;~ ~~(.)~~ u.. ::lO~ 'S""" 'O::l ~'4 000 U - - -= 1 ~ ... --::: -:::; ":i .-! --: ~ ... - ~ -; ~ ~ .... ~ -.;:: -;. - - -:. .- "',\ {on ~"l \'h. \ ~t ..., ~ \~ ..tfJ r.. ..... INVENTORY ~;, ,. r- lev ~.~ A"e JJm ,""-11 ,.. ... . . ..... · ....., .. c& tl.r- ()'i"" ~(V\q...~__",J c.,~'" "".~ (Nu ber and street) ~ ~, ct (City).. .. v """" tI" &. tilt . · ,.1::11 6111~' County, Pennsylvania, 179"$'0 (Zip Code) ->~.. " ...... FORM 16 REG. WILLS of all real and personal estate of GO"=t t{)#~ A/(<,n deceased, late of who died (Borough or Township) O~(1l.1 / O( (date of death) ot ~ PERSONAL ESTATE SCHEDULE 1989 Ford 150 Truck 1981 Honda 405 Motorcycle Pennsy Supply 401 (k) Retirement Pennsy Supply Profit Sharing Plan 1970 Honda 175 Motorcycle 8 ;,?""'o 0:;::0 ~t, ""0 ::1:1 ~p... ... I..,..zm 5'::0 ......C/)~ C:J (") 0 00." Oc: ; .33 ~ -0 :x N .. O!\ ~ <= ~ . :it: o -< f\) - :::::r.)~.. rn Ct-j C'S' m :n 0 c:)~. ....- . j J - --..~ $:;. f'-- f.- 0?~ Copyright 2000 David James Thorpe, Esq. ~ . AFFIDAVIT OF EXECUTOR OR ADMINISTRATOR Commonwealth 0/ PenMy/uania County of Cumberland } 55: Personally before me,the undersigned authority, a and State, appeared to law, deposes and says that he is the executor or administrator of the estate of , deceased, that the foregoing schedules constitute a complete inventory in and for said County who, being duly sworn according and appraisement of the real and personal estate of deceased, except real estate outside the Commonwealth of Pennsylvania, that the figures opposite each item of real and personal estate in the foregoing schedules are determined ~ by the un~n ~~ be fair value of said Kerns as of the date of the decedent's death. 'C ~ Sworn and subscribed before me ~ ~ this day of } EXECUTOR-ADMINISTRATOR ADDITIONAL INSTRUCTIONS 1. The inventory shall be filed no later than the date the account is filed or the due date, including any extension, for the filing of the Inheritance Tax Return (9 months from the date of death) whichever comes first. 2. A Supplemental inventory must be filed within thirty days of discovery of additional assets. 3. An original and two copies must be filed. 4. Additional sheets may be attached as to personalty or realty. 5. See Section 3301 et seq. Of the Probate Estates and Fiduciaries Code of 1972, as amended. 6. The inventory must be typed. )> ~ "'TI "'TI c.., < Co (I) ffi' ~ Co 0 (I) a: Cil .., ~ ::J lI> (I) Z lI> - '< " Z ? r < tQ m m . en ""'- ~ Z , r -i -I m -0 0 0 Q) " <0 L :::0 (I) CJ '" -< CD ~ ~ ~ Q) C/l CD 0. - ~ , Copyright 2000 David James Thorpe, Esq. Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name ofDecedent: Sh/r Ie '1 Nes/IJ/..j), Date ofDeath: ~1 t::t Y .;( I / ~ 0 0 / Estate No.: :<.. 0 0 / - CJ 0 s;- / 0 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes~ No 0 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 persOljkl~resentative file a fmal account with the Court? Yes 0 No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest?Ye~ No 0 c. Copies of receipts, releases, joinders and a accounts may be filed with the Cler e attached to this report. R~te: 'f/:J7/tJ.J Si e 'R,'d,a."e( C R",p fJ~ Name .3 .s-.s- /1/ ~ I .s:f ~ -/.} S"'" -4 0U;.i&- CC4rnp It ,'II/piA 170 /J Address '} / J - 7 t. / - 3 ~ ,5-9 Telephone No. Capacity: 0 Personal Representative 1&1. Counsel for personal representative c?f ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 :::::::::.::::::::::::~~:~::~:::~N~~::::::::::::::::::::::1 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ~L (,..&"0 NUMBER COUNTY CODE I- Z W Cl W U W Cl SOCIAL SECURITY NUMBER ~Q~~II(.9~a~ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ,"~MJm~" DATE OF DEATH DATE OF BIRTH 5/21/01 12/13/1938 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) REGISTER OF WILLS SOCIAL SECURITY NUMBER Gl ~~cn u"'~ Glo.u .ce.2 () lial <( "E Q) ~ c:: 8- en ~ 8 )( 1. Original Return 2. Supplemental Return 3. Remainder Return (date of deeth prior to 12- 13-82) 6. Decedent Died Testate (Attach copy of Will) 5. Federal Estate Tax Return Required 4a. Future Interest Comprise (date 01 death after 12.12-82) 4. Limited Estate 7. Decedent Maintained a Living Trust (AlIach a copy of Trust) 8. Total Number of Safe Deposit Boxes 10. Spousal Poverty Credit (date 01 death between 12-31.91 and 1.1.95) 0 ~I~~n to tax under Sec. 9113(A) THIS SECnON MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENnAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS ~c,hard, q.R,~Pk![;~!li~ 355 N. 2111 St., Ste. 205 FIRM NAME (If Applicable) Camp Hill, PA 17011 Rupp and Mei/de TELEPHONE NUMBER 717-761-~~~ 9. Litigation Proceeds Received z o ~ ::> l- n. <( () w a:: 1. Real Estate (Schedule A) (1 ) (2) (3) (4) (5) (6) $100,500.00 OFFICIAL USE ONLY ~ c:::::> c:::::> 0'" Z o ...::: N oJ ,-=-r, r;:.? '--) -..J.:J \-J ,c;"" o o '''T1 -on C'S ~-T' $85,679.81 o C;o "':5 ;g '::cO ~~~~ ,,) (") 0 ,~--:,O-n .-,.J~ ~ ..1> -0 :x N . . 2. Stocks and Bonds (Schedule B) $0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship $0.00 4. Mortgages & Notes Receivable (Schedule D) $11,220.42 $34,126.58 5. Cash, Bank Deposits & Misc. Personal Property (Schedule E) 6, Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Misc. Non-Probate Property (Schedule G or L) $134,869.20 (7) 8. Total Gross Assets (total Lines 1-7) (8) (9) $14,161.00 (10) $5,522.82 $366,396.01 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) (11) !!i19 6R3 R2 12. Net Value of Estate (Line 8 minus Line 11) (12) $346,712.19 13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) (13) !!iOOO 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) $346,712.19 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (aX1.2) $0.00 (15) (16) (17) (18) (19) x z o i= ~~ 1-:1 11. :::i: o () $15,602.05 $346;:n2'1e .045 16. Amount of line 14 taxable at lineal rate x $0.00 .12 17. Amount of line 14 taxable at sibling rate x 18. Amount of line 14 taxable at collateral rate x .15 !!iOOO 19. Tax Due 20. G2f $15,602.05 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~n~s# ~~J*<~~~~~;{ ~}~il:~~:t:~ "__~~~~~1~~( _-L~~ 'J~~: =l{~ i~: .' :~~)l ~ ' 1:' I ~~, 0 ~ ~"=~_!~~1~~,,"i; ~~~~ ~~~~ :;(~~ ~ Copyright 2000 David James Thorpe, Esq. Decedent's Complete Address: STREIiT ADDRESS 607 Wayne Drive Mecha~icsburg I STATE IPA \ZIP 17055 Total Interest/Penalty (D + E) (3) If line 2 is greater than line 1 + line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT CITY Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount $15,000.00 $750.00 Total Credits (A + 8 + C) 3. Interest/Penalty if applicable D. Interest E. Penalty 4. 5. (1 ) $15,602.05 (2) $15,750.00 $0.00 $147.95 1. PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN X IN THE APPROPRIATE BLOCKS 2. 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 revisionary interest; or d. receive the promise for life of either payments, benefits or care? If death occurred on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequate consideration? If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? Did decedent own an individual retirement account, annuity, or other non-probate property? 3. 4. Yes ~ No ~ 6a ~ VE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. SIGNA T ADDRESS 355 N. 210t Street, Suite 205 Camp Hill, Pa 17011 DATE J J I zDt!)(p DATE II For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P .5. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does no exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P .5. ~9116(a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P .S. ~9116(1.2) [72 P.S. ~9116(a) (1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P .S. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Copyright 2000 David James Thorpe, Esq. , c:wp60\wil/s \Shirley Nesmith LAST WILL AND TESTAMENT OF SHIRLEY NESMITH I, SHIRLEY NESMITH of Mechanicsburg, Cumberland County, PenilSylvania, 17055, being of sound and disposing mind and memory, do hereby make, publish and declare this for and as my Last Will and Testament hereby revoking any and all Wills or Codicils by me at any time heretofore made. ITEM I - I direct my Executors, hereinafter named, to pay all my just and lawful debts and funeral expenses out of my personal estate as soon after my decease as is convenient. ITEM n - I specifically give and bequeath my diamond and wedding band to my granddaughter, HOLLY MECK. ITEM ill - I specifically give and bequeath my Family Ring and Birth stone to my granddaughter, KATIE MEeK. ITEM IV - I specifically give and bequeath one of my late husband David's wedding bands and class ring to my grandson, BEN MECK. . ITEM V - I specifically give and bequeath my late husband David's other wedding band and onyx ring to my grandson, MATTHEW NESMITH. ITEM VI - I specifically give and ~queath all of the rest of my jewelry not otherwise sPecifically given away hereinabove and my jewelry bo~ to my granddaughters, KATIE MECK and HOLLY MEeK. ITEM vn - I give, devise and bequeath all the rest, residue and remainder of my estate, real and personal, and mixed, wherever situate, as follows: Twenty-five percent (25 %) to my daughter, KIM MECK, per stirpes; Twenty-five percent (25 %) to my son, ROD NESMITH, per ~tirpes; 2 Fifty percent (50%) to my TRUSTEES, IN TRUST, NEVERTHELESS, for my grandchildren, in accordance with my TRUST PROVISIONS hereinbelow. ITEM vm - TRUST FOR GRANDCHILDREN: I give, devise and bequeath the above referenced fifty percent share of my rest, residue and remainder of my Estate, real, personal and mixed in ITEM VII, to my Trustees, IN TRUST, for my grandchildren as follows: I direct my Trustee, for the Trust of my grandchildren, to hold, invest, and reinvest the rest, residue and remainder of my estate which is distributed into