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Home My WebLink About01-0123 PETITION FOR PROBATE and GRANT OF LETTERS (faNQ.. BD\ (\ .)../. 0 /- I 23 No. To: Register of Wills for the II .(. ,,,p;,cJ:.ased. County of ClJN\bLr~^,~ in the Social Security No. '-\ 33 - 'fL. - ::> ~ ~ ~ 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 executor in the last will of the above decedent, dated 10 hlA~ and codicil(s) dated Estate of Sh",f'le..y also known as named ,19~ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ell'" be.rI4t#J Co.unJ:y, Pennsylvania, with her last family or princ!pal residence at 3(!)2. Ht>9(!.<g. foWIV /<.Il.." #1~N'€Jbv'lJ ~I?DSD Si/~r 'stp/1N.5 7'~5Jt,P (list street, number and muncipality) Decendent, then 71 years of age, died 2.1 :rANt) AR-y ,.Jilt 2tJO I, at HoLY S13,/i!. , r fIoS~r174L Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: 800 lOOO $ $ $ $ ~ 190 , "00 , WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters TESTAMENTARY theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) ~ '" 'tr u <::: <1) ~";;' "'~ <1) ... a:; <1) <::: -00 c'';:: clj"';::: ~<1) ~~ <1),- ;0 ~ <::: OJ) c;j ~K~ y: CNIfI!.L.R:.S 1<. BALL ~L/\{ TWe..v6. ~s ~I(/~ W/N1'e/l. sffe,l\6.S', It.. 3'Z?oH Lfo7- 32.7- ~Sb'2.. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF CUMBERLAND 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 p titioner(s) a that as pe onal represen- tative(s) of the above decedent petitioner(s) will well a lya ini t ccording to law. VOl 0<;' ::l l:l ..... l:: ~ ~ Sworn to or affirmede;,(., and subscribed { befO'e~ ~ '-tn~I!. , .(1, ~~A.O.Of)fUifI ' , Register 8AI..t... 3Y'I 1W~L Ll6. 01tl1CS ~(Ve. wINT62. ~'N6S I I=L 32708 '107- 3'2. 7- q S""& 'Z- / 0 -::160 - q N 21-01-0123 o. Estate of SHIRLEY JANE BALL , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW JANUARY 30th xx 2001 . 'd' f h . . T9'"_, 10 conSI eratlOn 0 t e petItion on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated MARCH 10, 1987 described therein be admitted to probate and filed of record as the last will of SHIRLEY JANE BALL and Letters TESTAMENTARY are hereby granted to CHARLES R. BALL ~e.~~ CU/I..,rP,a.~/(L.",,/~- , ,~----r RegIster of Wills FEES Probate, Letters, Etc. ......... $ 515.00 Short Certificates(1l) .......... $ 30.00 ~EXTRA.PGS..4... $ 12.00 JCP $ 5.00 TOTAL _ $ 562.00 Filed .J!NJJAE.'l. .3.Q,. 2.QQl............... ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE CALLED EXECUTOR JANUARY 30, 2001, ORDERS GIVEN. This Local is to certify that the information here given is correctly copied from an original certificate of death dul~ filed with Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filIng. WARNING: It is illegal to duplicate this copy by photostat or photograph. me as No. ~~~;<>r - Local Registrar Fee for this certificate, $2.00 p 7175038 JAN 2 2 2001 Date ITEM # ). J 13 SI-IOULl) r~:El\D .AS FOLLOWS: / /.2 Y /.l ()tll ~ ftZ~~r-- Rev 2/87 COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH UNDER' VEAR MonIha Oayt, UNDER , ORt -- -.. SEX 2. F e.ma.le. STAtE FilE NUMBER $OCtAL SECURITY NUMBER NAME Of' DECEDENT IF Irsr. Middle. tall) .. Sh-iA.f.e. AGE (lase 8lr1NJay) J. Ba'u .. 433 - 42 -3253 BlRTHPl..ACi (C"'-' ~ PlACE OF DEATH (Ct>eck 0I'ty 0f'Ie .... .nSlrucltOn$ on other 51081 Stale 01 fcre.gnCounuYI HOSPITAL: (lU-<'n.c." MA I...... ~ ER/Ouq>aI..... 0 7. ~ ':J , ... CITY. BOAO, TWP OF OEATH FACA.ITY NAME (tI noIlf\5MuIIon. gr..e Slreer and numberl Twp ... EMt Pe.n.Y/.J.)bOJto Id. KlNO OF BUSlNESSI1NDUSlRV 000.0 ~lo 71 v... COUNTY OF OEArH .. C umbvr..f.a.n.d DECEDENT'S USUAl OCCUAVION ~-~~"=':::~:i' Il CooHn. Te.a.c.hvr. IlI1.. Se..f.6-Emp.f.otje.d DECEDENT'S MAIlING AIlIlMSS (So..... C..,ITown. _. Z", CodeI DECEDENT'S ACTUAl RESlIlIENCE ISH_ an_soclol .t. MARITAl STRUS._ Nevet Married. Widowed. Diw<cod (Speofy) ... W-<.dowe.d RACE. Ametican 1ndiIIn. BIKk. Whit.. etc. (Spoclyl .8. whUe. SUFMVINQ SPOUSE (If.... 0'''' maKJen name) 302 Hoge.~town. Road Me.c.ha.n.-<.c.~b~g, PA 17.. Slate PA 17050 '711. Cumbvr..f.a.n.d l>d - he in. -' .,..o....__in Si!VPA S~-<.Y/.g Twp. ...... CtIy- PA 17050 17109 171 09 24. 27. MIlT I: Ent., the d....... injuries 01 complicaliona wtIittl ca Lilt ontt ON c:a..... on each Iiine NeD PART n: 0III0r o;gn_ __.....i>uting 10 do.... buI ... ,""""",," tho.-rtying..... aMn .. PART I. ~') L"'>^ Co. '^-Of> r- OUE 10 COR AS A CONSEQUENCE Of): E DUE 10 COR AS A CONSEOUENCE Of): DUE 10 COR AS A CONSEOUENCE Of): WERE AUlOPSY FINDINGS A\Nl.A8LE PRIOA 10 COMPLETION OF CAUSE OF OEArH? _ER OF DEATH Hat",.. ~ o o DATE Of INJURY (MonI1. Day. 'IUf) TlUE OF INJURY INJURY AT 'NQRK' DESCRIBE HOW INJURY OCCURRED. Homicidl o o o PlACE OF INJURY - AI home, tarm, Sir"'. tactol'y. office building. etc. ISpeclfy) .... v.. 0 NeD -... Pending InvnUgllUon Could not be delermtned M. 3OC. N.~ v.. 0 No to Suicide I ~ I .? 1,111 o 2Ie. 2.... CERTifiER ICheck oni't onel -CERTIFYING PHYSICIAN (PhY$lClan Cefltlytng cause d death when anolhet' phYSICIan has plonounce<l de,}jh ana compeIed Item 231 To thebnlo'm,knowledge, de.thoccumtd due 10 Ihe uuse(a)and mllnner a. st8ted. ........ ......... _... 29. .PRONOUNCING AND CERTIFYING PHYStClAN (Physlcran bOth tJf~OCIll9 cJe,t1h .lnd cet1lfytf'IQ 10 cause 01 aealhl To the tae.t D' my knowledge, death occurred.1 the lime, date. and place, and dull 10 the clNM(a) and manner.. ataled.. . ... . . . . . . . . 32. DATE FilED {Month. DaV, 'iean .. 4~,~DC/ LAST WI LL AND TESTAMENT 21-01-123 OF SH I RLEY JA NE BALL I, SHIRLEY JANE BALL, a legal resident of Cumberland County, Mechanicsburg, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this instrument to be my LAST WILL AND TESTAMENT. I hereby revoke any and all wi 11 sand codicils by me heretofore made. I IDENTIFICATIONS AND DEFINITIONS A. I am a widow. I have three (3) children, PATRICIA A. HARTMAN, CHARLES RANDOLPH BALL, and MARILYN L. GARMAN. References in this Will to "my children" include these children and any other lawful children born to or adopted by me. Except as otherwise provided in this my LAST WILL AND TESTAMENT, I have intentionally omitted to provide herein for any relatives or for any other per- son, whether claiming to be an heir of mine or not. B. The following definitions obtain in any use of the terms in this Will: 1. "Descendants" means the immediate and remote lawful, lineal descendants of the person referred to, and it means those descendants in being at the time they must be ascertained in order to give effect to the reference to them, whether they are born before or after my death or of any other person. The persons who take under this Will as Descendants shall take by right of representation, in accordance with the rule of per stirpes distribution and not in accordance with the rule of per capita distribution. Persons legally adopted when under the age of four- teen years shall not be differentiated from blood descendants for any purpose. 2. "Survive me" is to be construed to mean that the person referred to must survive me by thirty days. If the person referred to dies within thirty days of my death, the reference to him shall be construed as if he had failed to survive me. 3. As used in this Will, the words "Executor," "he," "him," "his," and the like shall be taken as generic and applicable to a natural person of either sex or or a corporate person of other legal entity. Page 1 of 4 Pages I I PAYMENT OF DEBTS AND TAXES I direct my Executor to pay the following as soon after my death as may be practicable: 1. All of my just debts and the expenses of my last illness, funeral and of the administration of my estate; but my Executor need not accelerate and pay those unmatured obligations which, in his opinion, it might be proper and more advantageous to retain or renew and pay as they become due and payable. 