The URL can be used to link to this page

Home My WebLink About01-0163 PETITION FOR PROBATE and GRANT OF LETTERS Estate of D < v ; ~ )' . also known as fr,r c. e...- No. To: 21-01-163 Register of Wills for the County of CUMBERLAND in the Commonwealth of Pennsylvania . Decea~ed. Social Security No. .'?) 0 LI - ~"3 '- '1 ;t I 6 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut Y in the last will of the above decedent, dated ft1 ' /' C " and codicil( s) dated /1.1 .. '" '. · ~ .r J I I "- IT named , 19-.22 (state relevant circumstances, e.g. renunciation, death of executor, etc.) Dece, ndent was domiciled at death in ~ - J^ IS <?T j,., </ Countl' Pennsylvania, with h ,( last family or principal residence at S' a 5 -1" l' Y /' A C c:.-- &!... /' . /l-- r i-C/ (' '" - h--r /' J ~ .,.( j (J v. / '7 0 7 D , (list street, number and muncipality) / :;2 <J ~' i Decendent, then !" \" years of age, died / ~ S , ~ , at If '" r /'. r ~ _' ",/ I:r:- ( /' - -;-. I _. ;rr -" ~ ( ~ .. I ~ eo, . 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 ;n Pennsylvania situated as follows: $/0&7; t:1 .;., $ $ $ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and th)'rant of letters '---/-.. ~ Ii /---j // (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. ~_-' _ 'lLt(((r~ t" ~ /' 17 ~ L-._ L( r I /1 J ~Z 1Y ~ ~ Ie. -g .g ::; c. C e,l"-,, :.'~ c ? ..... 11 If. {( r ~~ I 1),- ~ 0 (rC/ V'-_/~ /t.- ... t: C ) t:J.~ ~ ;0 v: OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I sC"t COUNTY OJ' ___ CUMBERLAND J ~ The petitioner(s) ahove-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the besr 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 admin' r the tate according to law. / fJ -L2... sw..o". r, n to ,0, r affirmed ",nd subscribed { before me this .. 9th day of 7J~~~U/~~~~~~'/{J /~////~~j~~ ~ ~/ /' .''/ ~, . '/ Register v, ~. ~ t:l ""'- ~ ~ ~ /6-u2cI9-Y No. 21-01-163 Estate of DAVID S NACE , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW FEBRUARY 9 2!~ 2001, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated March 19th 1997 described therein be admitted to probate and filed of record as the last will of DAVID S NACE and Letters TESTAMENTARY are hereby granted to JULIET D NACE n. k. a. JULIET NACE DOWNS '2 '~/) )'(f //1" p(/ /:e5ri / L/...'/ ~JI/ / / )]/7 / J-4u /~// '/ .1 'J ./' - i / 1/ ~%ster of Wills t' FEES Probate, Letters, Etc. ......... $ 200.00 Short Certificates( ).......... $ 18.00 x-pag~~ ~~O RenUnCIatIOn ................ $ JCP $ 5.00 TOTAL _ $ 235.00 Filed .. .Z~9:-.2.QQ t. . . . . . . . . . . . . . . . . . . . . . . /11 "i./ Ic_1. S-', /1 r I~<:'''y ATTORNEY (Sup. Ct. J.D. No.) S' c; rJ 2- L,' Pt;;/ c ) 1- r '-".&1 V.i~~ ADDRESS /j-z'F r. (~t.- 1 ( /? " / 7 / I 2-- PHONE '77llL~/> 6.; O;t/(~Y';7Z1-;1 u is [I' LenIn lZc~ 1 st~ ~ll t!J,n rtlC :nrO!'lUll;lll hert' ~,I\l'I1 u,,[,:vi\ '!'OIL ,~!l the' cniti.JlC \vIll \" fO!'Wli,k(\ !.Ii ;\1\' $ lil \, \l.ll n,l IL'rrifiL;HC ".j d'(;l[h dul)' tilcd with me' IS ]Z,'( (J!lj.. (Htl\,l' j~ll' PCllIUIk;J\ lilmg, WARNING: it is illegal to duplicate this copy by photostat or photograph. r", dll" ~,~:r;t!,n', "},i)!) ./1 ;1/1;,: ~i'~t:' '.c~;,;~.r~:::~ ",i', ~\.