this Trust, and after paying all the expenses necessary or incidental to the management of the Trust, to pay over or to apply such part or parts of the income and/or principal as in my Trustees' sole discretion, may be necessary or advisable for the maintenance, support, education, health and welfare, of my grandchildren, as follows: (a) Until my oldest grandchild reaches the age of eighteen (18) years, the Trustees shall pay to or apply for the benefit of all of my children, in monthly or other convenient 3 installments, so much of the net income, up to the whole thereof, as the Trustees in their discretion deem advisable for their proper maintenance, support, health, education and welfare. At the end of each year, the Trustees shall accumulate and add the remaining net income to the principal. In the event that the incom~ shall be insufficient to provide my grandchildren with adequate maintenance, support, health, education and welfare, the Trustees may invade the principal of this Trust for these purposes. (b) At the time my oldest grandchild attains the age of eighteen (18) years, said trust shall be divided into equal separate trusts for each reSPeCtive child then living, each trust to be held and administered as a separate trust for each of my grandchildren, then living. (c) At the time each of my grandchildren attains the age of twenty- five (25) years, all of the remaining balance of principal and interest of said child's respective Trust shall be then paid to him or her and said child's respective Trust shall terminate. 4 (e) After each of my grandchildren attains the age of twenty-two (22) years, each child shall receive the net income from his or her respective Trust, at least quarter annually. The Trustee shall continue to have sole discretion with respect to the application of principal for each grandchild's maintenance, support, education, health and welfare. (f) If one of my grandchildren should predecease me or die . during the term of his or her TRUST, then I give, devise and bequeath said deceased grandchild's share of the rest, residue and remainder of my Estate or the remaining balance of principal and interest in his or her respective TRUST to my Trustee, IN TRUST, for the benefit of my remaining grandchildren then living, to be held and administered in accordance with the provisions of This Will and Trust. 5 -' ITEM IX - I nominate and appoint my children, ROD NESMITH AND KIM MEeK, or the survivor of them, be to be the Executors of this, my Last Will and Testament AND Trustees of any Trust or Trusts established herein. IN WITNESS WHEREOF, I have hereunto set my hand and seal this / fL day of ~ (. , 200 1. A' p/) ~ _ _ _ ,.~ //L.J47-t- __' _ SHIRLEY SMITH (SEAL) Witnesses: ,'f'4 tC 7/tf4JJI-&/-'; residing at 1// 'g C. ~'r6 ~;4a-dIo/~-, ;d4, '/ //V\S- e::~ ff~ residing at 't/OflMw~,tce.4~a~i$.Of1 6 COMMONWEALTH OF PENNSYLVANIA INI..eRITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF Shirley L. Ne13mith FILE NUMBER 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 jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH $100,500 607 Wayne Drive, Mechanicsburg, PA 17055 TOTAL (Also enter on line 1, Recapitulation) (If more space is needed, insert additional sheets of the same size) $100,500.00 Copyright 2000 David James Thorpe, Esq. A. V,S. OEPARTMENT OF HOUSING Bl\d URBAN O~vELOPM!:Nl OMS No. 2S0~.02S5 SETTLEMENT STATEMENT llll.EPRO I.aM/Prtnt CORNERSTONE LAND TRANSFER, INC. a, TYPE OF LOAN 4705 East Trindle Road 1.[ 1 FHA ~, [ I FMHA 3'+) eoNY. uNINS. Mechanlcsburg, PA 17050 4.I)VA 6. [ J CONV, INS. 11. FIL!; NUMBER: I 7, L.OAN NUMBER: Phone: (717) 730-9664 Fex: (717) 730-9665 20254 ,) unDT '''IC:! ,..^<le 1<11"l. I I'" ",,",",. "...... ............ ........ C. NOT~: This form Is furnished 10 glva you a statimenl 01 actulll sottlcmlJnl ccsls. AmQUnt6 paid to and by tho settlement agenl are sho'Nfl, Ilems marked .(p.o.c.). \\Iere paid oulslde the closing: thay are shown here lor informational purposes and are nOT inc:luc:lad in tho totals. '0. NA~e Al\IJ ADDRESS OF BORROWER: E. NAME AND ADDRESS o~ seLLEFI: F, NAME AND ADCFIESS OF LENDER: Rodney I". Nesmith Estate of Shirley Nesmith Waypoint Sank Karen I. Nesmith 101 South George St. York, PA 17401 G. PAOPliiR'N LOCATION: ~. SETTLEMENT AGENT~ I. SETTLEMeNT DATE: Mec:hanicsburg, PA 17055. 607 Wayne Drive CORNERS TOm:: I..ANO TRANSFER, INC. 05/14/02 Upper Allen Township PLACE OF SETTLEMENT: Cumberland County 4705 E. Trindle Rd., Meehanicsburg, PA 1 J. SUMMARY M BORROWEA'S TRANSACTION: K, SUMMARY OF SELLER"! TRANSACTION: 100. GROSS AMOUl'fT DUE FROM BORROWER 400. GROSS AMOUNT CUE TO 8!I.I.1!A 101. Contrllct snlcs oriee 93000.00 101.Contracl sales criC9 93000.00 tO~, p$r$onal proportv .o,.pgrsonal proQortv 103. Settlement CharQ8S to borrower Cline 140m 3273.66 4Q3, 101. 10<1. 10&. 1~. Adjustments lor Items Dllid- bv seller In advance Adiuslmtmlt 'elr Itema Daid bv GOllor in advance lOG, Cily/T"l;Iwn l8lI: to 401l.Cilvliawn lax to 10', Coun1Vll1X 05/14/02101:2/31/02 153.74 401,CQunty lax 05/14/02\012/31/02 153.74 108. As~oscmr:ntG 10 1I08.Ascoscmonul to 109. OCIIOOL 05/14/0210 06730702 136.22 4C.. !lCliOOJ.. 05/147021006/30/02 136.22 110. to -410. to 111. "". 11~. 412. I 120. GROSS AMOUNT DI,JI; FROM BORROWER 96563.84 "2D. GROSS AMOUNT DUE TO SE1.UiA 93289.96 :JOD. AMOUNTS PAID IV OR IN II~HAU= OF BOIUtOWER IICO.RIiOUCTlONS IN AMQUNT DUETO SELLEfl 201. Decosil or oamosl monov tiOl.E)(coss dcposil1see instrugtjr;)I'Js} zaz. PrlnclClal amount of new loan(s} 60000.00 ~.S(jnl(lOlE'lnl enaraec to 101lDr rllne 1400) 10.00 a1G. Exietina loan's) taken $ubiect 10 ~.ExI.Una IOM(S) laken Sl.JblQct to :rod 1 ti04.Poyoff c~ ~jrst Mortgage Loan 2OG. IiOG,Payofl ctf Second Mortgago Loan 2mi. :5OlS. '07. {iC7. :IDS. !lOB. 209 &l9. Adiu~lmonts for itoms unoaid bv seller Adiustmonts for itomB unpaid by seller 210. CltvrrQWl1I(\)C ID bl0.Cltv/T"C1wn t.'ll< to 1111. Counl\i kilt to ' St1.county~ to ",;'>>. A8Ie.amenJ.& to li1 ;:l.A&1088manla to 4113. SOIOOL 10 513. SCHOOL 10 ~t4. blot. 21~. I b1b 216. ~11l 217. lil,. .:118. [,tR. ~19. 619. 2'-0. TaTAL PAID BYIFOR BORROWER 60000.00 5:20. TOrAl. REDUCTION AMOUNT Due saLER 10.00 30a. CASH AT SeTTLEMENT FROM OR TO BORROWER /laD. CASH AT SETTLEMENT TO OR IIROM seu.ePt :lD1. Gress amount due from borr<1W$r7Iine '20) Sl5S63.S4 GOI,Grou amount due 10 sellBr (Iin; 420) SJ3:i!SSl.S-6 :102. ~ amount paid bvtfor borrower (Iino 220) 60000.00 li02.LeSB reduelion amount dU& .ener (line 5:20) 10.00 :103. CASH ([X FROM) ([ 1 TO) BORROWlR 36563.84 803. CASH ([ XTO) ([ ] flROM) SELLER 9~279.96 ByYor or Borrowor's Slgnaturo S<:1~t Slgnatur() HU0-1 R..... G/8G 800/~00'd 9996 08L LLL(X~d) _ .._----.i j~~suejl puel ~UO+S~~U~08 08:90 (3nl)~00~-vl-^~W Ileallon Fee 10 Bank Sank Bank Bank .$ Ida Bank Sank 425.00 81. 00 14.00i 290.00 16.00 100.00 225.00 27.33 Imo. Imo. Imo. 20.24 Imo. Imo. 88.16 Imo. Imo, /mo. 109.:32 101.20 1057.92 -346.31 10 to to to to ~~Ol' 1103 POC 6.00 CCRtmR.STONB LAND 1102 1103 1104 100 300 81 60 000 93 000 Fide11t National Title CORNERSTONE LAND TRANS FE CORNERSTONE LAND TRANSFE 4.00 Misc. $ 6~.00 of Deeds 14.00 3273.88 10.00 i>anlN.gfM ~hlllllQ li8t1ilily ilIi1uUlllud by SlltIemenl AglnllDr 1M !Il;1:1""CY .., i,Il.W",,,llolllumlwtl by alhlrt flll "ho"," on U'I> Hue., senlemlnl 9181llmllnl. Scllklmolll Agenl h.rlllY ..preN;!y ,.....1\1.. in. rtahllO d'llt'lil ""Y ""'''lItll. colaatal!! IUf rJlllbutMllllnlln In Inlor"" tHlllrin; :IceDI",1 itl ;r. r"ildwl&llV In"u,~ In,'It'Hin~ IInd 10 eradit ..ny 1111.,.1t 10 Illlnnd 10 ~ll IIW11I1CGIlUlU .. ealllllonal Garnl'onaatlon IIlI' nl Mrvlcn In Ihils 1 r8l3llot inn , HUg CIiiRnfllCATION OF IUVERS AND SELLERS I haw carofully relJlewod the '-IUD. 1 St:Weml;!nl Statamant Bnd to the boet of my knowlQdSQ IInd balier, it Ii ~ truo ~"d aceurato ltalenw'llof :all receIPts and dlaburtOmonls mado on my Il;ccunt by melh this tr~nstlctlon, I furthl;!Y Qortify thall have rGCalved a copy of tho HUD. I SeUlem.nl StDtolT1<ll'll. Ouyar a, 00_,\0 GillllIII~r. Ila.,..rs "clcI",,~ l PIonn'" Elnlnr'!: SignlllUrd Sllera New "CUlrll~ ,. PIlonc: rne HUl).l Set'",",""1 l;lalllllllllll wllk;Ii 11101'111 PI.plreelle. lr\Il Ind I<:Curllln ~<;..n"''' al U,;,; Ir.."....clIlOlI. I have eeulld Dr 11\1111 ~ll"" the !uncl. ht Ilu cllllClII'NG In Icoomane:ll wi., U,i11I1lIlIIlIl',1I11. Salllllmllnl ^OQAI Dale WARNING.: It i!;1I cri'll!: 10 kngw1ni:lIV mike talN 8l8tlm.n,,, III Ilia 1,Ir/IIC!d S!;lllls allltll. or any smUllf Iorm. Pe nail iolJ 'l;lltn """"i.:IIOO can lIICludl a tine Ind iIr1"r....nm.nt. ",,' *IIlII_ III. 111: 1,I.l;, Cada :acet,un 10C111lnd Sotello" to 10. HI,ll).1 Rend;JIB 800/800'd 9996 08L LLL(X~~) J~~sue~l puel auo+8J~UJ08 L8:90 (3nl)l00l-vl-^~~ ~3000.00 Total: OMB No. 2502.0265 fl.g. 2 u.s. DI:PARTMENT D~ HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT L SET1LEMENT CHARGeS :2 0254 TOTAL IlAL&8IBROICIR"8 COMMI8810N ulOd on 1"Icc' Oivicia"l Of Commiss:ion (Iino 700) ac follows: 701. S 10 10 . $ to 1 CommiGcion nid at Sottlomcnt 7G4. 800. ITBIS PAYABLE IN CONNECTION WITH LOAN 601. loan Orl lnallon Fee ~ 802. Loon Discount 'J\. SI!lJ,.ER'S IIUNDS AT ~~~~~~~;~ Wa oint Bank 75.00 COMMONWEALTH OF PENNSYLVANIA INHIiRITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Shirley L. Nesmith All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION NUMBER 1. U S Savings Bonds - See Attachment FILE NUMBER VALUE AT DATE OF DEATH $85,679.81 TOTAL (Also enter on line 2, Recapitulation) (If more space is needed, insert additional sheets of the same size) $85,679.81 Copyright 2000 David James Thorpe, Esq. 