2. All inheritance, transfer, estate and similar taxes (including interest and penalties) assessed or payable by reason of my death, on any property or interest in my estate for the purpose of computing taxes. My executor shall not require any beneficiary under this will to reimburse my estate for taxes paid on property passing under the terms of this Will. I I I RESIDUARY ESTATE A. I define "my Residuary Estate" as all of my property after the payment of debts and taxes under Article II, including real and personal property, whenever acquired by me, property as to which effective disposition is not otherwise made in this Will, and property as to which I have an option to purchase or a reversionary interest. B. I direct my Executor to divide my Residuary Estate into equal shares and to distribute those shares as follows: 1. one share to each of my Children who survive me; 2. if any of my Children fail to survive me, then his or her share shall be distributed among his or her descendants who survive me; 3. if any of my Children fail to survive me and leave no descendants who survive me, then his or her share shall be divided equally among such of my Children who survive me, or their descendants who survive me, as set forth in subparagraphs 1 and 2 above. Page 2 of 4 Pages IV APPOINTMENT AND POWERS OF EXECUTOR I nominate and appoint my Son, CHARLES R. BALL, 342-48-1937, currently a member of the U.S. ARMY stationed at Fort Meade, Maryland, as Executor of this my LAST WILL AND TESTAMENT. If my Son, CHARLES R. BALL, is unable or unwilling to serve in this capacity, I appoint my Daughter, MARILYN L. GARMAN, 186-56-0411, who is married to Captain ASHLEY W. GARMAN of the U.S. Army currently stationed at Fort Benning, Georgia, to serve instead. I request that my executor be permitted to serve without bond or surety thereon. I authorize my Executor to do any and all things which in his opinion are necessary to complete the administration and settlement of my estate, including full right, power and authority, without the order of any court and upon such terms and under such conditions as my Executor shall deem best for the proper settlement of my estate; to bargain, sell at public or pri- vate sale, convey, transfer, deed, mortgage, lease, exchange, pledge, manage and deal with any and all property belonging to my estate; to compromise, settle, adjust, release and discharge any and all obligations or claims in favor of or against my estate; and to borrow money for the payment of inheritance and estate taxes or for any other purpose. Without in any way limiting the scope of the powers enumerated herein of my executor, I hereby specifically give to him full power to retain any and all securi- ties or property owned by me at the time of my decease whenever, in his absolute and uncontrolled discretion, such a course shall seem to him to be best, without liability for depreciation or loss, and free from investment restrictions incident to execu- torship, whether imposed by common law or statute. In the execu- tion of his duties and powers as Executor he shall have the power to comply with all legal requirements as to the execution and delivery of deeds and all other writings, documents or formalities without the order of any court; and he shall furnish a statement of receipts and disbursements at least annually to each person then entitled to receive income or property from my estate. Page 3 of 4 Pages IN WITNESS WHEREOF, I have at Carlisle Barracks, Pennsylvania, this L~~ day of __~--- 1987, set my hand and seal to this my LAST WILL AND TESTAMENT consisting of four (4) typewritten pages. <> "h _________c...- ~_ (SEAL) S~ E BALL Testator Signed, sealed, published and declared by the Testator, SHIRLEY JANE BALL, as and for her LAST WILL AND TESTAMENT, in the presence of us, who at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. NAME ADDRESS '. tJ;}~ , ----~---------- ~~----- A15!Z~4~I/ft '11}$"~~(--{}-~~, ~ Page 4 of 4 Pages Acknowledgment COMMONWEALTH OF PENNSYLVANIA) SS: COU NTY OF CUMBERLA ND ) I, SHIRLEY JANE BALL, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. (SEAL) and acknowledged before me, by SHIRLEY th i s lY~ day of _~A -c.L. ~ 1987. S~~L~tator------- ~~~-------- RO;:I\l\. ROI1R!GlIEZ. NOTA~Y PlIBlIC A f f i da v i t c^::'" 'j(:hlH!~il. cU'Y.!.lf.ln,';:,:' ~i)IJNTY \";~ \,_~:., ,~;,1...:~)j,)N F\pnaS f,]e,. ',.'?, 1989 Sworn or affirmed to JANE BALL, the Testator, COMMONWEALTH OF PENNSYLVANIA) SS: COU NTY OF CUMBERLA ND ) We, ~~-1&k_L_L~{!.Drt:=_, and _~L1A_J..4 &;qi,/VE4:-___, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as her Last Will; that SHIRLEY JANE BALL signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. "'~;j,:b.;r. f~;:.~:n';,lIj.';.;':^i~" :"]~:;)Jcj.:'::.,,',:H Ji' ~'~t.riarjes Sworn or affirmed to and subscribed to before me by m&fd~J.e~__~_-r~-PlLa nd __{;JOR tA-_Ll,-Gr;u,JJLC~___________ ' witnesses, this ~lb day of __~~e~d______ 1987. ~~q~ ,$-/ - f ~ : J Ii ;j / . ~~ ~----- ~puf:T#p------ (SEAL) ROSA A, RODRIGUEZ, NOTA:lY PUBLIC C^~i.:2l: f.iOfWUGH, CUMBr:RL';.:-<\~ COUNTY I.,'i C(}:.ri,,:;510N EXPIRES OCT. ,:8. 1989 M?ml;,.lr. f'er:nsyl'iania Association of Notaries 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 NO. CD 000396 CHARLES R BALL 344 TWELVE OAKS DRIVE WINTER SPRINGS, FL 32708 ACN ASSESSMENT CONTROL AMOUNT NUMBER -------- fold ---------- -------- 101 I $64,623.58 ESTATE INFORMATION: SSN: 433-42-3253 I FILE NUMBER: 21-2001- 0123 I DECEDENT NAME: BALL SHIRLEY JANE I DATE OF PAYMENT: 1 0/ 1 7 /2001 I POSTMARK DATE: 10/16/2001 I COUNTY: CUMBERLAND I DATE OF DEATH: 01/21/2001 I I TOTAL AMOUNT PAID: $64,623.58 REMARKS: CHARLES R BALL CHECK#109 INITIALS: SK SEAL RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: CHARLES R BALL 344 TWELVE OAKS DRIVE WINTER SPRINGS, FL 32708 -.------ fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: SSN: 433-42-3253 FILE NUMBER: 21-2001- 0123 DECEDENT NAME: BALL SHIRLEY JANE DA TE OF PAYMENT: 12/26/2001 POSTMARK DATE: 12/21/2001 COUNTY: CUMBERLAND DATE OF DEATH: 01/21/2001 REMARKS: CHARLES BALL CHECK#184 SEAL ACN ASSESSMENT CONTROL NUMBER 101 TOTAL AMOUNT PAID: INITIALS: VZ RECEIVED BY: REGISTER OF WILLS REV-1162 EX(11-96) NO. CD 000691 MARY C. LEWIS REGISTER OF WILLS AMOUNT $416.01 $416.01 r s: \A, C:, C --". ~ -- :1.: C -' 'F" 'iT'\ '\ r r;, ..: '.~ "il .. .......... .,<<..... r'.....' "''''" ..~ \ ",,,,,- \},,; C t \""'- 10-> ,,,,; <:. -....J ~ .:..:-.'~ r" Cj v" _.~;:. r ~ "- 1\" ,. ", I ?) v'" ,... --.!.o r L. .J :1~ , + .. r , 8J r 7; ",,* r'~ .... ~Jo " 7, ',..... C I V ._\ I-I r- <;,' f' ," '-_J "t ..-...;. ,,- , ~, ... I \ ,- ED -~1"- \> '", '. '\ ~~ t\'. + '- [G] x - c.. F \' D I" L-..-. L. .J [}] '\~i"~ .,.- . 0 . '.' 0 ~ ~ .. ........1 ',--' 'f" i !i a: . ~o ~ D JI J;; ~ I ~ DIiJ ~ ~ '" CD i i1! o o o i "if E r ~ ~ 9- i J (I) .... o ~ -- o h1 d :b t) t) ::0 m (I) ~. m ! > :; . CD 3 " ~ . D [ ~0 "Dj 3._,~ I " "CD t 1 . ::1 0 ::1' * i ~ "i 1""1 ~ . D "" " i: Ln m m LLJ 3 3 " '2. f i ~ rJl rJl IT" is ir ~ a c c iil iil D:I .... IT" c:: VJ * Addressee Copy LlIbe111-B May 2001 if!i~'.. ~- 51! ~ if i. ... f : ~,: II!.! ' --! .- - --"',,5 ..1'....':. ,.-,W .-,-. .~ ;"iy' /j 7' / I \ <S'~ ';?~ lo... ,b~ O'f 'Y ~ ~ -,{,..,~: ,<::- ~ 1;_~. ::tbh ~ ",,,J ,.),......~ ..>~v l' -!l 00 :tin )i. j) .j :j '. ,tI ~..... I'll '''~- ~f~i~ ~,,!~ ~ :. J~~ ~i i~ II ~5 Ii l~ Ii " . ITI =~ -[11 g~ .~ ~ .. ~ "< A11~ ~ fil c: ..... ~ JZ ~ I ~~ ~ !- 10' ~ :b II ! at a ~ rg. m ~ Q?'b iii ~ 8 3! 2.0 R ~ is: "(j ; ~ cr I~ s,8 ~~ fo tD ~ at" 7' ~~ at) ~~ I\)N I .~ ~'!!4 ...~ ... 6- - CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: SHIRLEY JANE BALL Date of Death: January 21st, 2001 Will No. 2001-00123 PA No. 21-01-0123 To the Register: I certify that notice of estate administration required by rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above captioned estate on January 31st, 2001: Patricia A. Hartman 1602 Bailey Avenue Chattanooga, TN 37404 '~Q~wJDwJ---- \\bdo\ , .. Signature: Date: Marilyn L. Garman 302 Hogestown Road Mechanicsburg, PA 17055 Signature: '\<\o~1.~. J:lo~ Date: \\~\\D\ Notice has now been given to all persons entitled thereto under Rule 5.6(a). Date: t1r "lbD/ Signature: ~~~ Name (print): t!/I"'R~. ~ &tL Address: 344 Twelve Oaks Drive Winter Springs, FL 32708 Telephone: 407-327-9562 ;-',J , , Capacity: Personal Representative IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you receive any money or property will be determined wholly or partly by the decedent's will. If the decedent died without a will, whether you receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, CARLISLE, PA In re Estate of Shirley Jane Ball, deceased, Estate No. 2001-00123 SHIRLEY JANE BALL Late of: 302 Hogestown Road Mechanicsburg, PA Silver Spring Township To: Marilyn L. Garman 302 Hogestown Road Mechanicsburg, PA 17055 Please take note of the death of the decedent and the grant of letters to the personal representative named below. Charles R. Ball The decedent SHIRLEY JANE BALL died on 21st day of January 2001 at Holy Spirit Hospital, East Pennsboro Township, Cumberland County. The Decedent died testate (with a Will) . The personal representative of the Decedent is Charles R. Ball 344 Twelve Oaks Drive Winter Springs, FL 32708 Phone: 407-327-9562 The will has been filed with the office of Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, FA 17013. Phone No. 717-240-6345. A copy of the Will may be obtained by contacting the Register of Wills and paying charges for duplication. Date: 31 ~2Po/ ;'"j J . <-.." (:::J :--:~ Signature: Name (print): Address: Telephone: ~/P elfllRLGS /. LlAtL 344 Twelve Oaks Drive Winter Springs, FL 32708 407-327-9562 Capacity: Personal Representative IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you receive any money or property will be determined wholly or partly by the decedent's will. If the decedent died without a will, whether you receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, CARLISLE, PA In re Estate of Shirley Jane Ball, deceased, Estate No. 2001-00123 SHIRLEY JANE BALL Late of: 302 Hogestown Road Mechanicsburg, PA Silver Spring Township To: Patricia A. Hartman 1602 Bailey Avenue Chattanooga, TN 37404 Please take note of the death of the decedent and the grant of letters to the personal representative named below. Charles R. Ball The decedent SHIRLEY JANE BALL died on 21st day of January 2001 at Holy Spirit Hospital, East Pennsboro Township, Cumberland County. The Decedent died testate (with a Will) . The personal representative of the Decedent is Charles R. Ball 344 Twelve Oaks Drive Winter Springs, FL 32708 Phone: 407-327-9562 The will has been filed with the office of Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, PA 17013. Phone No. 717-240-6345. A copy of the Will may be - obtained by contacting the Register of Wills and paying charges for duplication. Date: 81rzPfJ1 t$d ~d Signature: Name (print): ellAtPLCS tf. tfllLL Address: 344 Twelve Oaks Drive Winter Springs, FL 32708 Telephone: 407-327-9562 Capacity: Personal Representative ;:...:' , 1",..J /b-;2LJb- 9 '\ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ";C of \ ,]\\\S . BUREAU OF INDIVIDUAL TAXES IMHE~ITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 Recorded Rer':sto" ,~;,....\,. DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 12-17-2001 BALL 01-21-2001 21 01-0123 CUMBERLAND 101 '01 me 27 A10 :10 CHARLES R BALL 344 TWELVE OAKbg~v' WINTER SPRINGS Cut~b~~J.~' PA *' REV-1547 EX iFP 1l2-DDI SHIRLEY J Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=is4f-EX-AFP-li2'=oOY-NoYicE--OF-YNHEifiiANCi-YAitAPPRAisEMENT~--Ai'rOWANci-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BALL SHIRLEY J FILE NO. 21 01-0123 ACN 101 DATE 12-17-2001 TAX RETURN WAS: ) ACCEPTED AS FILED ( x) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedula A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) 119,700.00 1,137,463.06 .00 .00 216,517.43 .00 .00 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of Abb returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxabla at Collateral/Class B rate (18) 19. Principal Tax Due C EDITS: A E T DATE 10-16-2001 NOTE: T ECEI T NUMBER CDoo0396 INTEREST IS CHARGED THROUGH 01-01-2002 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM 26.296.40 2.220.56 (11) (12) (13) (14) (9) (10) .00 X 1.445.163.53 X . DO X . DO X AMOUNT PAID 64.623.58 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE (8) DO = 045 = 12 = 15 = (19)= NOTE: To insure proper credit to your account. subllit the upper portion of this forll with your tax paYllent. 1.473.680.49 ?8.1i16 96 1.445.163.53 .00 1.445.163.53 .00 65.032.35 .00 .00 65.032.35 64,623.58 408.77 7.24 416.01 . IF PAID AFTER DATE INDICATED. 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.) REV-1470 EX (6-88) . '* INHERITANCE TAX .. EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME FILE NUMBER Ball, Shirley J. 2101-0123 REVIEWED BY ACN Daniel Heck 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES The value of the charitable bequests has been disallowed. The decedent's Will did not contain a specific bequest to the charities. ROW Page 1 r- '-l~~~~\. ./ J' f'3 \ .~. <\'1" " ..) /" ~_.~ .~~ C,__, -t "\1 >.J . , ~,4' -7/ ~ - - 6 \'::1 l" N Q) ... .... ~ ~ () 0 - .i1CD CD..... - >N ~ "E:C") . --- C ...J 'Ci.f.!LL >-m ca uj ~~O~ mU)~~ -~IlCl) Oca~... CD .c F- CD liO::!c :J.g(7)~ V l: to' d SH!{'/., to ,..... eX) Q)~ ~ ,." CUI :Jew> crT"" .!!}. (f)~ ::> Q)T"" >Q)0<( 006~ :J ~ _ ~O-Q) Q)s:;1::_ (;) 1::0 :J .~ '-:J '- 0)00 CU ~ 0 T"" o~ , , ,j8!JequIIlQ ';' .... '-:->jJa(l 9Z.. J c.l~ 0.., 10. Acll::, I _ ceo ~ ~ -"-, ~ ~ ._- - - 1 -: ~ - -: -: -: - :: .. - ~ -:: - -: .. - -:: - -:: - -:: ~ ~ ~ ~ ~ - - 1 - - -:: ~ ~ - :.~! " :--;' ....: ~ ~: .: .s. ~: ~ ,.. . . -.: '. :\. ~ " /&-;)0(;"--9 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT ..-:,.( .0 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 REY-1U7 EX AFP liZ-DOl Recore of Re~F~rc ,lil:3 .02 JAN 25 P2 :04 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-22-2002 BALL 01-21-2001 21 01-0123 CUMBERLAND 101 SHIRLEY J CHARLES R BALL 344 TWELVE OAKS DR WINTER SPRINGS FL 3{tttbclkJ,;j Amount Rellitted ..~;, , PA MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYIIBnt. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ifiy=i6'ifj-ix-AFP-li'2=ooY------...--iNHERi'i'-ANCE-fAX-STA-fEMENf-OF-AC-coi:itif--.-..--------------------- ESTATE OF BALL SHIRLEY J FILE NO.21 01-0123 ACN 101 DATE 01-22-2002 THIS STATE"ENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE N~ED ESTATE. SHOWN BELOW IS A S~"ARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAY"ENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-17-2001 P R I N C I PAL TAX DUE: u...uu...u..............u........u......u........uu.u.............u...uu.........u........u....uuuu..........uuu...uuuuuu......uuuuuu......uuuu....u.......u...uuu...uuu..... 65,032.35 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 10-16-2001 CDOO0396 .00 64,623.58 12-21-2001 CDOO0691 6.16- 416.01 TOTAL TAX CREDIT 65,033.43 BALANCE OF TAX DUE 1.08CR INTEREST AND PEN. .00 lIE IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 1.08CR SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. J . t c.- Estate Receipt and Release Subject: Estate of Shirley J. Ball Marilyn L. Garman, the undersigned beneficiary of the Estate of Shirley J. Ball, acknowledges receipt of a distribution in the amount of Three Hundred Seventy Three Thousand Eighty Two Dollars and Ninety Eight Cents ($373,082.98) and does hereby: I.Accept and approve the attached accounting of receipts and disbursements for the Estate with the same force and effect as if it had been duly filed and audited in the Probate Court and adjudicated and confirmed absolutely. 2.Agree that if any just and proper claim is hereafter presented to the Executor of the Estate, to be responsible for her pro rata share of the same, up to the amount of her distribution. 3.Release Charles R. Ball, Executor of the Estate of Shirley J. Ball, of and from any and all claims against the said Estate, or the said Charles R. Ball in his capacity as Executor. 