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 David H. or Shirley L. Nesmith: US Savings Bonds 8178 8178 8/78 8/78 8/78 8/78 8/78 8/78 8/78 8178 8/78 9/78 9/78 9/78 9/78 9/78 9/78 10178 10/78 10/78 10/78 10/78 11/78 11/78 11/78 11/78 11/78 11/78 11/78 12/78 12/78 12/78 12/78 12/78 12/78 1/79 1/79 1/79 1/79 1n9 1/79 1n9 2179 2179 2179 C2075825456E C2075825457E C2075825458E C2075825459E C2075825460E C2075825461E C2075825462E C2075825463E Q6262851699E Q6274855657E Q62748556nE C2070537491E C2070537495E Q6262851769E Q6262851840E Q6275916441E Q6275916461E C2075845574E C2075845582E Q6262851933E Q6275916472E 06275916485E C2072338966E C2075825499E C2075825500E Q6275866058E 06275866059E 06275866125E 06275915300E C2072338978E C2075845656E Q6275866136E 06300447227E 06309124123E 06309124619E C2072344487E C2078015609E C2078015610E C2080020902E C2080020903E L2146884627E 06309124699E C2057689875E C2080020917E C208oo20918E Total Number of Bonds = 559 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 David H. or Shirley L Nesmith: US Savings Bonds 2179 2179 2179 3/79 3/79 3179 3/79 3/79 4179 4179 4179 4179 4179 5/79 5/79 5/79 5/79 5/79 5/79 6/79 6/79 6/79 6/79 6/79 7179 7179 7179 7179 7179 7179 8n9 8n9 8/79 8/79 8n9 9179 9179 9179 9179 9179 9179 10/79 10/79 10/79 10/79 C2080020959E C2080020960E 06309447646E C2080020929E C2080020930E C2080020971E C2080020972E Q6309124960E C2080020939E C2080020940E C2080020947E C2080020948E 06309454724E C2080020992E C2080020993E C2087135162E C2087135163E Q6309454802E 06309454864E C2087121572E C2087121573E C2090154728E C2090154729E Q6309454950E C2090154753E C2090154754E C2090154n9E C2090154780E 06309455055E Q6309455080E C2090154793E C2090154794E C2090154800E C2090154801E Q6309455153E C2090154807E C2090154808E C2093982841E C2093982842E 06309455222E 06309455281E C2093982851E C2093982852E C2093.982856E C2093982857E Total Number of Bonds = 559 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 10/79 11/79 11/79 11/79 11/79 11/79 11/79 11/79 11/79 11/79 11/79 12/79 12/79 12/79 1/80 1/80 1/80 1/80 1/80 1180 1/80 2/80 2/80 2/80 2/80 2/80 2/80 2/80 2/80 2/80 2/80 3/80 3180 3/80 3/80 3/80 3/80 3/80 4/80 4/80 4/80 4180 4180 4180 5/80 David H. or Shir1ey L Nesmith: US Savings Bonds 06309455357E C2093982883E C2093982884E C2093982894E C2093982895E C2096343723E C2096343724E C2096343725E C2096343726E C2096343727E Q6309455440E C2093982904E C2093982905E 063m25402E C4577003EE C4S77004EE C4577005EE C4577007EE C4577008EE C4577009EE Q6377725429E C4577013EE C4S77014EE C4S77015EE C4577016EE C4577017EE C4577018EE C4577019EE C4577020EE C4577021EE L2188907606E C4577023EE C4577024EE C4577025EE C4577027EE C4577028EE C4577029EE L2786829EE C4S77030EE C4577031EE C4577032EE C4586928EE C4586929EE C4586930EE C12629203EE Total Number of Bonds = 559 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 David H. or Shirfey L. Nesmith: US Savings Bonds 5/80 5/80 5/80 5/80 5/80 5/80 5/80 6/80 6/80 6/80 6/80 6/80 6/80 6/80 7/80 8/80 8/80 10/80 10/80 11/80 3/81 5/81 5/81 6/81 7/81 7/81 8/81 10/81 11/81 12/81 1/82 3/82 4/82 5/82 5/82 6/82 7/82 8/82 9/82 11/82 11/82 12/82 1/83 3/83 4/83 C12629204EE C12629205EE C45n035EE C45n036EE C45n037EE L4611655EE L4611678EE C45n051EE C45n052EE C45n053EE C45n055EE C45n056EE C45n057EE L4611765EE L4611849EE L4611885EE L4611927EE L4611981EE M967660EE L35368066EE L35368254EE L35368338EE L35368357EE L35368396EE L35368448EE L35368466EE L35368505EE L35368586EE M2710947EE L35368917EE L35369280EE L35369352EE L35369385EE C28468145EE L35369432EE L35369487EE L35369512EE L64695808EE L64696004EE L64696195EE M3685266EE L75343522EE L75343706EE L75343807EE L75343850EE Total Number of Bonds = 559 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 David H. or Shirley L. Nesmith: US Savings Bonds 5/83 6/83 7/83 7/83 8183 9/83 10/83 11/83 12/83 1/84 5/84 6/84 7/84 8/84 9/84 10/84 10/84 11/84 11/84 12/84 1/85 3185 4/85 5/85 6/85 7/85 8/85 9185 10/85 10/85 11/85 12/85 1/86 2/86 2/86 3186 4/86 5/86 5/86 6/86 6/86 6/86 6/86 7/86 7/86 L75343895EE L 118690124EE L118691281EE L118691318EE L 118691943EE L141176946EE L 141200668EE L 141200715EE M5971424EE L 155250931 EE L 155275792EE L 155275850EE L 155275853EE L 155275897EE L1n365359EE L 175999547EE L 175999609EE L1n365293EE M6864547EE L 18331 0355EE L 186700395EE L 186700491 EE l186700544EE L 186700589EE L204165043EE L 189280953EE L189280997EE L204437905EE L212839253EE M012462115EE L218605898EE L218605927EE L253630780EE L258011526EE L258011581 EE L258011629EE L259621945EE C117836934EE L259621725EE C117836947EE L259622012EE M15745030EE R30506730EE C117836979EE C117836981 EE Total Number of Bonds = 559 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 David H. or Shir1ey L Nesmith: US Savings Bonds 7/86 7/86 7/86 7/86 7/86 7/86 7/86 8186 8186 8/86 8/86 8/86 8/86 9/86 9/86 9186 10/86 10/86 10/86 10/86 10/86 10/86 10/86 11/86 11/86 12186 1/87 2187 3/87 4187 4187 5/87 5/87 6/87 6/87 7/87 7/87 7/87 8/87 9/87 9/87 10/87 10/87 1 0/87 11187 L259621751 EE M15745032EE M16073964EE R31841241EE R31841242EE R31841243EE R31841244EE C117836986EE D11512813EE D11512814EE L261912306EE R34392400EE R34392401 EE C117837003EE L261912346EE R34392405EE C117837010EE C117837013EE L274631742EE M19727447EE R34392415EE R34392416EE R34392418EE C117837047EE L274631802EE L261912044EE L261912232EE L288223468EE L288223515EE L301862831 EE L301862875EE L301862915EE L301862960EE L301863003EE L301863038EE L301863071 EE L301863132EE L301863135EE L301863204EE . L301863232EE L301863244EE L31 081 0406EE L310810424EE L3108.10436EE L31 081 0506EE Total Number of Bonds = 559 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 David H. or Shirley L Nesmith: US Savings Bonds 11/87 12/87 12/87 12/87 1/88 1/88 2/88 2/88 3/88 3/88 4188 4188 5/88 5/88 6/88 6188 7/88 7/88 7/88 8/88 8/88 9/88 9/88 10/88 10/88 11/88 11/88 12188 12/88 12/88 1/89 1/89 2/89 2/89 3/89 3/89 4189 4/89 5/89 5/89 6/89 6/89 6/89 7/89 7/89 L31 081 0557EE L310810870EE L331637991EE L331638112EE L331638150EE L331638207EE L331638262EE L331638271 EE L366491327EE L366491339EE L366491047EE L366491058EE L366491101EE L366491157EE L366491221EE L366491263EE L366491362EE L366491384EE L366491449EE L366491586EE L366491646EE L366491471EE L366491513EE L366491543EE L366491687EE L366491739EE L366491783EE L386157599EE L386158004EE L388900492EE L386158031EE L386158074EE L386158111EE L386158129EE L386158197EE L386158217EE L387589541 EE L387589572EE L387589625EE L387589657EE L387589736EE L387589767EE L387589829EE L387589864EE L387589925EE 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 David H. or Shirley L. Nesmith: US Savings Bonds 8/89 8/89 9/89 9/89 10/89 10/89 11/89 11/89 11/89 12/89 12/89 1190 1/90 2/90 2/90 3/90 3/90 4/90 4/90 5/90 5/90 6190 6/90 7/90 7/90 8/90 8/90 8/90 9/90 9/90 10/90 10/90 11/90 11/90 12/90 12190 1/91 1/91 1/91 2/91 2/91 3/91 3/91 4/91 4/91 L387589955EE L387590012EE L387590052EE L387590093EE L387590148EE L387590178EE L387590250EE L387590297EE L413966560EE L413967020EE L413967137EE L413967174EE L413967242EE L413967280EE L413967299EE L413967360EE L413967411EE L413967496EE L457157796EE L458957304EE L458957326EE L458995001 EE L461171077EE L473603776EE L473636200EE L475019076EE L475523753EE L476336505EE L476404150EE L476404151EE L476431352EE L476457461EE L476494806EE L476546081 EE L477358124EE L477358125EE L477394905EE L477412280EE L477431167EE L472766259EE L47745BB31EE L472787523EE L477467316EE L477490269EE L477517731EE Total Number of Bonds = 559 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 David H. or Shirley L Nesmith: US Savings Bonds 5/91 5/91 6/91 6/91 7/91 7/91 7/91 8/91 8/91 9/91 9/91 10/91 10191 10/91 11/91 11/91 11/91 12/91 12/91 1/92 1/92 1/92 2/92 2/92 3/92 3/92 4/92 4/92 5/92 5192 6/92 6/92 7/92 7/92 7/92 8/92 8/92 9/92 9/92 10/92 10/92 11/92 11/92 12/92 12/92 L477549472EE L477S82911EE L477S95103EE L477630237EE L477660297EE L477684491EE L477699721 EE l4m25255EE L4m44966EE L47m6750EE L477801572EE l35368562EE L478991099EE L479037473EE L479069694EE L479123965EE l483453107EE L479212750EE L480656768EE l480697438EE l480715504EE L480736833EE L480761326EE L480786047EE L480819721EE L480845868EE L480887356EE L480922558EE l480974804EE L481009414EE L481041397EE L481 072801 EE L481100808EE L481123864EE L481147710EE L481179600EE L481197273EE L481228529EE L481252568EE L481279034EE L481322854EE L481405011EE L481451027EE L502299904EE L502407280EE Total Number of Bonds = 559 491 492 493 494 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532 533 534 535 David H. or Shirley L Nesmith: US Savings Bonds 12/92 1/93 1/93 2/93 2/93 3/93 3/93 4/93 4/93 5193 5/93 6/93 6/93 6/93 7/93 7/93 8/93 8193 9/93 9/93 10/93 10/93 11/93 11/93 12/93 12/93 1/94 1/94 1/94 3194 3/94 4/94 4/94 4/94 4/94 4/94 4/94 4/94 6/94 6/94 6/94 6/94 6/94 6/94 6/94 L502452610EE L502494365EE L505352825EE l505376719EE 1505390252EE l505419009EE 1505432221 EE l505462040EE l505483501EE l505525759EE l511594462EE l511619850EE L511643582EE l511662938EE l511685608EE L515034110EE 1515082973EE l515155936EE l515184520EE l515217871EE l515308592EE l515349518EE 1515470587EE l515560825EE 1518274040EE l521020356EE 1521112013EE 1521167622EE 1521207512EE l523401436EE 1523401437EE L523491925EE L523491926EE 1523491927EE l523637 411 EE L523637412EE l523637413EE l523637414EE l523914975EE l523914976EE l523914977EE l523914978EE l525837912EE l525837913EE l525837914EE Total Number of Bonds = 559 536 537 538 539 540 541 542 543 544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 6/94 8/94 8/94 8194 8/94 9/94 9/94 10194 10/94 12/94 12/94 12/94 12/94 2/95 2/95 4/95 4/95 5195 7/95 7/95 7/95 7/95 11/98 11/98 David H. or Shirley L. Nesmith: US Savings Bonds L525837915EE L527349374EE L527349375EE L527349376EE L5273493nEE C486915745EE C486915746EE C493291947EE C493291948EE C504n9535EE C504779536EE C504n9537EE C504n9538EE C514283785EE C514283786EE C516204147EE C516204148EE C516789181EE C530511725EE C530511726EE C530511727EE C530511728EE C2072338965E C2072338972E Total Number of Bonds = 559 SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Shirley L. Nesmith FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with the right of survivorship must be disclosed on Schedule F. COMMONWEALTH OF PENNSYLVANIA INH~ITANCE TAX RETURN RESIDENT DECEDENT ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH $1,392.42 Miscellaneous Personal Property 2. 