4.Declare that this instrument shall be legally binding upon her and upon her heirs and personal representatives. IN WITNESS WHEREOF, I have hereunto set my hand and seal this u? day 0 f"IU!Y\ 0 ;{ 0 O~ swo~ BEFO~E ME ON.LZ.::O~ 200~ xj;,.l J J yJ ArllJa (' } if-V ~~d,~~~ Marilyn L. Garman SSN: 186-56-0411 302 Hogestown Road Mechanicsburg, PA 17050 717-697-5183 NQTAR\Al SEAL GAIL P. STRICKLER. Notary Public Silver Spfing Twp., Cumberland County My Commia$on Expirea Feb. 3, 2003 Estate Receipt and Release Subject: Estate of Shirley J. Ball Charles R. Ball, the undersigned beneficiary of the Estate of Shirley J. Ball, acknowledges receipt of a distribution in the amount of Three Hundred Seventy Three Thousand Eighty Two Dollars and Ninety Eight Cents ($373,082.98) and does hereby: 1.Accept and approve the attached accounting of receipts and disbursements for the Estate with the same force and effect as if it had been duly filed and audited in the Probate Court and adjudicated and confirmed absolutely. 2.Agree that if any just and proper claim is hereafter presented to the Executor of the Estate, to be responsible for her pro rata share of the same, up to the amount of her distribution. 3.Release Charles R. Ball, Executor of the Estate of Shirley J. Ball, of and from any and all claims against the said Estate, or the said Charles R. Ball in his capacity as Executor. 4.Declare that this instrument shall be legally binding upon her and upon her heirs and personal representatives. IN WITNESS WHEREOF, I have hereunto set my hand and seal this zs-p, day of lTvN(L , 200 z. ST ATE OF FL'C1~ J( >=- COUNTY OF lJ The foregoing instrument w~s 25 AC.kno~_b.for. me ttn'Oi Day (fl ~q i 20 ~. By (~QJf. Who is personally known to me or Who has ~reF'~~ (Ty?e off IdenUiication) As Identification and who (did) n t al<e at . d~ Charles R. Ball SSN: 342-48-1937 344 Twelve Oaks Drive Winter Springs, FL 32708-6192 407-327-9562 ()/--:J ~ ViCtoria L.. De Shle1d8 Notary PubIIo. Slate of FlorIda My comm. expires Oct. 28. 2003 Corrvn. No. DO 087683 Estate Receipt and Release Subject: Estate of Shirley J. Ball Patricia A. Hartman, the undersigned beneficiary of the Estate of Shirley J. Ball, acknowledges receipt of a distribution in the amount of Three Hundred Seventy Three Thousand Eighty Two Dollars and Ninety Eight Cents ($373,082.98) and does hereby: 1.Accept and approve the attached accounting of receipts and disbursements for the Estate with the same force and effect as if it had been duly filed and audited in the Probate Court and adjudicated and confirmed absolutely. 2.Agree that if any just and proper claim is hereafter presented to the Executor of the Estate, to be responsible for her pro rata share of the same, up to the amount of her distribution. 3.Release Charles R. Ball, Executor of the Estate of Shirley J. Ball, of and from any and all claims against the said Estate, or the said Charles R. Ball in his capacity as Executor. 4.Declare that this instrument shall be legally binding upon her and upon her heirs and personal representatives. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 20th day of JunQ 7007 ~ . - \ ,( J -~~~-----~- Patricia A. Hartman bl~l~~ SSN: 342-48-3586 1602 Bailey Avenue Chattanooga, TN 37404 423-622-7246 State of Tennessee County of Hamilton Expiration date ~-(2.c)! Estate Summary Worksheet Estate Description Court File Number Estate of Resident at Date of Death Will Personal Representative Address Date of Appointment Date of Notice to Beneficiaries Date of Notice to Creditors The Patriot News Cumberland Law Journal Date of this Summary Account E:x~ Summary Register of Wills of Cumberland County, Pennsylvania 2001-00123 Shirley J. Ball 302 Hogestown Road Mechanicsburg Cumberland County, Pennsylvania, 17050 01/21/01 Yes Charles R. Ball 344 Twelve Oaks Drive Winter Springs, FL 32708-6192 01130/01 01/31/01 2/1/01,2/8/01,2/15/01 2/9/01,2/16/01, 2/23/01 06/09/02 Page 1 Principal Assets Real Estate (Appraised Value) Joint Real Estate Stocks/Bonds (Sale Price) Cash/Notes (As of 1/31/01) Life Insurance to Estate Titled Personal Property 1991 Mercury Wagon Other Personal Property Other Assets Total Assets Adjustments to Asset Values Principal Receipts Income Tax Refunds Dividends Interest Other Total Adjustments Adjusted Principal Balance Value Summary Page 2 $119,700.00 $0.00 $1.135.050.79 $182,127.04 $0.00 $3,500.00 $4,239.24 $3,342.92 $1,447,959.99 $5,478.00 $16,532.72 $15.712.74 $200.00 $37,923.46 $1,485,883.46 Summary Disbursements Court Fees Advertisements Postage Copies/Office Expenses Personal Property Taxes Real Estate Taxes Income Taxes Tax Year 2000 (Form 1040) Tax Year 2001 (Form 1040) Tax Year 2001 (PA Income Tax) Tax Year 2001 (Form 1041) Other Taxes Hazard Insurance Utility Bills Title Transfer Fees Recordation Fees Appraisal Fees Property Disposal Expense Investment Expense Funeral Expenses Monument Costs Last Illness Fees Other Professional Fees Notary Fees State estate/Inheritance Taxes Federal Estate Taxes Living Expenses/allowances Personal Representative Commission Other Expenses Travel Debts Total Disbursements Principal Before Distribution Page 3 $307.50 $101.24 $972.27 $0.00 $476.75 $0.00 $0.00 $845.00 $8,383.00 $4.95 $0.00 $1,235.96 $167.00 $933.00 $300.00 $165.54 $5,028.48 $378.44 $100.00 $65,039.59 $256,022.67 $15,000.00 $1,382.60 $706.52 $357,550.51 $1,128,332.94 Distribution to Beneficiaries/Heirs Amount Charity Patti A. Hartman Initial Payout Second Installment Third Installment Fourth Installment Final Installment Charles R. Ball Initial Payout Second Installment Part of Third Installment Part of Third Installment Fourth Installment Final Installment Marilyn L. Garman Initial Payout Transfer Car to Lyn Transfer House to Lyn Second Installment Third Installment Fourth Installment Final Installment Total Distributions Summary Amount Date $9.084.00 $373.082.98 $100.000.00 03/26/01 $125.000.00 06/13/01 $100.000.00 12/05/01 $44.000.00 04/07/02 $4.082.98 07/01/02 $373.082.98 $100.000.00 03/26/01 $125.000.00 06/13/01 $10.000.00 12/05/01 $90.000.00 12/05/01 $44.000.00 04/07/02 $4.082.98 07/01/02 $373.082.98 $2.700.00 02/21/01 $3.500.00 03/26/01 $119.700.00 03/26/01 $100.000.00 03/26/01 $100.000.00 12/05/01 $43.100.00 04/07/02 $4.082.98 07/01/02 $1,128,332.94 Page 4 ~~~mmmmm~m~~~~~~m~m~mmm~~~o~~o~~~o~~~~~~~~~~~~~~~~~~~~~~ ~~~II~~I~~~~~~~~~e~~i~;o~)>;~~~i~~t~~~t~~~~~~~~~~~~~~~~~~~~~I ~~Ol I ~~I ~~~~~~~~I III~OtD ~~~'~~CII)>~~CII~~~~~~~~~~~~~~~~~~~~~(I) )> .99~~9)>~)>)>)>)>)>~9~~.~tDI)>)>)>)>)> )>)> )>)>)>)>)>)>)>)>)>)>)>)>)>)>)>)>)>)>)>)>)> ~~~~~~~ ~ ~~~co~~ ~~lClC ~ 1C 7t:' o OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO_~______________________~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~m ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~B~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~WW~~W~~W~~~ ~~~~~~~~a~ --~----------------------------oo~~oo~oo8o~ooo~ooooo~o0 o ~ ~ 0 m m mm m 0 Z m x x m ~ ~ ~~ ~ m c ~ ~ ~ ~ ~ ~ ~~ ~ ~ 3 tD~~~~~~~~~~~~~ooooooooog~~~~~~I~~~~~~~~OO~i~~~O~~~~OC~og 1~~~~~~~~~~~i~1111111113~1~[~'~~~!i~i!~II~~~~~1!2o~i~~l~ O~~~~~~~~~~=~c~~~~~~~~~i ~~~ III~O~~~~~~~~ ~~===~-3~~~=0~~ (t ~ II; ~ ~ ~ ~ II; C tD.g cI2.Q.cocococococococo.c ~Q cg~CO::7"" ~_.~'< mQ.~c.g c~mg'g :r-. 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ClCl ClClC5C5Cl C3ClClCl t\JI\JNI\JI\JI\Jt\Jt\JNIVN -I -1......--- ~ ~ffig:~g: ::0 ::0 <:I;:na-l-l-lc<:I;:n llDlif(1JiiJiiJiilVlllDlif ~~m~~~~i~~m ~CD::om"''''''''U'I::lm::o 3(;)" 01;:;:;:<:3(;)" !!!DllD3ggg-<DlllllD -3~lL~.9l.9l "3~ 01 01 " " ... ... ... ............ 000 000000 NNN i.oi.oi.o 000000 ... '" ... 8D: 00 000 '1('...... ~~et ll:g:"g ....080 8888 <5 ~ ~ a: I[ ::0 4A- -Wt ~ .,. iIt ~ .... ~ .8 ~~NNNNN~~~ ![ b~N:""a,U,:""'i.ntn(n ~ ~~m&~~~f~~:j 8:i~~~fo~~~~~ '=OO:U"'ammn~"=O"" ~~~(1J~~~~~~~ s.s.s.~lDlDi:<:IS.S.S. ()ocr5"99~~o6'o <:I~::on~~,-a<:l~::O CU=,Dt 7C"~O 01::31>> .s~ ~ ,g",g" a .s~ ~ ~ ~~ VI ~ ~ S" IC .J!!. ... '" Estate of Shirley J. Ball c/o Charles R. Ball 344 Twelve Oaks Drive Winter Springs, FL 32708 Phone: 407-327-9562 Fax: 407-327-4715 8 July 2002 Register of Wills and Clerk of the Orphans' Court Attention: Cheryl Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 Subject: Estate of Shirley J. Ball, 21-2001-0123 Dear Cheryl, Enclosed is the $10.00 due for filing the receipt and releases for the Shirley J. Ball estate per your letter of 5 July. ~::3 i "'--. ~ l.......: 'O:~ Jurl 2~~ \1 -\ :\ 4 Estate of Shirley J. Ball clo Charles R. Ball 344 Twelve Oaks Drive Winter Springs, FL 32708 Phone: 407-327-9562 Fax: 407-327-4715 I"~, r' ". ,,\T, 23 June 2002 Register of Wills Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 Subject: Status Report under Rule 6.12 for the Estate of Shirley J. Ball, 21-2001- 0123 To Whom It May Concern: Name of Decedent: Shirley J. Ball Date of Death: 21 January 2001 Will Number: 2001-00123 Administration Number: 21-01-0123 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. The administration of the estate is complete. 2. I am enclosing an informal accounting of the estate. 3. I have provided a copy of this informal accounting to all parties in interest. 4. I have distributed the assets of the estate and obtained receipt and release from all parties in interest (copies enclosed). (;Jknd~ 6# f!d, 6-./,2 ~ ~ ~h ~ REV.1500,r:t1t-OO) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 w ,.., ::.::::!cn 0"'''' w"o ,,00 0"'.... ..'" .. '" . Z <~S2 .-~ 1"', :) D. :E o u ~ INHERITANCE TAX RETURN RESIDENT DECEDENT I- Z W C W U W C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) BRLL Sff/f!.LE-Y j' /0-02-0~- 9 (i,f'ICIAL thE ONLY , '7'</ DATE OF DEATH (MM-DD-YEAR) 01 - 2-1 - Z.OD 1. DATE OF BIRTH (MM-DD-YEAR) O>-O'/-IQ2..'1 FILE NUMBER .2 L-ilL CtuNTYCODE YEAR ililLJ....:L NUMBER (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~ 1. Original Return o 4. Limited Estate ~ 6. Decedent Died Testate (Attach copy 01 Will) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date ofdsalh after 12.12-82) D 7. Decedent Maintained a Living Trust {Attach copy 01 Trust) D 10. Spousal Poverty Credit (date ofdealh between 12.31.91 and 1-1-95) SOCIAL SECURITY NUMBER 1.\33 - tt2.. 3253 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Return (date ofdealh prior 10 12.13-82) ~ 5. Federal Estate Tax Return Required .i 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Allach Sch 0) NAMEc.ItAitLES p... BA lJ- I ex.c.c.vTD<'7- ,.., z w o z o .. Ul W '" '" o o COMPLETE MAILING ADDRESS ^-...., 3"1<1 rw E'-I/a Om.... W /NTefI... S t"alrJ6S, ~L FIRM NAME (II Applicable) TELEPHONE NUMBER I:l' ~ l..fo1-~2..,- -,'5'"",,- D~ 1 U,B. 32. 7D~ OFFICIAL USE ONLY 9. Funeral Expenses & Administrative Costs (Schedule H) (8) ----1/ tn . b3o./.f'l (9) ~2.b . zlfl,.. 40 . ~ 2:,2-2..0 .5""" (11) (12) (13) ~ 2."1 .51". 'n .t I I 't'f S Jib ? . S 3 "I.oi'i.oo ~1/-t~b.'07'l. 5"3 t. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1)~\~ )100.00 (2) :l> I) \';7) '1h? . 0," (3) (4) (5) ~ 2.!i.. . S 17. 'i 3 . (14) 1.6'1. 623.58 , (19) J ''I. 623. 5B ,. 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) z o ~ :) l- ii: <C u w 0:: 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) (7) (6) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) (10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) ~ I J "I)b J 07'1 . s ~ ,.0_(15) ,.0~(16) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate ,12 (17) 18. Amount of Line 14 taxable at collateral rate , .15 (18) 19. Tax Due 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUNO OF AN OVERPAYMENT Decedent's Complete Address: STREET ADDRESS 30 Z. IfOb~S--roWN {(.f)AD CITY (Y\E:::cIfAN ICS dV.eb I STATE fA I ZIP 17oS-0 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount Total Credits ( A + 8 + C ) (2) 3. InteresUPenally ff applicable D. interest E. Penally TotallnteresUPenaily ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. 8. Enter the total of Line 5 + SA. This is the 8ALANCE DUE. (SA) (58) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred;... .................................. ................. ..................... ....... D b. retain the right to desi9nate who shall use the property transferred or its income; ............................... ........... D c. retain a reversionary interest; or....................................................................... ...................................... ........... D d. receive the promise for life of either payments, benefits or care? .......... .................................... 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .. .......................... ............................ ......................... ............ 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.. . . 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................... ................................ ................. ........ 0 No 1)(1 ~ tl?J ~ ~ ~ ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN. Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statemellts, alld to the best of my knowledge and belief, it is true, correct alld complete. Declaration of arer olher than the personal representative i a nail infolTl1ation of which preparerhas allY knowledge. AD RESS bt.t'1 TWt::I...VE- 0A-f::S 1>~lvE ) WIN Tel.. S"f..e.11\J6S J FL. 31-7~~ SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the survivin9 spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116(a)(I.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblin9s is 12% [72 P.S. 99116(a)(I.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV'~~"[''''. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF <5I+IRLEY 0-. /!;AtJ-. '133-tt2.-~2S3 All real property owned salety or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property woukl be ex.changed between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorshin must be disclosed on Schedule F. ITEM NUMBER 1. FILE NUMBER $E.e DESCRIPTION A-TIOCIt/VI.eNr fE.P~ es,rATe. 1"1+)( , S C.\-l-I"--DO.....e.. />0- VALUE AT DATE OF DEATH ~\\"I)100.00 TOTAL (Also enter on line 1, Recapitulation) $ j II ~ 7 c:v. OC:> (If more space is needed, insert additional sheets of the same size) Fam 706 (Rev. 1-99) Estate of: Shirley J. Ball, 433-42-3253 SCHEDULE A-Real Estate . For jointly owned properly that must be disclosed on Schedule E, see the instructions on the reverse side of Schedule f.. . Real estate that is pan of a sole proprietorship should be shown on Schedule F. . Real estate that is included in the gross estate under section 2035, 2036, 2037, or 2038 should be shown on Schedule G. . Real estate that is included in the gross estate under section 2041 should be shown on Schedule H. . If you elect section 2032A valuation, you must complete Schedule A and Schedule A-I. 'em Oescrtption Alternate Alternate value Value at date of death number valuation date 1 House and lo~ 302 Hogestown Road, Mechanicsburg, PA $119,700.00 (Assessors Parcel Number 38-21-0291-061). Value based upon appraisal, copy of which is attached. TOlal from continuation schedules or addttional sheets allached to this schedule . TOTAL. /Also enter on Part 5. Recaoitulation, Daae 3, at ttern 1.) $119,700.00 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (See the instructions on the reverse side.) Schedule A-Page 4 REV-1503Ex+(1-97) . SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF 5~IR(.E'I T. 6ftLL, Y 3>'?> -'"1-2..- 3253 FILE NUMBER All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. se E. AIT~r I OF F~&z.I-k- S-s.Tf+Te. 'f f f+6 e.:s ) S CH e-O()l..€:. 11<\)(.. mv p-{\J 8 VALUE AT DATE OF DEATH 51) \3/, ~,,~. 