1995 Mercury motor vehicle $8,500.00 3. Jewelry (insurance proceeds) $1,000.00 4. Jewelry (2 wedding bands and class ring $78.00 5. Honda CM4WC Motorcycle $250.00 $240.51 6. Medical insurance refund TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) $11,220.42 Copyright 2000 David James Thorpe, Esq. ... J-D..TIJ es CHf'IIOUJ CHEVROLET, INC.. 3400 HARTZDALE DRIVE AT CAPITAL CITY MALL DRIVE CAMP HILL. PA 17011 REASON FOR VISITING US: NO. SURVEY AND APPRAISAL FORM -- THIS IS NOT AN ORDER STREET NAME S~~ \.-J e....~~~"'" ADDRESS \c:,O-, \ CI~....'\-"",...~TATE ~ AGE _ PHONE NO. .~ ~ 1E L 'W\ 't"-\ \A) '?<<:5 X bY \ cq S ~ RADIO WEST SHORE SHOPPER'S GUIDE TELEVISION PATRIOT FRIEND OLD CUSTOMER LA,..I cZ.. ...,'\........... . , ~~ DATE/_ ~- 0 I OTHER ~~'"- ~ '"^^~ ~\3...c..... YEAR \t\ ~S MAKE "'-'\~~ MODEl. c: <:. BODY STYLE l...\, ~ ~ \ MILEAGE~AUTO TRANS. ~ @;J...(PjfD ~ q/~ ~ @:) l.-\.. ~YL. V . ~ COLOR "^~",,,P AI NT '-"" .' INTERIOR '- GLAS S __ TIRES L.F. R.F. L.R. R SPARE FENDERS L.F. R.F. L.R. R. DOORS REMARKS ~.~ 17 WHOLESALE VALU : - ;;.0;;00 ~~~~ FOLLOW DATE APPRAISED BY MOTOR. REAR. TRANS. REMARKS PHYSICAL DAMAGE REPORT YOU KNOW ANYBODY INTERESTED IN YOUR TRADE: ~~ A=>. ~ .-.2. /~v-- ~LESMAr ~ - ~ ~TO NAME CHECKED IN BY ~G . ".-' HONDA aprilia 6653 Carlisle Pike, balucsburg, PA 17050-1707 717-766-2523 Fax 790-9114 E-mail info@imotosports.com To Whom it may concern: According to the N.A.D.A YJebsite the average retail value of a 1981 Honda CM400C vin # JH2NC0120BM009619 is $840.00. HO'Never, in our experience, a unit that has been sitting for several years requires repairs to the fuel and hydraulic systems and has a market value of approximately $250.00. Sincerely I Q~ c~omo President ~ COMMONWEALTH OF PENNSYLVANIA INHBRITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Shirley L. Nesmith FILE NUMBER If an asset was made joint within one year of the decedent's date of death, It must be reported on Schedule G. B. Rodney L. Nesmith ADDRESS 43 ~ Rd., Oillsburg,'PA1'7~19 ~~~ 1118 W. Lisburn Rd., Mechanicsburg, PA 17055 RELATIONSHIP TO DECEDENT Daughter SURVIVING JOINT TENANT(S) NAME A. Kimberly A. Meck Son C. Matthew Nesmith 1118 W. Lisburn Rd., Mechanicsburg, PA 17055 Grandson D. Other grandchildren (see attachment) Grandchildren JOINTl V-OWNED PROPERTY: ITEM LETTER DATE DESCRIPTION OF PROPERTY DATE OF DEATH %OF DATE OF DEATH NUMBER FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach VALUE OF ASSET DECO'S VALUE OF TENANT JOINT deed for jointly-held real estate. INTEREST DECEDENT'S INTEREST 1. NB 7/14/97 Savings Account at MemberS First -82662-00 $103.00 33% $33.99 2. A?B 7/14/97 Savings Account at Members First - 82662-05 $81,108.75 33% $26,765.89 3. AlB 7/14/97 Checking Account at Members First $2.415.89 33% $797.24 4. AlB 7/14/97 Certificate of Deposit at Members First $14,068.22 33% $4,642.51 5. C U S Savings Bonds (see attachment) 50% 6. D US Savings Bonds (see attachment) 50% 7. B VANGUARD GNMA Fund (366.042 shares) $3,773.89 50% $1886.95 TOTAL (Also enter on line 6, Recapitulation) $34,126.58 (If more space is needed, insert additional sheets of the same size) Copyright 2000 David James Thorpe, Esq. \ fJih, Smoker, Smith & Associates, p.e. Memo To: Richard Rupp From: Jackie Wolpert CC: Date: July 8, 2002 Re: Estate of Shirley Nesmith Hello Richard, As we discussed, here are copies of the bonds that were jointly owned by Shirley Nesmith with her grandchildren valued as of her date of death. Please feel free to use these values for valuation purposes when preparing the PA REV -1500, Pennsylvania Inheritance Tax return. If you have any comments or questions, please feel free to call. . Thanks, Jackie Wolpert . ~ " .~ ;,,1' ~. :f ~ 11, . ..I I ,... (717) 533-5154. FAX (717) 533-1442 339 West Governor Road. Hershey, Pennsylvania 17033 (717) 441-9069. FAX (717) 441-9068 2000 Technology Parkway. Mechanicsburg, Pennsylvania 17055 TOll FREE (888) 277-1040. E-Mail: ssa@ssa-pc.com Savings Bond Calculator V.dllp th nl 19.?!.?99J ... ! Bond Info Page 10f6 - Denomination Serial Number Series I~~~?~~~ ....JI Rp.sults # Bonds 206 Serial Number L319734365EE L457175976EE C567221051EE C572380714EE C572380715EE C556804561EE C556804560EE C567221052EE C541172513EE C541172515EE C556804559EE C514283696EE C530511634EE C541172514EE C464692864EE C464692865EE C514283695EE C409271595EE C472751792EE C472751793EE C481258460EE C481258461EE C409271596EE C434369250EE C493291888EE C493291889EE C447259183EE C447259184EE $I~~.......II t.. . Total Price $8,775.00 Total Interest $5,116.92 Total Value $13,891.92 Issue Interest Issue Date Series Denom Price Interest Value . Rate 08/1988 EE $50 $25.00 $26.84 $51.84 4.00% 05/1990 EE 50\ 25.00 22.92 47.92 6.00% 04/1996 EE 100 . 50.00 12.40 62.40 5.23% 07/1996 EE 100' 50.00 10.92 60.92 5.36% 07/1996 EE 100 . 50.00 10.92 60.92 5.36% 02/1996 EE 100 . 50.00 12.40 62.40 5.23% 02/1996 EE 100" 50.00 12.40 62.40 5.23% 04/1996 EE 100' 50.00 12.40 62.40 5.23% 10/1995 EE 100 . 50.00 14.08 64.08 5.23% 10/1995 EE 100. 50.00 14.08 64.08 5.23% 02/1996 EE 100. 50.00 12.40 62.40 5.23% 02/1995 EE 100 . 50.00 17.88 67.88 5.29% 07/1995 EE 100 . 50.00 14.08 64.08 5.23% 10/1995 EE 100. 50.00 14.08 64.08 5.23% 04/1994 EE 100 . 50.00 20.96 70.96 5.21% 04/1994 EE 100. 50.00 20.96 70.96 5.21% 02/1995 EE 100 . 50.00 17.88 67.88 5.29% 07/1993 EE 100. 50.00 22.64 72.64 5.20% 06/1994 EE 100 . 50.00 19.48 69.48 5.26% 06/1994 EE 100. 50.00 19.48 69.48 5.26% 08/1994 EE 100. 50.00 19.48 69.48 5.26% 08/1994 EE 100 . 50.00 19.48 69.48 5.26% 07/1993 EE 100 . 50.00 22.64 72.64 5.20% 10/1993 EE 100 . 50.00 22.64 72.64 5.20% 10/1994 EE 100' 50.00 19.48 69.48 5.26% 10/1994 EE 100' 50.00 19.48 69.48 5.260/0 12/1993 EE 100. 50.00 20.96 70.96 5.21% 12/1993 EE 100 ." 50.00 20.96 70.96 5.210/0 http://www .publicdebt.treas.gov /servlet/SBCPrice Issue Date I i ..................,............................1 YTD Iul;.. $241.5'f' Next Final Accrual Maturity 08/2001 08/2018 11/2001 OS/2020 10/2001 04/2026. 07/2001 07/2026, 07/2001 07/2026. 08/2001 02/2026 08/2001 02/2026- 10/2001 04/2026 10/2001 10/2025 10/2001 10/2025 08/2001 02/2026 08/2001 02/2025 07/2001 07/2025 10/2001 10/2025 10/2001 04/2024 10/2001 04/2024 08/2001 02/2025 07/2001 07/2023 06/2001 06/2024 06/2001 06/2024 08/2001 08/2024 08/2001 08/2024 07/2001 07/2023 10/2001 10/2023 10/2001 10/2024 10/2001 10/2024 06/2001 12/2023 . 06/2001 12/2020 6/24/2002 Savings Bond Calculator Page 2 of6 C434369251EE 10/1993 EE 100 . 50.00 22.64 72.64 5.20% 10/2001 10/2023 C516789125EE 05/1995 BE 100. 50.00 15.76 65.76 4.250/0 11/2001 OS/2025 C504779245EE 12/1994 EE 100 . 50.00 17.88 67.88 5.29% 06/2001 12/2024 C504779246EB 12/1994 BE 100 . 50.00 17.88 67.88 5.29% 06/2001 12/2024 C516789124BE 05/1995 BE 100 . 50.00 15.76 65.76 4.25% 11/2001 OS/2025 L457175959EE 05/1990 EE 50 . 25.00 22.92 47.92 6.00% 11/2001 OS/2020 L457175958EE 05/1990 EE 50 . 25.00 22.92 47.92 6.00% 11/2001 OS/2020 L457175957EE 05/1990 EE 50 . 25.00 22.92 47.92 6.00% 11/2001 OS/2020 L457175962EE 05/1990 BE 50 . 25.00 22.92 47.92 6.00% 11/2001 OS/2020 L457175961EE 05/1990 EE SO . 25.00 22.92 47.92 6.00% 11/2001 OS/2020 L457175960EE 05/1990 EE 50_ 25.00 22.92 47.92 6.00% 11/2001 OS/2020 L457175965EE 05/1990 EE 50 . 25.00 22.92 47.92 6.00% 11/2001 OS/2020 L457175964EE 05/1990 EE 50. 25.00 22.92 47.92 6.00% 11/2001 OS/2020 L457175963EE 05/1990 EE 50 . 25.00 22.92 47.92 6.00% 11/2001 OS/2020 L457175966EE 05/1990 EE 50 . 25.00 22.92 47.92 6.00% 11/2001 OS/2020 C277083399EE 12/1990 EE 100 .. 50.00 40.32 90.32 6.00% 06/2001 12/2020 C277083401EE 12/1990 EE 100 ,; 50.00 40.32 90.32 6.00% 06/2001 12/2020 C254942666EE 04/1990 EE 100 - 50.00 45.84 95.84 6.00% 10/2001 04/2020 C277083400EE 12/1990 EE 100, 50.00 40.32 90.32 6.00% 06/2001 12/2020 C277083402EE 12/1990 EE 100 . 50.00 40.32 90.32 6.00% 06/2001 12/2020 C310803416EE 12/1991 EE 100 . 50.00 35.16 85.16 6.00% 06/2001 12/2021 C31 080341 SEE 12/1991 EE 100 . 50.00 35.16 85.16 6.00% 06/2001 12/2021 C310803414EE 12/1991 EE 100 . 50.00 35.16 85.16 6.00% 06/2001 12/2021 C308835566EE 07/1991 EE 100 . 50.00 37.68 87.68 6.00% 07/2001 07/2021 C308835567EE 07/1991 EE 100 . 50.00 37.68 87.68 6.00% 07/2001 07/2021 6 C31083417EE 12/1991 EE 100' 50.00 35.16 85.16 6.00% 06/2001 12/2021 C345839057EE 06/1992 EE 100 . 50.00 32.68 82.68 6.00% 06/2001 06/2022 C308835564EE 07/1991 EE 100' 50.00 37.68 87.68 6.00% 07/2001 07/2021 C308835565EE 07/1991 EE 100 '- 50.00 37.68 87.68 6.00% 07/2001 07/2021 C345839060EE 06/1992 EE 100 . 50.00 32.68 82.68 6.00% 06/2001 06/2022 C345839059EE 06/1992 EE 100 . 50.00 32.68 82.68 6.00% 06/2001 06/2022 C345839058EE 06/1992 EE 100 . 50.00 32.68 82.68 6.00% 06/2001 06/2022 C386975419EE 01/1993 EE 100 50.00 30.24 80.24 6.00% 07/2001 01/2023 C386975418EE 01/1993 EE 100' 50.00 30.24 80.24 6.00% 07/2001 01/2023 C345839061EE 06/1992 EE 100' 50.00 32.68 82.68 6.00% 06/2001 06/2022 C386975422EE 01/1993 EE 100 l 50.00 30.24 80.24 6.00% 07/2001 01/2023 C386975421EE 01/1993 EE 100 " 50.00 30.24 80.24 6.00% 07/2001 01/2023 C386975420EE 01/1993 EE 100 50.00 30.24 80.24 6.00% 07/2001 01/2023 http://www .publicdebt. treas. gov /servlet/SBCPrice 6/24/2002 Savings Bond Calculator Page 3 of6 C434369279EE 10/1993 EE 100 < 50.00 22.64 72.64 5.20% 10/2001 10/2023 C409271600EE 07/1993 . EE 100. 