0' DESCRIPTION ~ TOTAL(Alsoenteronline2,Recapitulation) $ ~ 1,/37. ~"3> of, (If more space is needed, insert additional sheets of the same size) Form 706 She<< 1 af ~ Estate of: Shirley J. Ben, 433-42.3253 Schedule B -- Stock and Bonds I~ I Descrlptioo I UnR Value I Value at date af death r 1 800 shares Apex Mcpl Fund Inc; Share Type: Mutual Fund; Exchange: 8 5/8 $6,900.00 NYSE; CUSIP Number: Not Available 2 219 shares AT&T; Share Type: Common; Exchange: NYSE; CUSIP 23 27/32 $5,221.78 Number: Not Available 3 81 shares Avaya Inc; Share Type: Common; Exchange: NYSE; CUSIP 1511/16 $1,270.69 Number: Not Available 4 568 shares Bellsouth Corp; Share Type: Common; Exchange: NYSE; 42 3/16 $23,962.50 CUSIP Number: Not Available 5 300 shares Compaq Computer Corp; Share Type: Common; Exchange: 20 4/25 $6,048.00 NYSE; CUSIP Number: Not Available 6 303.75 shares Dollar General Corp; Share Type: Common; Exchange: 18 3/4 $5,695.31 NYSE; CUSIP Number: Not Available 7 100 shares Eastman Chemical Co.; Share Type: Common; Exchange: 44 1/2 $4,450.00 NYSE; CUSIP Number: Not Available 8 126.635 shares Edison Intemational; Share Type: Common; Exchange: 9 $1,139.72 NYSE; CUSIP Number: Not Available 9 775.571 shares Federated Govtlncome See Fund; Share Type: Mutual 8.75 $6,782.37 Fund; Exchange: NA; CUSIP Number: Not Available 10 216.515 shares Fidelity Advisor Equity Income; Share Type: Mutual 25.16 $5,446.43 Fund; Exchange: NA; CUSIP Number: Not Available 11 300 shares First Union Corp; Share Type: Common; Exchange: NYSE; 31 3/4 $9,525.00 CUSIP Number: Not Available 12 174.817 shares Ford Motor Company; Share Type: Common; Exchange: 26 23/32 $4,670.89 NYSE; CUSIP Number: Not Available 13 924 shares Fulton Financial Corp; Share Type: Common; Exchange: 22 19/32 $20,876.63 Nasdaq; CUSIP Number: Not Available 14 2,000 shares Gabelli Equity Trust; Share Type: Mutual Fund; Exchange: 10.41 $20,812.50 NA; CUSIP Number: Not Available 15 146 shares Gabelli G Multimedia Tr; Share Type: Mutual Fund; 12.78 $1,866.06 Exchange: NA; CUSIP Number: Not Available Total from this sheet Total from Continuation Sheets Total ~ Form 706 Estllte of: Shirley J. Ball, 433-42-3253 Sheet 21 Schedule B -. Stock and Bonds litem I Description Number . I Un~ Value I Value at date of deeth f 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 206.448 shares Gabelli Growth Fund; Share Type: Mutual Fund; Exchange: NA; CUSIP Number: Not Available 200 shares Gabelli Util Tr, Share Type: Mutual Fund; Exchange: NA; CUSIP Number: Not Available 38.63 8.50 $7,974.05 $1,700.00 $3,209.38 $13,387.50 $4,301.09 $16,250.00 $3,783.22 $4,212.65 $8,887.50 $10,300.00 $8,627.45 $28,645.96 $7,025.00 $1,187.38 $7,556.25 Total from this sheet I~ 1'2.1 o<li. <l?, Total from Continuation Sheets Total 100 shares Health Care Property Investors; Share Type: Common; Exchange: NYSE; CUSIP Number: Not Available 32 3132 400 shares Intel Corp; Share Type: Common; Exchange: Nasdaq; CUSIP Number: Not Available 33 15132 324.488 shares Lazard International Equity; Share Type: Mutual Fund; Exchange: NA; CUSiP Number: Not Available 200 shares Lilly Eli Co; Share Type: Common; Exchange: NYSE; CUSIP Number: Not Available 13.26 81 1/4 594.379 shares Mainstay High Yield Bond A; Share Type: Mutual Fund; Exchange: NA; CUSIP Number: Not Available 213.353 shares Massachusetts Investors Trust; Share Type: Mutual Fund; Exchange: NA; CUSIP Number: Not Available 6.37 19.75 200 shares Mellon Financial Corporation; Share Type: Common; Exchange: NYSE; CUSIP Number: Not Available 400 shares Merril Lynch Cap TR 1; Share Type: Mutual Fund; Exchange: NA; CUSIP Number: Not Available 44 7/16 25.75 832.765 shares ML Aggregate Bond index; Share Type: Mutual Fund; Exchange: NA; CUSIP Number: Not Available 3,682 shares ML Muni Bd Insured PI A; Share Type: MutUal Fund; Exchange: NA; CUSIP Number: Not Available 10.36 7.78 800 shares Muniinsured Fund Inc com; Share Type: Mutual Fund; Exchange: NA; CUSIP Number: Not Available 28 shares NCR Corp New; Share Type: Common; Exchange: NYSE; CUSIP Number: Not Available 8.78 42 13132 300 shares Pacific Telesis Fin II; Share Type: Mutual Fund; Exchange: NA; CUSIP Number: Not Available 25 3116 Form 706 Estate of: Shirley J. Ball, 433-42-3253 S_3cA"1 Schedule B -. Stock and Bonds litem I Description Number .. 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 I Un~ Value I ValuealdaleQldeelh , 100 shares Phelps Dodge Corp; Share Type: Common; Exchange: NYSE; CUSIP Number: Not Available 48 17/32 $4,853.13 $5n,991.39 $5,584.36 $8,852.78 $60,711.14 $794.17 $19,271.88 $449.06 $108,813.00 $15,919.06 $526.56 $3,231.25 $7,896.43 $13,125.00 $2,455.01 Total from this sheet &' 30 . <<t1'f .V Total from Continuation Sheets Total 13,173.593 shares Philip Manis Cas Inc; Share Type: Common; Exchange: NYSE; CUSIP Number: Not Available 100 shares Phillips Petroleum Co; Share Type: Common; Exchange: NYSE; CUSIP Number: Not Available 43 7/8 55 27/32 850.003 shares Pimco Total Retum Fund A; Share Type: Mutual Fund; Exchange: NA; CUSIP Number: Not Available 3,134.29 shares Putnam Investments; Share Type: Mutual Fund; Exchange: NA; CUSIP Number: Not Available 10.42 19.37 41 shares Putnam Investors Fund - Class; Share Type: Mutual Fund; Exchange: NA; CUSIP Number: Not Available 700 shares Questar Corp; Share Type: Common; Exchange: NYSE; CUSIP Number: Not Available 19.37 27 17/32 10 shares Qwest Comm Intllnc; Share Type: Common; Exchange: NYSE; CUSIP Number: Not Available 44 29/32 2.208 shares SBC Communications Inc; Share Type: Common; Exchange: NYSE; CUSIP Number: Not Available 605 shares Scana Corp New; Share Type: Common; Exchange: NYSE; CUSIP Number: Not Available 49 9/32 26 5/16 50 shares Senior HSG Pptys; Share Type: Common; Exchange: NYSE; CUSIP Number: Not Available 10 17/32 100 shares Storage USA; Share Type: Common; Exchange: NYSE; CUSIP Number: Not Available 32 5/16 734.552 shares Strong Corporate Bond Fund; Share Type: Mutual Fund; Exchange: NA; CUSIP Number: Not Available 2,000 shares Templeton Global Income; Share Type: Mutual Fund; Exchange: NA; CUSIP Number: Not Available 10.75 6.56 229.762 shares Twentieth Century Inti Growth; Share Type: Mutual Fund; Exchange: NA; CUSIP Number: Not Available 10.69 Foon 706 Sheel4 of 4 Estate of: Shirley J. Ball. 433-42-3253 Schedule B -- Stock and Bonds litem I Oeocription Number .. 46 47 48 49 50 51 I Un~ Vlllue I Valueatdaleofcleolh I 100 shares USX-U.S. Steel Group; Share Type: Common; Exchange: NYSE; CUSIP Number: Not Available 16 9/32 $1,628.13 158.454 shares Van Kampen American Value; Share Type: Mutual Fund; Exchange: NA; CUSIP Number: Not Available 18.54 $2,937.74 642 shares Verizon Communications Com; Share Type: Common; Exchange: NYSE; CUSIP Number: Not Available 13 shares Visteon Corp; Share Type: Common; Exchange: NYSE; CUSIP Number: Not Available 54 21/32 $35,089.31 1329/32 $180.78 100 shares V1asic Foods Intllne; Share Type: Common; Exchange: OTCBB; CUSIP Number: Not Available 13/16 $81.30 450 shares Vodafone Grp PLC; Share Type: Common; Exchange: NYSE; CUSIP Number: Not Available 34 1/8 $15,356.25 Total from this sheet $SS- I Z7, .51 Total from Continuation Sheets Total .RE"".."..I.'''I. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SIt/f<LE.Y J"'. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY BALL) t.t33-<i2.- 3'2..S""3 FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. '5 e:e.. l+~fYIG.tJT I :5Cl+6OVu:. c... DESCRIPTION f"g.p~ e.... T1+T€.. 'P\X. VALUE AT DATE OF DEATH ~ 183 )'S'to .5g 2.. ~e e.. fr71ftCtl ME.1'ff ) oS c..~-Dt}LC. F. FE:.P&'2-A'- esmte.. ~x. ~ 32 /'f7l:.. ~s- TOTAL (Also enter on line 5, Recapitulation) $ "2..1 b :S 17 . '1-3 (If more space is needed, insert additional sheets of the same size) Fon'n 706IRev. 7-99) Estate of: Shirley J. Ball, 433-42-3253 SCHEDULE F-Other Miscellaneous Property Not Reportable Under Any Other Schedule (For Jointly owned propetty that must be disclosed on Schedule E, see the instructions for Schedule E) (If vou elect section 203ZA valuation. you must complete Schedule F and Scheduie A-I.) 1 Did the decedent at the time of death own any artides of artistic or collectible value in excess of $3,000 or any Yes No collections whose artistic or collectible value combined at date of death exceeded $1O,000? '" If "Yes: submit futl details on this schedute and attach appraisals. 2 Has the decedent's estate, spouse, or any other person, received (or wHl receive) any bonus or award as a resutt '" of the decedent's employ-men! or death? . ; If "Yes," subm~ full details on this schedule. ii 3 Did the decedent at the time of death have, or have access to, a safe depos~ box? . '" If "Yes," state location, and if held in joint names of decedent and another, state name and relationship of joint ./ +> depositor. j ii If any of the contents of the safe depos~ box are omitted from the schedules in this return, explain fully why ; omitted. .it ~i. ; ;) Item Desaiption Alternate Memate va... Value at date of death number FCK securities, give CUSIP number. valuation date 1 Income Tax Refund, Year 2000 Income Tax $5,178.00 2 Teacher Protective Mutual Life Insurance Company, $627.73 Refund of Long Term Care Policy Premium 3 Seabury & Smith, Return of Insurance Premium $195.24 4 1991 Mercury Station Wagon, value based upon Blue Book $3,500.00 at date of death 5 Household Furnishings $20,000.00 6 The Doll Express, Proceeds from Sale of Doll Collection $193.55 7 Ziegler Auction Company, Proceeds from Estate Sale $3,282.03 Total from continuation schedules (or add~ional sheets) attached to this schedule TOTAL. (Also enter on Part 5. Recapitulation, oaoe 3, at ~em 6.) $32,976.55 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (See the instructions on the reverse side.) Schedule F-Page 19 Form 706 Sheellofl Esta. of: Shirley J. Ball. 433-42.3253 Schedule C --. Mortgages, Notes and Cash I Vlllue II! dole of _h r jltam I Description Numbet . 1 2 3 4 Members 1st FCU, PO Box 40, Mechanicsburg, PA 17055, Account Type: Savings, Account Number: 4826()"()() $6,727.28 Members 1st FCU, PO Box 40, Mechanicsburg, PA 17055, Account Type: Checking, Account Number: 48260-11 $6,041.51 Mellon Bank, Commonwealth Region, 2 W Main Street, Mechanicsburg, PA 17055, Account Type: Checking, Account Number: 142-107-8195 Mellon Bank, Commonwealth Region, 2 W Main Street, Mechanicsburg, PA 17055, Account Type: Savings, Account Number: 140-070-2187 $46,508.66 $32,326.03 5 Mellon Bank, Commonwealth Region, 2 W Main Street, Mechanicsburg, PA 17055, Account Type: CD, Account Number: 936506 USM, 9800 Fredericksburg Road, San Antonio, TX 78288, Account Type: Subscriber Savings Account, Account Number: 33n569 AFIE, PO Box G. Ft Leavenworth, KS 66027, Account Type: SubSCriber Savings Account, Account Number: 95196 $30,065.48 6 $819.21 7 $595.62 8 Merrill Lynch. 214 Senate Ave, Camp Hill, PA 17011, Account Type: Money Market. Account Number: 872-96102 $60,324.66 9 Merrill Lynch, 214 Senate Ave. Camp Hill. PA 17011, Account Type: Money Market, Account Number: 872-70227 $132.43 Total from this sheet $183,540.88 Total from Continuation Sheets Total $183,540.88 . REV-1511EX:(1-S7) '*' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. See. A-~,vr) FE.I>E./l-A-'- es rn--re. m-X ~I) f.n.O" Sc.H-E...OtJLE.. T B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) CHAIUes f...MLL ~ I $"") 000. 00 Social Securtty Number(s) I EIN Number a! Personal Representative(s) - Street Address 3't'l TWf;.L.lIG. O~/::S f)iC.IU/:" City 1.\)1 NTeIL 5 ftl..foJbS State F'- Zip 3'2-)08 Year(s) Commission Paid: Zoo 1 2. Attorney Fees ~ 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 'f 5. Accountant's Fees rp 6. Tax Return Preparer's Fees r) 7. /111' Ce. t.J,..~NeOIJs. G-)t.PE..N';~ see ATTAC.ttME 11.1, ~')"'l..3'{ , ~~t.. EsTATE. ~ sc,...eov'-€.. ~. TOTAL (Also enter on line 9, Recapitulation) $ 2." .2."1"'. c.lo .. (If more space IS needed, Insert addltronal sheets of the same Size) Form 706 (Rev. 7.99) Estate of: Shirley J. Ball, 433-42-3253 SCHEDULE J-Funeral Expenses and Expenses Incurred in Administering Property Subject to Claims Note: Do not list on this schedule expenses of administering property not subject to claims. For thoSe expenses, see the instructions for Schedule L. If executors' commissions, attorney fees, etc., are claimed and allowed as a deduction for estate tax purposes, they are not allowable as a deduction in computing the taxable income of the estate for Federal income tax purposes. They are alfowable as an income tax deduction on Form 1041 if a waiver is filed to waive the deduction on Form 706 (see the Form 1041 Instructions) Item Oesaiption Expense amount T olel amount numbe< A. Funeral o>xpenses: 1 Cremation Society of PA . Cremation Services and Associated Fees $1,237.00 2 Memorial Service $445.06 Total funeral expenses. ... ._____J_1,l!!I.~,I!!l__ B. Administration expenses: 1 Executors' cornrnissions-amount estimated/agreed upon/paid. (Strike out the words that do rot $15,000.00 apply.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .----------.-....... 2 Attorney fees-amount estimated/agreed upon/paid. (Strike out the words that do not apply.). 0 ..n.._..__._....... 3 Accountant fees-amount estimated/agreed upon/paid. (Strike out the words that do not apply.). 0 ..U.n____h...___. Miscellaneous expenses: Expense amount 4 3 Administrative Expenses: Petition for Probate, Short Certificates, Reference $2013.42 material, Legal Notices, Newspaper publication charges, Office Supplies, Computer Software to Manage Estate, Copying & Faxing, Mail and Postage Cost 4 Maintenance: Power, Water and Phone for House while being disposed $1259.04 5 Property Disposal Costs: Appraisals, Boxes and Packing Materials, $632.54 Transfer of Deeds (Car and Home), Material Transportation Costs 6 Travel Costs - 3 Trips for Executor from Home in Florida to Home of Decedent $1362.60 for Administration, Maintenance and Property Disposal 7 Investment Property Disposal Costs: Commissions, Investment Account Fees $4,326.74 Total miscellaneous expenses from continuation schedules (or add~ional sheets) attached to this schedule . Total miscellaneous expenses ... $9,614.34 TOTAL. (Also enter on Part 5. Recap~ulaIion. moo 3, at item 13.) ... $26,296.40 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (See the instructions on the reverse side.) Schedule J-Page 23 "".,,,m.,,.,,,,,. COMMONWEALlH OF ~SYLVANtA INHERIT~E lAX RE.iURN RESIOENT DECeDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABIUTIES & UENS B AU... I cB 3 - 'i 2.. - ~ 2..S":3 FLE NUMBER ESTATf OF Sit I ~Lf; Y .:r. Include umllllbuned medlCII expenses. ITEM NUMBER t DESCRIPTION see. ~"""~..Jf"lV\6-NT' FB.~ttL 85 r4Te- 1?1 x. sctHWUL.E.. K.. I AMOUNT ~ 2.) '22. C> , s:l. TOTAL (1\Iso en\efon line 10, RecaplIuIallon) (K more Space is needed, Insert additional sheets of Ihe salTlO size) $ 22-2.0. 5"h Form 706 (Rev 7-99) Sheet 1 of 1 Estate of: Shirley J. Ball, 433-42-3253 Continuation Schedule Continuation of Schedule K - Debts of the Decedent, and Mortgages and Liens ] Item I Description I Value at date of - I Number 1 The Medicine Shoppe: Wheelchair Rental Aug-Dec - $300.00 $300.00 2 UN Postal Administration: Outstanding Stamp Order - $16.52 $16.52 3 Sears Gold Mastercard: January Bill - $24.61 $24.61 4 E. Murphy And Sons: Outstanding Bill - $278.36 $278.36 5 Andrews And Patel Associates: Medical Expense - $100.00 $100.00 6 Merrill Lynch VISA: January Visa BiII- $157.37 $157.37 7 AOL Online Service: Final Bill - $21.95 $21.95 8 Debra Basehore Wiest: Property Tax for 302 Hogestown Rd - $357.60 $357.60 9 Pennsylvania Department Of Revenue: CY2000 Tax Retum - $845.00 $845.00 10 Silver Spring Township Authority: Property Tax for 302 Hogestown Rd - $119.15 $119.15 Total from this sheet $2,220.56 Total from Continuation Sheets Total $2,220.56 ,,''''.,''''',''",1. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER SItI~L12'f ;r.6A-U-, 9'3'>-'-/2- 32.5"""3 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I . TAXABLE DISTRIBUTIONS (include outright spousal distributions) RELATIONSHIP TO DECEDENT Do Not List Trustee(s) f'A-rrlloA A. f/AR.TMA-,\J ~\f2. -"'Ie - 35~G. I i,oz. eML6-Y ME. c tt-Arrlt N 00 Gp. J IN 2> 7c.tol.{ 2.. G/-fA RL..E:.S R.. f3 flU- e,<{1.. - <{B - (Gj ?> 1 ?A4 T(,\J6L-V," oA/CS D.c.. WINTf:-fl- Sft2.INbS) R- 32.7o~ ('{lAR..\ L'ftJ 1... Gf+RJY\AN , ~b - $'"(, - O't II 307- If-o6e.S.7bwi0 ({D t'Y'e..c.14ANI c..s.s\J~c.) fA- f1 o~r/l 1. DA\l6 tt T€-~ ':>0,0 DAVt<.I-+Tfn-. 3. AMOUNT OR SHARE OF ESTATE 1/3 S II-AAe. IU it 3so, 000 1/3 sJI.A~E ~.3~) 000.00 1/3 ~~ IV ~ ~S"o , 000. 00 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS -see ArrA-c-l+/VI6./VT, Ft:Det2-AL .