50.00 22.64 72.64 5.20% 07/2001 07/2023 C409271599EE 07/1993 EE 100 50.00 22.64 72.64 5.20% 07/2001 07/2023 C447259191EE 12/1993 EE 100 50.00 20.96 70.96 5.21% 06/2001 12/2023 C447259192EE 12/1993 EE 100 50.00 20.96 70.96 5.21% 06/2001 12/2023 C434369280EE 10/1993 EE 100 50.00 22.64 72.64 5.20% 10/2001 10/2023 C472751798EE 06/1994 EE 100' 50.00 19.48 69.48 5.26% 06/2001 06/2024 C464692869EE 04/1994 EE 100' 50.00 20.96 70.96 5.21% 10/2001 04/2024 C464692870EE 04/1994 EE 100. 50.00 20.96 70.96 5.21% 10/2001 04/2024 C481258471EE 08/1994 EE 100 50.00 19.48 69.48 5.26% 08/2001 08/2024 C481258472EE 08/1994 EE 100' 50.0e 19.48 69.48 5.26% 08/2001 08/2024 C472751797EE 06/1994 EE 100 . 50.00 19.48 69.48 5.26% 06/2001 06/2024 C504779562EE 12/1994 EE 100. 50.00 17.88 67.88 5.29% 06/2001 12/2024 C493291892EE 10/1994 EE 100 . 50.00 19.48 69.48 5.26% 10/2001 10/2024 C493291893EE 10/1994 EE 100 50.00 19.48 69.48 5.26% 10/2001 10/2024 C514283699EE 02/1995 EE 100 50.00 17.88 67.88 5.29% 08/2001 02/2025 C514283700EE 02/1995 EE 100 . 50.00 17.88 67.88 5.29% 08/2001 02/2025 C50477956 lEE 12/1994 EE 100 I 50.00 17.88 67.88 5.29% 06/2001 12/2024 C530511636EE 07/1995 EE 100- 50.00 14.08 64.08 5.23% 07/2001 07/2025 C516789128EE 05/1995 EE 100' 50.00 15.76 65.76 4.25% 11/2001 OS/2025 C516789129EE 05/1995 EE 100. 50.00 15.76 65.76 4.25% 11/2001 OS/2025 C541172521EE 10/1995 EE 100. 50.00 14.08 64.08 5.23% 10/2001 10/2025 C541172520EE 10/1995 EE 100 . 50.00 14.08 64.08 5.23% 10/2001 10/2025 C541172519EE 10/1995 EE 100 . 50.00 . 14.08 64.08 5.23% 10/2001 10/2025 C556804566EE 02/1996 EE 100. 50.00 12.40 62.40 5.23% 08/2001 02/2026 C556804567EE 02/1996 EE 100, 50.00 12.40 62.40 5.23 % 08/2001 02/2026 C556804565EE 02/1996 EE 100 . 50.00 12.40 62.40 5.23% 08/2001 02/2026 C572380719EE 07/1996 EE 100 . 50.00 10.92 60.92 5.36% 07/2001 07/2026 C567221055EE 04/1996 EE 100.: 50.00 12.40 62.40 5.23% 10/2001 04/2026 C567221056EE 04/1996 EE 100 . 50.00 12.40 62.40 5.23% 10/2001 04/2026 C572380718EE 07/1996 EE 100 . 50.00 10.92 60.92 5.36% 07/2001 07/2026 L366833746EE 12/1988 EE 50 . 25.00 25.82 50.82 4.00% 06/2001 12/2018 L366833745EE 12/1988 EE 50. 25.00 25.82 50.82 4.00% 06/2001 12/2018 L366833744EE 12/1988 EE 50 . 25.00 25.82 50.82 4.00% 06/2001 12/2018 L366833742EE 12/1988 EE 50. 25.00 25.82 50.82 4.00% 06/2001 12/2018 L366833474EE 09/1988 EE 50 ~ 25.00 26.84 51.84 4.00% 09/2001 09/2018 L366833743EE 12/1988 EE 50 ;'"25.00 . 25.82 50.82 4.00% 06/2001 12/2018 L366733473EE 09/1988 EE 50 ..25.00 26.84 51.84 4.00% 09/2001 09/2018 http://www .publicdebt. treas.gov /servlet/SBCPrice 6/24/2002 Savings Bond Calculator Page 4 of6 L366833387EE '09/1988 EE 50 '25.00 26.84 51.84 4.00% 09/2001 09/2018 L366833386EE 09/1988 EE 50, 25.00 26.84 51.84 4.00% 09/2001 09/2018 L319734363EE 08/1988 EE 50. 25.00 26.84 51.84 4.00% 08/2001 08/2018 L319734364EE 08/1988 EE 50 . 25.00 26.84 51.84 4.00% 08/2001 08/2018 L366833337EE 06/1988 EE 50 . 25.00 26.84 51.84 4.00% 06/2001 06/2018 L319734366EE 08/1988 EE 50 . 25.00 26.84 51.84 4.00% 08/2001 08/2018 L319734367EE 08/1988 EE 50 . 25.00 26.84 51.84 4.00% 08/2001 08/2018 L319734259EE 06/1988 EE 50, 25.00 26.84 51.84 4.00% 06/2001 06/2018 L366833278EE 05/1988 EE 50~ 25.00 27.88 52.88 4.00% 11/2001 OS/2018 L319734258EE 06/1988 EE 50. 25.00 26.84 51.84 4.00% 06/2001 06/2018 L366833282EE 05/1988 EE 50. 25.00 27.88 52.88 4.00% 11/2001 OS/2018 L366833279EE 05/1988 EE 50, 25.00 27.88 52.88 4.00% 11/2001 OS/2018 L366833280EE 05/1988 EE 50. 25.00 27.88 52.88 4.00% 11/2001 OS/2018 L319734048EE 03/1988 EE 50' 25.00 27.88 52.88 4.00% 09/2001 03/2018 L319734044EE 03/1988 EE 50. 25.00 27.88 52.88 4.00% 09/2001 03/2018 L366833281EE 05/1988 EE 50 ' 25.00 27.88 52.88 4.00% 11/2001 OS/2018 L319733953EE 02/1988 EE 50. 25.00 27.88 52.88 4.00% 08/2001 02/2018 L319734047EE 03/1988 EE 50 - 25.00 27.88 52.88 4.00% 09/2001 03/2018 L319734045EE 03/1988 EE 50 - 25.00 27.88 52.88 4.00% 09/2001 03/2018 L319733955EE 02/1988 EE 50' 25.00 27.88 52.88 4.00% 08/2001 02/2018 L319733954EE 02/1988 EE 50. 25.00 27.88 52.88 4.00% 08/2001 02/2018 L319733952EE 02/1988 EE 50. 25.00 27.88 52.88 4.00% 08/2001 02/2018 L319733859EE 01/1988 EE 50 - 25.00 27.88 52.88 4.00% 07/2001 01/2018 L319733860EE 01/1988 EE 50. 25.00 27.88 52.88 4.00% 07/2001 01/2018 L319733857EE 01/1988 EE - 50' 25.00 27.88 52.88 4.00% 07/2001 01/2018 L319733853EE 12/1987 EE 50, 25.00 27.88 52.88 4.00% 06/2001 12/2011 L319733858EE 01/1988 EE 50. 25.00 27.88 52.88 4.00% 07/2001 01/2018 L319733854EE 12/1987 EE 50- 25.00 27.88 52.88 4.00% 06/2001 12/2017 L319733851EE 12/1987 EE 50. 25.00 27.88 52.88 4.00% 06/2001 12/2017 L319733848EE 12/1987 EE 50' 25.00 27.88 52.88 4.00% 06/2001 12/2017 . L319733852EE 12/1987 EE 5Q 25.00 27.88 52.88 4.00% 06/2001 12/2017 C386975424EE 01/1993 EE 100- 50.00 30.24 80.24 6.00% 07/2001 01/2023 C386975423EE 01/1993 EE 100. 50.00 30.24 80.24 6.00% 07/2001 01/2023 C277083406EE 12/1990 EE 100' 50.00 40.32 90.32 6.00% 06/2001 12/2020 C386975427EE 01/1993 EE 100 50.00 30.24 80.24 6.00% 07/2001 01/2023 C386975426EE 01/1993 EE 100, 50.00 30.24 80.24 6.00% 07/2001 01/2023 C386975425EE 01/1993 EE 100. 50.00 30.24 80.24 6.00% 07/2001 01/2023 C43436927lEE 10/1993 EE 100 . 50.00 22.64 72.64 5.20% 10/2001 10/2023 http://www.publicdebt.treas.gov/servlet/SBCPrice 6/24/2002 Savings Bond Calculator Page 5 of6 C409271597EE 07/1993 EE 1 00 ~ 50.00 22.64 72.64 5.20% 07/2001 07/2023 C409271598EE 07/1993 EE 100 r;> 50.00 22.64 72.64 5.20% 07/2001 07/2023 C220607075EE ,01/1990 EE 1 00 ~ 50.00 45.84 95.84 6.00% 07/2001 01/2020 C434369270EE 10/1993 EE 100.- 50.00 22.64 72.64 5.20% 10/2001 10/2023 L457175974EE 05/1990 EE 50" 25.00 22.92 47.92 6.00% 11/2001 OS/2020 L457175973EE 05/1990 EE 50. 25.00 22.92 47.92 6.00% 11/2001 OS/2020 L457175975EE 05/1990 EE 50 . 25.00 22.92 47.92 6.00% 11/2001 OS/2020 L457175969EE 05/1990 EE 50 . 25.00 22.92 47.92 6.00% 11/2001 OS/2020 L457175972EE 05/1990 EE 50 25.00 22.92 47.92 6.00% 11/2001 OS/2020 L457175971EE 05/1990 EE 50 . 25.00 22.92 47.92 6.00% 11/2001 OS/2020 L457175968EE 05/1990 EE 50. 25.00 22.92 47.92 6.00% 11/2001 OS/2020 L457175967EE 05/1990 EE 50. 25.00 22.92 47.92 6.00% 11/200 J. OS/2020 L457175970EE 05/1992 EE 50.-.: 25.00 ' 17.58 42.58 6.00% 11/2001 OS/2022 L390485185EE 02/1989 EE 50-: 25.00 25.82 50.82 4.00% 08/2001 02/2019 L390485182EE 02/1989 EE 50. 25.00 25.82 50.82 4.00% 08/2001 0212019 L390485183EE 02/1989 EE 50 ' 25.00 25.82 50.82 4.00% 08/2001 0212019 L390485186EE 02/1989 EE 50. 25.00 25.82 50.82 4.00% 08/2001 02/2019 L390485188EE 02/1989 EE 50 25.00 25.82 50.82 4.00% 08/2001 0212019 L390485184EE 02/1989 EE 50. 25.00 25.82 50.82 4.00% 08/2001 02/2019 C481258467EE 08/1994 EE 100. 50.00 19.48 69.48 5.26% 08/2001 0812024 C472751795EE 06/1994 EE 100' 50.00 19.48 69.48 5.26% 06/2001 06/2024 C472751794EE 06/1994 EE 100 . 50.00 19.48 69.48 5.26% 06/2001 06/2024 C493291891EE 10/1994 EE 100. 50.00 19.48 69.48 5.26% 10/2001 1012024 C493291890EE 10/1994 EE 100' 50.00 19.48 69.48 5.26% 10/2001 1012024 C481258468EE 08/1994 EE 100' 50.00 19.48 69.48 5.26% 08/2001 08/2024 C345839056EE 06/1992 EE 100 . 50.00 32.68 82.68 6.00% 06/2001 06/2022 C504779255EE 12/1994 EE 100, 50.00 17.88 67.88 5.29% 06/2001 12/2024 C504779254EE 12/1994 EE 100. 50.00 17.88 67.88 5.29% 06/2001 12/2024 C345839053EE 06/1992 EE 100. 50.00 32.68 82.68 6.00% 06/2001 06/2022 C345839054EE 06/1992 EE 100. 50.00 32.68 82.68 6.00% 06/2001 06/2022 C345839055EE 06/1992 EE 100. 50.00 32.68 82.68 6.00% 06/2001 06/2022 C308835561EE 07/1991 EE 100 50.00 37.68 87.68 6.00% 07/2001 07/2021 C308835560EE 07/1991 EE 100 50.00 37.68 87.68 6.00% 07/2001 07/2021 C345839052EE 06/1992 EE 100. 50.00 32.68 82.68 6.00% 06/2001 06/2022 C310803421EE 12/1991 EE 100' 50.00 35.16 85.16 6.00% 06/2001 12/2021 C308835563EE 07/1991 EE 100'.- .50.00 37.68 87.68 6.00% 07/2001 07/2021 C308835562EE. 07/1991 EE 100" 50.00 37.68 87.68 6.00% 07/2001 07/2021 C310803418EE .' 12/1991 EE 100'",50.00 35.16 85.16 6.00% 06/2001 12/2021 http://www . publicdebt. treas.gov /servlet/SBCPrice 6/24/2002 Savings Bond Calculator Page 6 of6 C310803419EE 12/1991 EE 100. 50.00 35.16 85.16 6.00% 06/2001 12/2021- C310803420EE 12/1991 EE 100: 50.00 35.16 85.16 6.00% 06/200 1 12/2021 < C277083403EE 12/1990 BE 100,' 50.00 40.32 90.32 6.00% 06/2001 12/2020- C277083404EE 12/1990 EE 100' 50.00 40.32 90.32 6.00% 06/2001 12/2020' C277083405EE 12/1990 EE 100- 50.00 40.32 90.32 6.00% 06/2001 12/202Q. C514283698EE 02/1995 EE 100, 50.00 17.88 67.88 5.29% 08/2001 02/2025 R46511768EE 12/1988 EE 200 -100.00 103.28 203.28 4.00% 06/2001 12/2018 R38869969EE 12/1987 EE 200 -100.00 111.52 211.52 4.00% 06/2001 12/201?- C516789127EE 05/1995 EE 100 '50.00 15.76 65.76 4.25% 11/2001 OS/2025 C516789126EE 05/1995 EE 100 50.00 15.76 65.76 4.25% 11/2001 OS/2025' C514283697EE 02/1995 EE 100 - 50.00 17.88 67.88 5.29% 08/2001 02/2025 C541172517EE 10/1995 EE 100' 50.00 14.08 64.08 5.23% 10/2001 10/2025 ~ C541172518EE 10/1995 EE 100 - 50.00 14.08 64.08 5.23% 10/2001 1012025- C530511635EE 07/1995 EE 100, 50.00 14.08 64.08 5.23% 07/2001 07/2025' C556804563EE 02/1996 EE 100- 50.00 12.40 62.40 5.23% 08/2001 02/2026, C556804562EE 02/1996 EE 100 50.00 12.40 62.40 5.23% 08/2001 02/2026' C541172516EE 10/1995 EE 100' 50.00 14.08 64.08 5.23% 10/2001 10/2025' C567221053EE 04/1996 EE 100' 50.00 12.40 62.40 5.23% 10/2001 04/2026 C567221054EE 04/1996 EE 100 50.00 12.40 62.40 5.23% 10/2001 04/2026' C556804564EE 02/1996 EE 100' 50.00 12.40 62.40 5.23% 08/2001 0212026 C447259186EE 12/1993 EE 100' 50.00 20.96 70.96 5.21 % 06/2001 12/2023 C572380717EE 07/1996 EE 100' 50.00 10.92 60.92 5.36% 07/2001 07/2026 C572380716EE 07/1996 EE 100- 50.00 10.92 60.92 5.36% 07/2001 0712026- C464692867EE -04/1994 . EE 100. 50.00 20.96 70.96 5.21% 10/2001 04/2024' C464692866EE 04/1994 I EE . 100' 50.00 20.96 70.96 5.21% 10/2001 04/2024 C447259187EE 12/1993, EE 100" 50.00 20.96 70.96 5.21% 06/2001 12/2023 _I Viewing Bonds 1-206 lelJend Note Description NI Not Issued NE Not Eligible for Payment P5 Includes 3-month interest penalty ME Matured (Exchangeable for HH) MN Matured (Not Exchangeable for HH) http://www .publicdebt. treas.gov/serv let/SBCPrice 6/24/2002 Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/15/2005 RUPP RICHARD C POBOX 395 355 NORTH 21ST ST SUITE 205 CAMP HILL, PA 17011 RE: Estate of NESMITH SHIRLEY File Number: 2001-00510 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 5/21/2005 Your prompt attention to this matter will be appreciated. Thank You. A:~~ GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge ~ -- J '"/juires to: '.'. "~i I nberslsr . '. 'REDrr IJNION " ,.. .,..oard: (717) 697-1161 or (800) 283-2328 · (717) 697-4372 or (800) 283-4372 (717) 697.5312 or (800) 283-2328 eld. 5312 (711) 795-6049 or (800) 237-7288 5000 Louise Drive PO Box 40 Mechanicsburg, PA 17055 www.members1st.org Member;s Statement of Account Account Number From TO Page 82662 05-01-01 05-31-01 1 of 2 ,. NOW YOU CAN REORDER YOUR CHE'CKS ONLINE. SEE THE ENCLOSED INSERT FOR MORE INFORMATION. 1...111...111....1.1..1.1..1..11.1..,..1.'.11111.111.11"...II SHIRLEY L NESMITH C/O RODNEY NESMITH AND KIMBERLY MECK 607 WAYNE DR MECHANICSBURG PA 17055-4987 75 T~~. . -:;::;6ZE .' ;./:;::ii;::i;i~i;i;!;;i:;r:iiii!iii!i!i!i~i:i:ii!ii~iiii!!!!!~;:::ii;i:ii:!!!i:;J.iRANsAcTIQN~O_mj~;';J_~j~~iiiii~iii~~![iii[iiiiiiii~i~ii~i~iii!ir~i1iIiiriiii~iiii~1iii!iiiij!:i" .::j!!i!!i!;i!:ii!i!i!iiiiii!iIIPUNT SUFFIX:OO SAVINGS TFR FROM SHARES US TREASURY 303 LIBERTY LIFE ASS DIVIDEND JOINT OWNERS: KIMBERLY A MECK RODNEY NESMITH ~ Y-T-D DIVIDENDS: (6.84 TRUTH IN SAVINGS INFORMATION ANNUAL PERCENTAGE YIELD I 2.90% ANNUAL PERCENTAGE YIELD EARNED / 2.90% ----------~------------------------------------------------------ SUFFIX:OS INVESTMENT SAVINGS 051901 TFR TO SHARES 82662-11 052101 TFR TO SHARES 82662-11 052101 TFR TO SHARES 82662-00 053101 DIVIDEND JOINT OWNERS: 052101 052301 053101 053101 82662-05 5000.00 864.00 62.84 5. 17 )!i:ii~_~!!;i: 102.8" 5102.84 5966.84 6029.68 6034.85 -1500.00 -20000.00 -5000.00 296.43 ------------~--- 82390.'" 80890.64 60890.64 55890.64 56187.07 ANNUAL ANNUAL KIMBERLY MECK RODNEY NESMITH Y-T-D DIVIDENDS: TRUTH IN SAVINGS INFORMATION PERCENTAGE YIELD / 4.75% PERCENTAGE YIELD EARNED / 4.89% 1762.31 -- -- - - - - -- ---- --------- ----- --- -- ---------- ----- ---- .-------- --- -- SUFFIX:11 CHECKING BEGINNING BALANCE DEPOSITS DRAFTS DEBITS/FEES MAINT/SERVICE CHGS ENDING BALANCE ------------~--- 799.03 22057.58 12067.94 .00 .00 10788.67 TOTAL NUMB~R DRAF S CLEARED YOUR AVG DAILY BA ANCE WAS YOUR lOW MONTH SA ANCE WAS 11 5640.05 367.05 0502 050101 SHARE DRAFT ~ 486:/' 0501005221 -20.29 778. 74 0502 050101 SHARE DRAFT 487/ 0501008594 -45.87 732.87 0509 050801 SHARE DRAFT ! 488v' 0508025641 -123.59 609.28 0512 051101 SHARE DRAFT 489/ 0511009231 -20.00 589.28 0515 051401 SHARE DRAFT 484./ 0514016938 -222.23 367.05 051901 SHARE DEPOSIT V 548.00 915.05 051901 TFR FROM SHARES 82662-05/ 1500.00 2415.05 052101 TFR FROM SHARES 82662-05/ 20000.00 22415.05 J 0523 052201 SHARE DRAFT /I 490./ 0522010717 -228.06 22186.99 0525 052401 SHARE DRAFT /I 495/ 0524008436 -5400.00 16786.99 0526 052501 SHARE DRAFT II 494.""""- 0525009357 -5920.00 10866.99 NOTICE: SEE RFVJ:J:lCE: t:"1"~ ...";'PIl. .....................i...:..........."..A'TJ"..:. ,: .' ~~t!.\!i1~~r 76 SEND AlL INQUIRES TO THE CREDIT UNION AT THE ADDRESS SHOWN ON PAGE # ~ :!i~!:!:::!:_I:II~!:ii::i: :~i:i:it~!ii:~!:f~iij!:~i:i!ii:!!::i! 1!i:~!:!!:::!!:~ji:!j::~!:iiii!jiii:!ii:!:!; !!!!!!:i!iiiii:lli!1!iii!iii!iit 8 2 6 6 2 05 -0 1 -0 1 05 - 3 1 -0 1 2 of 2 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * CERT NO: 0 ISSUE DATE: 100300 MATURITY DATE:1003 1 DIV RATE: --- ----- ------------------------------------------------------- ------------ SUFFIX:~O 1 YEAR CERTIFICATE 053101 DIVIDEND 67.30 JOINT OWNERS: KIMBERLY MECK RODNEY NESMITH Y-T-D DIVIDENDS: 343.99 F RFEITURES: TRUTH IN SAVINGS INFORMATION ANNUAL PERCENTAGE YIELD / 5.80% ANNUAL PERCENTAGE YIELD EARNED I 5.80% NO. AMOUNT NO. AMOUNT NO. 48 222.23 488 123.59 491 *48 20.29 489 20.00 492 48 45.87 490 228.06 493 JOINT OWNERS: KIMBERLY MECK RODNEY NESMITH Y-T-D DIVIDENDS: TRUTH IN SAVINGS INFORMATION ANNUAL PERCENTAGE YIELD . / 2.02% ANNUAL PERCENTAGE YIELD EARNED / 2.02% SUFFIX:16 IRA 12 MONTH CERTF 053101 DIVIDEND Y-T-D DIVIDENDS: TRUTH IN SAVINGS INFORMATION ANNUAL PERCENTAGE YIELD / 6.80% ANNUAL PERCENTAGE YIELD EARNED I 6.80% { '~..' AMOUNT 29.77 39.02 19. 11 NO. 494 495 TOT A L : AMOUNT - 5920.00 - 5400.00 - 12061.94 9.58 128"98.49 720.30 129218.79 3471.13 F RFE/TURES: .00 6.6000 1"02".80 14092. 10 .00 CERT NO: o ISSUE DATE:040901 MATURITY DATE:0409 2 DIV RATE: 5.6500 FOR 2001 * IRA YTO DIVIDENDS 3471.13 * OTHER YTD * TOTAL YTO * TOT L YTD * TOT L YTD * DIVIDENDS DIVIDENDS WITH OLDING FOR EITURES 2122.72 5593.85 .00 .00 IV lembers 1- Mechanicsburg, PA 17055 www.members1st.org :'EDERAL CREDIT UNION Main SwitchbOllfd: (717) 697-1161 or (800) 283-2328 , Call-24: (117) 697-4372 or (800) 283-4372 , > '0: (717) 697-5312 or (800) 283-2328 ext. 5312 .eBranch: (117) 795-6049 or (800) 237-7288 ::ilatemem of Account 82662110-01-01 I 11-30-0111.. of 2,1 HAPPY HOLIDAYS FROM MEMBERS 1ST FEDERAL CREDIT UNION. 1...111.1.111....1.1..1.1..1.111.1..1..1.1...111.. .1. ..11,1.11 995 SHIRLEY L NESMITH C/O RODNEY NESMITH AND KIMBERLY MECK 607 WAYNE DR MECHANICSBURG PA 17055-4987 SUFFIX:OO SAVINGS 25.00 JOINT OWNERS: KIMBERLY A MECK RODNEY NESMITH Y-T~D DIVIDENDS: 32.08 TRUTH IN SAVINGS INFORMATION ANNUAL PERCENTAGE YIELD / 2.00% ----------------------------------------------------------------- SUFFIX:ll CHECKING BEGINNING BALANCE DEPOSITS DRAFTS DEBITS/FEES MAINT/SERVICE CHGS ENDING BALANCE ---------------- 8680.49 14 31 .00 8694.80 .00 .00 TOTAL NUMBER DRAF S CLEARED YOUR AVG DAILY BA ANCE WAS YOUR LOW MONTH BA ANCE WAS o 6406.34 .00 103101 DIVIDEND 111501 SHARE DIVIDEND 111501 SHARE WITHDRAWAL 10.98 3.33 -8694.80 8691.47 8694.80 .00 *****~********************************* t**** JOINT OWNERS: KIMBERLY MECK RODNEY NESMITH Y-T-D DIVIDENDS: TRUTH IN SAVINGS INFORMATION ANNUAL PERCENTAGE YIELD I 1.00% ANNUAL PERCENTAGE YIELD EARNED I 1.34% 99.88 Y-T-D DIVIDENDS: TRUTH IN SAVINGS INFORMATION ANNUAL ,PERCENTAGE YIELD I 3.55% ANNUAL PERCENTAGE YIELD EARNED I 3.65% 7139.67 47.77 366.41 380. 10 F~RFEITURES: ------------..--- 132093.05 132140.82 132507.23 132887.33 ----------------------------------------------------------------- SUFFIX:16 IRA 12 MONTH CERTF 100301 DIVIDEND AT MATURITY 103101 DIVIDEND 113001 DIVIDEND .00 CERT NO: 0 ISSUE DATE:l00301 MATURITY DATE:1003t 2 DIV RATE: 3.4900 ----------------------------------------------------------------- ---------------- I. ..III.. .111....1.1..1.1..1..11.1. .1. .1.1. 11111.. .1. ..11...11 SHIRLEY L NESMITH & RODNEY L NESMITH JT TEN WRGS 607 WAVNE DR MECHANICSBUR6 PA 17055-4987 J',,~~':'.'. ~ '..~,-; THNanguaItbouR 1i'ade date Tr'ansactlon Balance on 12/31/2000 1/31 Income dividend 2/28 Income dividend 3/30 Income dividend Balance on 3131/2001 ,,~..,~,',~..:t.. .. _h _. _ '~_'. _.". -~,b___".,;.~.:', ~.-.....4, .,' ;...,""......, .,.....".,.,....,~:._;.'-<_~).l."....,.~;c.:....<~......".J'.,.:.i:,.,~~~......-.....:.-..;.I:'"'i"..,t..~~,;.,.".....,~. . ,~;,"'H.c;r;; N~';~.''''''''''-~ ....,..> -, .. _.. . March 31~ 2001, year-to-date Page 1 o.f 1 'Vanguard GNMAj!und- . Investor Shares . .--', ,',: ---"-,,,-,,,,,"'~';;""'''''_.;...', For promt>t service when calling please provide your Statement number: 008995846 (800) 662-2739 - Client Services www.vanguard.com Access Vanguard (800) 662-6273 - Tele-Account Fund number: 36 Account number~ 9910940484 ACCOUNT VALUE On 12/31/2000 $ 3,667.45 On 3/3112001 $ 3,788.13 Dollar afT1OlJ"lt Share price $10.24 10.35 10.35 10.35 $10.35 Total shares CMned 358..149 360..131 362..f)99 364..071 364.071 Shares transacted $ 20.51 20.37 20.41 1.982 1.968 1.972 Income dividends $ 3,n3.26 10.36 '. , "1'.... ( 'f':J (~ ~~ ,,~ \0'" r . ~ 1', \ .~. h\)\ . ~ ~ ~\J . ~\ V . .~ 'V \" ,,-. .... $ 61.29 Total cost basis on 3/31/2001 Average cost per share INVEST-BY-MAIL Do not alter this slip. Use olltf to purchase additional shares in: Vanguard GNMA Fund Investor Shares Fund number: 36 Account number: 9910940484 Make checks payable to: The Vanguard Group - 36 Ust each check separat~. Total amount enclosed $ $ $ $ 0036 0"]'0940484 3D 30-day Share Trade Dis1ribution yield price date payable date January 6.53% $10.32 1/30/2001 2/01/2001 February 7.08 10.33 2/27/2001 3/01/2001 March 6.44 10.33 3/29/2001 4/02/2001 SHIRLEY LNESMITH & RODNEY L NESMITH JTTEN WAOS 607 WAYNE DR MECHANICSBURG PA 17055-4987 o Check box if changing your address; note new address on reverse. ~. THE VANGUARD GROUP PO BOX 7800 PHILADELPHIA PA 19101-9892 1- 3 1 - 1 3655 l04B M1 ~ 113801 1111111111111 1111111111111111111111111111111111111111118 111111111111 COMMONWEALTH OF PENNSYLVANIA IN~ERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Shirley L. Nesmith FILE NUMBER This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE ATTACH A COPY OF THE DEED FOR REAL ESTATE. 1. Individual Retirement Account at Members First $128,963.20 100% None ,. $128;963.20 2. Annuity with survivor benefit up to ten year certain term (see attachment) $5,656.00 100% None $5;656.00 3. 