<:.s.m~ 77't)< SCthE.DoLE... 0 C.ON TI/U UA-1lo/\.i .51f.6e:rS, fAbS.s ~,v/l.N (-r $9 ,08<-t .CD TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 'l. 0 ~ .00 (If more space IS needed, insert additional sheets at the same size) Form 706 (Rev 7-99) Sheel1 cAJ15'" Estate of: Shirley J. Ball, 433-42-3253 Continuation Schedule Continuation of Schedule 0 - Charitable, Public, and Similar Gifts and Bequests ] item I Desctlplicn I Value at date aI deoth I Number 1 AAUW, AAUW Educational Foundation, 1111 Sixteenth Street, N.W., Washington, DC $40.00 20036, Type: Charitable 2 Alzheimer's Association, 919 North Michigan Avenue, Suite 1000, Chicago, IL 60611- $25.00 1676, Type: Charitable 3 American Business Women's Association, 9100 Ward Parkway, PO Box 8728, Kansas $10.00 City, MO 64114-0728, Type: Charitable 4 American Cancer Society, Pennsylvania Division, Inc., PO Box 897, Hershey, PA 17033, $125.00 Type: Charitable 5 American Heart Association, Capital Region Division, PO Box 2763, Harrisburg, PA $25.00 17105-2763, Type: Charitable 6 American Institute for Cancer Research, 1759 R Street NW, PO Box 97167, Washington, $5.00 DC 20090-7167, Type: Charitable 7 American Kidney Fund, 6110 Executive Boulevard, Suite 1010, Rockville, MD 20852, $10.00 Type: Charitable 8 American Lung Association, 1740 Broadway, New York, NY 10019, Type: Charitable $85.00 9 American Parkinson's Disease Association, 1250 Hylan Blvd, Suite B, Staten Island, NY $20.00 10305-1946, Type: Charitable 10 American Red Cross, P.O. Box 37243, Washington, DC 20013, Type: Charitable $225.00 11 AMVETS, 4647 Forbes Boulevard, Lanham, MD 20706-4380, Type: Charitable $15.00 12 Bethesda Mission, PO Box 3041, 611 Reily Street, Harrisburg, PA 17105, Type: $50.00 Charitable 13 Bible Baptist School, 201 West Main Street, Shiremanstown, PA 17011, Type: Charitable $10.00 14 Care, 151 Ellis Street NE, Atlanta, GA 30303-2440, Type: Charitable $85.00 15 Cedar Crest College, Development Office, 100 College Drive, Allentown, PA 18104-4609, $125.00 Type: Charitable 16 Cystic Fibrosis Foundation, 6931 Arlington Road, Bethesda, MD 20814, Type: Charitable $10.00 Total from this sheet ~ glf-S' .00 Total from Continuation Sheets ~8 .2.3"1. 00 Total 1~ 08'\.00 Form 706 (Rev 7-99) Sheel2 ~ Estate of: Shir1ey J. Ball, 433~2.3263 Continuation Schedule Continuation of Schedule 0 - Charitable, Public, and Similar Gifts and Bequests litem I Description Number . 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 I Value at date of death Disabled American Veterans, 3725 Alexandria Pike, Cold Spring, KY 41076, Type: Charitable $75.00 Easter Seals, PO Box 4860, Harrisburg, PA 17111-0860, Type: Charitable Epilepsy Foundation, 4351 Garden City Drive, Suite 500, Landover, MD 20785-2267, Type: Charitable $15.00 $145.00 Friends of Mechanicsburg Area Public Library, 16 North Walnut Street, Mechanicsburg, PA 17055-3362, Type: Charitable $90.00 Friends of the State Museum, The State Museum Building, 300 North Street, Harrisburg, PA 17120-0024, Type: Charitable Guiding Eyes for the Blind, 611 Granite Springs Road, Yorktown Heights, NY 10598, Type: Charitable Harrisburg Opera Association, 301 Market Street, Suite 604, Harrisburg, PA 17101, Type: Charitable $25.00 $30.00 $75.00 Harrisburg Symphony Orchestra, 800 Corporate Circle, Suite 101, Harrisburg, PA 17110, Type: Charitable Help Hospitalized Vets, 36585 Penfield Lane, Winchester, CA 92596, Type: Charitable Leukemia Society of America, Central Pennsylvanial Chapter, 800 Corporate Circle, Harrisburg, PA 17110, Type: Charitable March of Dimes, PO Box 8659, Philadelphia, PA 19101-8659, Type: Charitable Mechanicsburg Museum Association, 3 West Allen Street, Mechanicsburg, PA 17055, Type: Charitable $225.00 $23.00 $5.00 $25.00 $40.00 Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, Type: Charitable Metropolitan Opera Guild, Lincoln Center, New York, NY 10023, Type: Charitable Military Heritage Foundation, 22 Ashburn Drive, Carlisle Barracks, PA 17013-5008, Type: Charitable $40.00 $625.00 $1,500.00 Total from this sheet ~2.'l~~. 00 Total from Continuation Sheets Total Form 706 (Rev 7-99) Sheel 3 dS- Estate of: Shlrtey J. Ball. 433-42-3253 Continuation Schedule Continuation of Schedule 0 - Charitable, Public, and Similar Gifts and Bequests 1 Item Number 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 I Oescrlpllon I Value at dale of deoth Mothers Against Drunk Driving, 511 East John Carpenter Freeway, Suite 700, Irving, TX $25.00 75062, Type: Charitable Multiple Sclerosis Association of America, 706 Haddonfield Road, Cherry Hill, NJ 08002, $20.00 Type: Charitable Muscular Distrophy Association, 3300 East Sunrise Drive, Tucson, AZ 85718-3208, Type: $40.00 Charitable National Cathedral Association, Washington National Cathedral, Massachusetts and $50.00 Wisconsin Ave., NW., Washington. DC 20016-5098, Type: Charitable National Society Daughters of the American Revolution, 1776 D Street NW. Washington, $60.00 DC 20006-5392, Type: Charitable National Trust for Historic Preservation, 1785 Massachusetts Avenue NW, Washington, $60.00 DC 20036, Type: Charitable National Wildlife Federation, 8925 Leesburg Pike, Vienna, VA 22184-0002, Type: $60.00 Charitable New Kingston Fire Company, 277 Locust Point Road, New Kingston, PA 17072, Type: $30.00 Charitable Project Hope, 255 Carter Hall Lane, Millwood, VA 22646, Type: Charitable $25.00 Republican National Committee, 310 First Street SE, Washington, DC 20003, Type: $30.00 Charitable Republican State Committee of Pennsylvania, PO Box 11906, Harrisburg, PA 17108, $30.00 Type: Charitable SADD National, Box 800, Marlboro, MA 01752, Type: Charitable $15.00 Salvation Army USA, 615 Slaters Lane, P.O. Box 269, Alexandria, VA 22313, Type: $110.00 Charitable Silver Spring Ambulance and Rescue Association, P.O. Box 177, Eleanor Drive, New $100.00 Kingstown, PA 17072, Type: Charitable Silver Spring Community Fire Company, STATION 31, 6471 Carlisle Pike, $75.00 Mechanicsburg, PA 17055, Type: Charitable Total from this sheet $730.00 Total from Continuation Sheets Total Form 706 (Rev 7-99) Sheel4 ~ Estate of: Shirley J. Ball, 433....2-3253 Continuation Schedule Continuation of Schedule 0 - Charitable, Public, and Similar Gifts and Bequests 1'''"'' I Oeocrtp\ion Number . I V8klo at dolo of - 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 Smithsonian Institution, Smithsonian Institution Building, 1000 Jefferson Drive SW, Suite 486, Washington, DC 20560-0043, Type: Charitable Special Olympics, 1325 G Street tW, Suite 500, Washington, DC 20005-3104, Type: Charitable $359.00 $132.00 St Luke's EpiSCOpal Church, 8 East Keller Street, Mechanicsburg, PA 17055, Type: Charitable $3,080.00 SI. Jude Children's Research Hospital, 501 SI Jude Place, Memphis, TN 38105, Type: Charitable $25.00 The Arthritis Research Institute of America, 300 South Duncan Avenue, Suite 240, Clearwater, FL 33755, Type: Charitable $20.00 The Cathedral Fund, Massachusetts and Wisconsin Avenues, tW, Washington, DC 20016-5098, Type: Charitable $165.00 The Humane Society of Harrisburg Area, Inc., 7790 Grayson Road, Harrisburg, PA 17111, Type: Charitable The James Beard Foundation, 6 West 18th Street, 10lh Floor, New York, NY 10011, Type: Charitable The Leukemia Research Foundation, 820 Davis Street, Suite 420, Evanston, IL 60201, Type: Charitable The Library of Congress, 101 Independence Ave. SE, Washington, DC 20540, Type: Charitable $35.00 $200.00 $10.00 $20.00 Theatre Harrisburg, 513 Hurlock Street, Harrisburg, PA 17110, Type: Charitable $75.00 $25.00 $45.00 $15.00 Toys for Tots Foundation, P.O. Box 1947, Quantico, VA 22134, Type: Charitable TROA. Cumberland Valley, PO Box 278, Carlisle, PA 17013-0278, Type: Charitable UNICEF, 333 Easl38th Street, New York, NY 10016, Type: Charitable US Olympic Committee, One Olympic Plaza, Colorado Springs, CO 80909, Type: Charitable $75.00 Total from this sheet ~qZ.CZL(p Total from Continuation Sheets Total " Fonn 706 (Rev 7-99) Sheet 5 of 5 Estate of: Shirley J. Ball, 433-42-3253 Continuation Schedule Continuation of Schedule 0 - Charitable, Public, and Similar Gifts and Bequests ] =ber I Descrip\kl<t I Value at date of death 63 usa World Headquarters, Department WS, PO Box 96860, Washington, DC 20090- 6860, Type: Charitable VFW, 406 West 34th Street, Kansas City, MO 64111, Type: Charitable WITF, 1982 Locust Lane, PO Box 2954, Harrisburg, PA 17105, Type: Charitable World Wildlife Fund, 1250 Twenty-Fourth Street NW, Washington, DC 20037, Type: Charitable $125.00 62 65 $15.00 $100.00 $50.00 64 Total from this sheet $2"0.00 Total from Continuation Sheets Total