1970 Honda 175 Motorcycle $250;00 100% None $250:00 TOTAL (Also enter on line 7. Recapitulation) $134,869.20 (If more space is needed, insert additional sheets of the same size) Copyright 2000 David James Thorpe, Esq. COMMONWEALTH OF PENNSYLVANIA IN~ERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Shirley L. Nesmith Debts of decedent must be reported on Schedule I. ITEM NUMBER FILE NUMBER DESCRIPTION AMOUNT 1. $5,920.00 A. B. 1. 2. 3. 4. 5. 6. 7. FUNERAL EXPENSES: Myers Funeral Home ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attorney Fees - Rupp and Meikle Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent $6,310.00 Probate Fees - Register of Wills of Cumberland County $355.00 Accountant's Fees - Smoker & Smith $1,541.00 Tax Return Preparer's Fees Filing Fees $35.00 TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) $14,161.00 Copyright 2000 David James Thorpe, Esq. ~_ il,;,~;:a'd ,,' excellenefi. 'Ce.tml pennsyl"..", since J 910 -2J Y U ;lei v Funeral Home, Inc. STATEMENT OI~ FUNERAL GOODS AND SERVICES SELECTED Ch~ are onl)' for th'..se items Ihal you selected or that arc required. If we arc required by law or by a ccmetCll or crematory iO use any items, we will explain in writing b\;iow. . \ . . . . . If )'00 selected a funeral that may require embalmmg,yiUch as a fUIICnl wnb viewing. you may have to pay for cmbalmmg. You do not have to pay for embalming )'00 did not apprO\'e if you selected arrangementS sUCh as a direct cremado or imtne1iale burial. If we cbused for embalming, we will tlIplain why below. For the Servic f - t. Z . Jlatc of Death S'" - 2. I - "'Z.a () J <:hargelo: L. '. 1-1 11/8 L;.s'~,..,.~ ~F.. j'l/tec-/-fA..wt.s l...~r: ,.{ City State ' Omer clOthing BOYD L. MYERS, JR., Supervisor 37 E. MAIN STREET MECHANICSBURG. PENNSYLVANIA 17055 (111) 166-3421 A. CHARGE fOR SERVICES SELECTED: I. PROfESSIONAL SERVICES Services of funeral Director/Staff .... S ~ Embalming ...... ........ S~ Other preparation of body I- S_ Cremation urn . . . . . . . . .. . . . . . . . .. S_ (lkscription) S_ S_ _ S_ Z6!:i1U TOTAl.MOCHANDISI SELECTED.................. B 1_ . C. SPEOAL CHARGES: forwarding of rcmaiRs to OTHER .................... S~ SUB-TOTAL OF PROFESSIONAL SEaVlCES......... AI S~. 2. fACILITIES AND SERVICES Use of facilities and services for viewing (VisitationIWakc)......... s~ Use: of facilities and services fodunerai ceremony . . . . . . . . . . .. ~ Use of facilities and services for McmorialScrvice ............... ~ Use: of equipment and services for gnvcsidc service... . ......... s~ Other use of facililies (funenl Home) Rtcciving of rcmail1$ from (Funeral Home) Immediate Burial .. _ _ . .. .. .. . .. ... S Direct Crcmation . . . . . . . . . . . . . . . .. S S SUB-TOTAL OF SPECIAL CHARGiS .. . . . . . . . . . . . . .. C I--=-" D.CASH ADVANCED Opening Grave... : ......... ..... I~ Cemettry Equipment.. . ... . . . . . . .. I-=- Lot and Deed.... .-_.... ;........., S~ Nn-spaper Noticcs-l.ocal ......... ,~ Newspaper Notices-Cut-of-town. . . . s_ Telephone & Ttlc8r:11D5 ........... S-==--. Airfare.. . . . _ . . _ . . . . . . . . . . . . . . .. S-=-- Ckr&Y~ Offering.............. S'Z.s-:CII Pallbearers. . . . . . . . . . . . . . . . . . . . .. S_ Certified Copies of tlae lkath Certificate.... .~~.!it. .~.~..... ,~ PoIicc Escort. . . . . . . ... . . . . . .. . .. ,_ FIOwct5 ........................I~-~ Vault Service ChatJc ... . . . . . . . . . . . S~ L'~,&....s ,~ I- I- S_ 1- SUB-TOTAL OF ADVANCES.......... ~~..... D ;"3YS'.~ SUB-TOT~i OF FAc~unESiiQUi~ ~~ .~. . .. A~ 3. AUTOMOTIVE EQUIPMENT Vehicle to transfer remains to Funeral Home. L. Local. . . .. . . . . . . . . . . . . . . . . . . . . .. ,~ :: .(C~~t. ~~~c~). . . . . . . . . . . . .. I~ Umousinc -.... L Local........................... I~ Family car Local. .. . .. . . . . . . . . . . . . . . . . . . . .. S--===--' Flower car or floral disposition Local.... ....................... ~ Lead car/clcrJy car .7"' 'r Local. . . . . ./J[.G.--:-.(4A.IqUi;.. ~ Car for pallbearers Local........................... I-=- Out of town Innsponation' . . . . . . . . . ~ I-=-- S-=- -r. .1 SUB-TOTAL OF AUTOMOTIVE EQUIPMENT........ A~ TOTAL OF PROFESSIONAL SERVICES, FACILITIES AND AUTOMOTIVE EQUIPMENT . .. .. .. .. . . . .. .. .. . . .. . . . . . . . . . . .., A We charJc you fO( our sc:nices in obtaining; (specify ctlSb advances thaI ani marked-up) _ ~....,c"' I v "'-"'- B. CHARGE FOR MERCHANDISE SELECTED: Caskel.......................... s~ D' (Descriplion) jf'*i ~ L~&1 . /4"SIr Other Receptacle . . . . . . . . . . . 1_ (Description) 13S~ . SlJMJIAKY OF CHARGES A. Professional Services. Facililies and E~pment. and AutOfJlOlh'e . S2,S:"'aw Equipment .. .. .. .. .. .. .. .. .. . ... ~ . B. ~rchandise.... .. . . .. .. . .. .. .... ~. AV 'C. SpccialCharges .... ....... ....... S~ O. Cash A~vances................... S:r:LL-1DiI c.-'2o.~ TOTAL OF ALL SEC1'IONS. . .. . . .. .. .. . .. .. . . . . ... ~ . PAID AT TIME Of OR PRIOR TO' . . ' -0 - AIlKANGEMENTS. . . . '-,0;.; ~c.f;I.. . ./ 'f i:;) '/ /.. 1m ufJ BAlANCE DUE. . .. . ~~-:-....~ . .. ..,.. . . . ":1. ~J. 'f. . . S ' ~ REASON FOR EMBALMING -. S- 'l:.l..-o I ~ '2>><- v (.. .""e- If any aw. cemetery, or crnnatory requirements have required the p of any ?f the items listed abuve lhe law or requirement is explain below. Outer burial container............. I~ (Descriprion) Acknowledgemcot cards ....:~. .".'''. ~ Regisler book(s) . . . . . . . . . . .. s~ Memory folders. . . . . . . . . . . . . _ S~. Pra)'er cards. . .. . . . . . . . . . . . . . .. s---i.i..- Temporary grave marker........... I~ Burial clothing... . .,. . . .. .. ..... . S_ agree that I have examintd the: items of 10005 and services sclected above and found the:m to be correct and according to the an:angements I have rcqllC5led. I acknowledge :ccipl o.f a copy of Ihis Statement of functal Goods and ScrviQl$ SeleCted. I reprcscntthall bave sufficient funds :JY;Jilablc for ll2yment of tbe cash price for lhe goods ~d scn'lces sclCCled. I also agree to make payment of S~N fV"- within 7 () days. I allree to be ~)intly and severally liable with an)'one ebe who IDS below. A laIr cha e of mon amounting to I 1.--"'Zu per year will be appliro to tbe unpaid balance beginning ;;> I days om lhe date of lhis men ill Iso to the F tal Director all reasanable COSts paid by the Funeral Director to collcct amounts I owe under this agrermcnl. Ilosc C~IS may . a s. c "COSIS and her COSts. An)' additional services or merchandise urderro or requesced afll:r lbe date of Ihis agrcemcRl will . 'COllSl red a8re t and he: tOSI Iher will be reRected on tbe final bill or 5latemcm. :-~I S- ~ L. 2.. . 2- -.. I ( , (Purchaser} WI liTE .' FuftCral DilCl:IUf ,.. COMMONWEALTH OF PENNSYLVANIA . . 114l-tERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER ESTATE OF Shirley L. Nesmith Include unreimbursed medical expenses. ITEM NUMBER 1. 2. 3. 4. 5. 6 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. DESCRIPTION AMOUNT PP&L $288.33 Verizon $131.47 April Health Care $68.77 M Yohn - taxes - real estate - $1,036.70 and taxes - $288.06 $1,324.76 Smith Radiology $10.00 Hartford Home Insurance $330.86 Comeast $148.85 Upper Allen Township - sewer $28.44 Hartford - ear insurance $46.54 Bank fee to open account $25.00 Susquehanna Surgeons $89.14 Andrews & Patel $185.97 World Painting $970.00 Home Depot $25.30 Rod Nesmith $92.67 Montour Oil Company $358.64 Mountz Jewelers $80.00 Potteger's Auction $241.08 Repairs $1037.00 Home Paramount $40.00 TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) $5,522.82 Copyright 2000 David James Thorpe, Esq. COMMONWEALTH OF PENNSYLVANIA . ' I IMiERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Shirley L. Nesmith FILE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1. Rodney Nesmith, 1118 W. Lisbum Rd., Mechanicsburg, PA 17055 Son 25% ofremainder 2. Kim Meek, 431'SAURY Rd., Dillsburg, PA 17019 Daughter 25% of remainder ~~~'f 3. Matthew Nesmith, 1118 W. Lisbum Rd., Mechanicsburg, PA 17055 Grandson Share 0150% of remainder In Trust and 2 rings 4. Holly Meek, 43 TS"'I'A)I Rd., Dillsburg, PA 17019 Granddaughter Share of 50% of ~,ueR't remainder in Trust and ring 5. Katie Meek, 43 ~ Rd., Dillsburg, PA 17019 Granddaughter Share of 50% of ~~~'f remainder in Trust and 2 rings 6. Ben Meek, 43 Tarnrny Rd., Dillsburg, PA 17019 Granddaughter Share of 50% of remainder in Trust --J~~'f and 2 rings ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. INUN- I:: IIIUN::>: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $0.00 (If more space is needed, insert additional sheets of the same size) Copyright 2000 David James Thorpe, Esq. 01-29-2007 NESMITH 05-21-2001 21 01-0510 CUMBERLAND 101 APPEAL DATE: 03-30-2007 ( See rellerse side under Objections) A.ount Re.ittedl I MAKE CHECK PAYABLE AND REMIT PAYMENT REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 2B0601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE. OF lI'lHERITANCE TAX 'APP~Ai$~t:tE:'~T,'!~[LOWANCE OR DISALLOWANCE ~F DEDUCTIONS ~D ASSESSMENT OF TAX 2001 FES - 2 Pli 12: 3~:~~TE OF DATE OF DEATH FILE NUMBER COUNTY ACN CLERK OF ORPHi\N'S COURT CUtF"'~':" 'I' FY\ RICHARD C RUPP ESQ RUPP & MEIKLE 355 N 21ST ST STE 205 CAMP HILL PA 17011 - REV-1547 EX AFP (06-05) SHIRLEY L TO: ~~!_~~~~~_!~!~-~!~~------~---~~!~!~-~~~~~-~~~!!~~-~~~-!~~~-~~~~~~~--~-------------------- REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF NESMITH SHIRLEY L FILE NO. 21 01-0510 ACN 101 DATE 01-29-2007 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. 3. 4. 5. 6. 7. 8. (1) (2) (3) (4) (5) (6) (7) Stocks and Bonds (Schedule B) Closely Held Stock/Partnership Interest (Schedule C) Mortgages/Notes Receivable (Schedule D) Cash/Bank Deposits/Misc. Personal Property (Schedule E) Jointly Owned Property (Schedule F) Transfers (Schedule G) Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: (9) ClO) 9. 10. 11. 12. 13. 14. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) Debts/Mortgage Liabilities/Liens (Schedule I) Total Deductions Net Value of Tax Return 100,500.00 85,679.81 .00 .00 11,220.42 34,126.58 134,869.20 (8) 14,161. 00 5.522.82 Cl1) Cl2) Cl3) Cl4) Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) Net Value of Estate Subject to Tax If an assess.ent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ~ returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due R I S: P YM NT DATE 08-20-2001 Cl5) .00 X DO .00 Cl6) 346,712.19 X 045 = 15,602.05 Cl7> .00 X 12 = .00 Cl8) .00 X 15 = .00 Cl9)= 15,602.05 AMOUNT PAID 15,000.00 NOTE: T R CEIP NUMBER CD000176 (+ PAID (-) 780.10 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 366,396.01 19.&R3.R? 346,712.19 .00 346,712.19 TOTAL TAX CREDIT 15,780.10 BALANCE OF TAX DUE 178.o5CR INTEREST AND PEN. .00 TOTAL DUE 178.05CR (i ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE " '--'. ,~- ,-~ INHER1TANCE TAX ~EtrlRDADJUSTMENT JOINTLY HELD OR TRUST ASSETS '* BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 2B0601 HARRISBURG PA 17128-0601 I,? (,' '- I I i KIMBERLY A MECK 410 CABIN HOLLOW RD DILLSBURG PA 17019 REV-1604 EX AFP (03-05) ,. ":,,PATE I' (-ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 01-30-2007 NESMITH 05-21-2001 21 01-0510 CUMBERLAND 209-28-9239 01137846 L SHIRLEY Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +- REV-1604 EX AFP (03-05) -- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 01-30-2007 ESTATE OF NESMITH SHIRLEY CUMBERLAND L DATE OF DEATH 05-21-2001 F I L E NO. 21 01 - 0510 ADJUSTMENT BASED ON: COUNTY S.S/D.C. NO. 209-28-9239 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACN 01137846 ACCOUNT NO. 82662-11 TYPE OF ACCOUNT: () SAVINGS (X) CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 07-14-1997 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.166 .00 .00 .00 .45 .00 TAX CREDITS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE 00 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) c;J BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRIS8URG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS *' REV-1604 EX AFP (03-05) RODNEY L NESMITH 1118 E LISBURN RD MECHANICSBURG PA 17055 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 02-02-2007 NESMITH 05-21-2001 21 01-0510 CUMBERLAND 209-28-9239 01137847 SHIRLEY L Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS ~ -----...--------.......------------------------.......---------------------------------------------------------------------------------....--------------------- REV-1604 EX AFP (03-05) __ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS -- DATE 02-02-2007 ESTATE OF NESMITH SHIRLEY L DATE OF DEATH 05-21-2001 COUNTY CUMBERLAND FILE NO. 21 01-0510 ADJUSTMENT BASED ON: S.S/D.C. NO. 209-28-9239 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 01137847 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 82662-11 TYPE OF ACCOUNT: () SAVINGS (X) CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 07-14-1997 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.166 .00 .00 .00 .45 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE nn * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), vnll M4V RI" nlll" 4 R"'I"UND_ S"'''' R"'VERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 2B0601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS '* REV-1604 EX AFP (03-05) KIMBERL Y A MECK 43 TANNERY RD DILLSBURG DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 02-02-2007 NESMITH 05-21-2001 21 01-0510 CUMBERLAND 209-28-9239 01137848 SHIRLEY L Amount Remitted PA 17019 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +- ------.---..----....----...-.....---------------------------------------.----.----.......-----------------....------------------------------------------------- REV-1604 EX AFP (03-05) -- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 02-02-2007 ESTATE OF NESMITH SHIRLEY L DATE OF DEATH 05-21-2001 COUNTY CUMBERLAND FILE NO. 21 01- 0510 ADJUSTMENT BASED ON: S.S/D.C. NO. 209-28-9239 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 01137848 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 82662-05 TYPE OF ACCOUNT: (X) SAVINGS () CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 07-14-1997 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.166 .00 .00 .00 .45 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE nn * IF PAID AFTER THIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ ( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS *' REV-1604 EX AFP (03-05) RODNEY L NESMITH 1118 E LISBURN RD MECHANICSBURG PA 17055 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 02-02-2007 NESMITH 05-21-2001 21 01-0510 CUMBERLAND 209-28-9239 01137849 SHIRLEY L Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS 4- --------..............--....--...-----.------------------------...-...-----------------...--------------------------------------------------....--------------- REV-1604 EX AFP (03-05) -- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 02-02-2007 ESTATE OF NESMITH SHIRLEY L DATE OF DEATH 05-21-2001 COUNTY CUMBERLAND FILE NO. 21 01-0510 ADJUSTMENT BASED ON: S.S/D.C. NO. 209-28-9239 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 01137849 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 82662-05 TYPE OF ACCOUNT: (X) SAVINGS () CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 07-14-1997 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.166 .00 .00 .00 .45 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE nn * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~~_ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRIS8URG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS '* REV-1604 EX AFP (03-05) KIMBERLY A MECK 43 TANNERY RD DILLSBURG DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 02-02-2007 NESMITH 05-21-2001 21 01-0510 CUMBERLAND 209-28-9239 01137850 SHIRLEY L Amount Remitted PA 17019 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS of- ...........-----------..------.--------..---....-------------....----------.---....--------.----------.-----------------.-.-----------...-----.-----...--------- REV-1604 EX AFP (03-05) -- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 02-02-2007 ESTATE OF NESMITH SHIRLEY L DATE OF DEATH 05-21-2001 COUNTY CUMBERLAND FILE NO. 21 01-0510 ADJUSTMENT BASED ON: S.S/D.C. NO. 209-28-9239 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 01137850 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 82662-40 TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST (X) TIME CERTIFICATE DATE ESTABLISHED 07-14-1997 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.166 .00 .00 .00 .45 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE nn * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) 0. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 2B0601 HARRISBURG PA 1712B-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS *' REV-1604 EX AFP (03-05) RODNEY L NESMITH 1118 E LISBURN RD MECHANICSBURG PA 17055 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 01-30-2007 NESMITH 05-21-2001 21 01-0510 CUMBERLAND 209-28-9239 01137851 SHIRLEY L Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +- ........-..-..---.------------..-----..-...-----------------------.------------.----------------...---------------------------------------- REV-1604 EX AFP (03-05) -- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 01-30-2007 ESTATE OF NESMITH SHIRLEY L DATE OF DEATH 05-21-2001 COUNTY CUMBERLAND FILE NO. 21 01-0510 ADJUSTMENT BASED ON: S.S/D.C. NO. 209-28-9239 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 01137851 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 82662-40 TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST (X) TIME CERTIFICATE DATE ESTABLISHED 07-14-1997 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 14,068.22 0.166 2,344.75 .00 2,344.75 .45 105.51 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) (AJ REV-1470 EX (6-88) '* INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME Shirley L. Nesmith FILE NUMBER REVIEWED BY Joan Peters ACN 2101-0510 01137846,01137847, 01137848,01137849, 01137850,01137851 ITEM SCHEDULE NO. EXPLANATION OF CHANGES The above referenced Account Control Number has been adjusted to zero since the joint bank account was reported on the Inheritance Tax Return. ROW PaQe 1 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO lOX 210'01 HARRISIURG PA 17121-0'01 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE (\I[!(,:: (iNHERITANCE TAX '\..,., i II I,i. ,: <. ',~T~TEMENT OF ACCOUNT * REV-l'07 EX AFP (03-05) 2007 MAR -5 PY'l I: 21 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-20-2007 NESMITH 05-21-2001 21 01-0510 CUMBERLAND 101 SHIRLEY L RICHARD C RUPP RUPP & MEIKLE 355 N 21ST ST CAMP HILL CLEI1;< OF ORPHA,N'S COLJRT E~!! !."'r~". 1:',", r" ~!i\':.';., -':.', r</-i, STE 205 PA 17011 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: CUT ALONG THIS LINE NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 REV-1607 EX AFP (03-05) --------------------------------------------------------------------------- ... RETAIN LOWER PORTION FOR YOUR RECORDS +- *** INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF NESMITH SHIRLEY L FILE NO. 21 01-0510 ACN 10 1 DATE 02-20-2007 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FI8URE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-22-2007 PRINCIPAL TAX DUE: 15,602.05 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-20-2001 CDOOO176 780.10 15,000.00 01-29-2007 REFUND .00 178.05- TOTAL TAX CREDIT 15,602.05 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN tl, 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. ) q