\,$, f'~A,~'" ~ll~:: · ~~9&~:, 'H~' (~~:, .' ~~: \~. (~",~.' 'i' \':.~;J . . ~~:i ~-'<'~91'.. .' ,,',::-.':';;,,: ~<; ,1ft NT ~\ ~,~ll '''~~~t,~,::! ~'.: ~ ":~:''.!!..~ ; (':.' P 7175328 ~":\,l 21-01-163 ~ ,.~ If;;:;<L~~;~~_ A --...-------+-t---- Li f~ ZOO1 [),iL COf.4MONWEAlTH OF PENNSVlVANIA. OEPARTMENT OF HEALTH. VITAL RECOROS CERTIFICATE OF DEATH ~J Rev 2187 NAME Of DECEDENT IF,rSl M,ddle ,aSl' SEX z. Male 1. AGE (La.. Bortt><lay) David Scott Nace UNDER 1 YEAA Montha Days UNDER 1 OIlY Hounl Minutes BIRTHPu\CE IC,ty ar.d PLACE OF DEATH IC~€C. ""'Y!)l'e -- _ ,nSlIucloOffl on 01"'" ".oe) Stale 01 f creogn CounlrYJ P A HOSPiTAl McConnellsburg, Inpatlenlfi ERlOutpallenlO [)()A 0 ~ k FACILITY NAME (II nol ,nsNUI'Of'. g,ve Sir"'" and number. g':='lyl 0 85 YIS 5. COUNTY OF DEnH lb. Dauphin DECEDENT'S USUAL OCCUPIITION (GIve Iund oI.WOtk done dur'"9 """" ~st~kltl1retrel~ed) Pa. Forest Adviso . lla. lIb. DECEDENT'S MAILING ADDRESS (Slreel. CotyfTOwn, s...,.lop Code) 525 Terrace Drive New Cumberland, PA 17070 DECEDENT'S ACTUAL RESIDENCE (See ~SlrucIJOnS on olher Stde) Pennsylvania 17a. Stale Did decedenc live en . ''''''''ship? Cumberland MOTHER'S NAME IF.51 MIddle. Ma,den Surname) Alice Dickson 1.. FMHER'S NAME (F~s1. MoOdie. La..) 1.. INFORMANT'S NAME (TypcwPrlllll 17b. Coun Merrill W. Nace Juliet Nace Downs It. INFORMANT'S MAILING ADDRESS (Str.... C1l'/lTown. Slate, lip Code' 2Gb. 26 Cedar Cliff Dr., Camp Hill, PA 17011 Pu\CE OF DISPOSITION - Neme 01 Cemetery, CrematOty LOCMION - CityfTown, Slale. Zip Code Of ou.., Place zlF.olling Green Mem. Park h~ Hill, PA 17011 NAME AND ADDRESS OF FACILITY 22e.Myers-Harner FH, 1903 Mkt St, CH, PA 17011 LICENSE NUMBER DME SIGNED (Month. Day. _I 23b. 23c. WAS CASE REFERRED TO MEDICAL EXAMINERlCORONER? Yee 0 No~ zo.. UETHOO OF DISPOSITION IlunIlI ~ Cramaloon 0 Oonelton 0 Othe< (Speclly . 21.. SlGHATURE OF FUNERAL 22a. c-.pleta 4._ 23a-<: only ~ phyaIclan IS not available ~ C8rtdy ca.- 01 deillh. . hems 24.26 must be compteled by ....,. peBon who pronouncee death ;:t LICENSE NUMBER 22b.0il.2755-L ()()/ IIIIIEOlAT E CAUSE (F 'oat .- or COf1<ldJOn r-.g on tl88Ih)- ~ Iislconditiona ileny, -.g1O _t. _. Ent.. UNOEIILYIHG CAUSE (00seaIa or ,"""y IhIIII'llIIaled a...... r-.g on tl88Ihl LAST ~~J:" DUE 10 (OR AS II CONSEQUENCE Of)' ~ AN AU10PSY PeRFORMED? d WERE AUTOPSY FINDINGS AVAlU\Ill.E PRIOA 10 COMPLETION OF CAUSE OF DEnH? HomICide MANNER Of DEATH ~ o o DATE Of INJURY IMoolt1. Day, Year) STATE F'lE ~UMBER SOCIAL SECURITY NUMBER 3. 204 03 (/d / White MAAITAL STMUS - Mamad NI..r Married. Widowed. DMltced ($peclly) 14. Widowed 17e.D Yes. decedenclived in SURVIVING Spouse (If 1Mf.. give maiden name) IWp 17d.~ :i.~='=ot New Cumberland cllYlbOro 21. I Approximate :~== !~ ~, PART II: Other sill"il\cant condItiona contnbuling to dealh. but noc resulting in the underlyi"ll ca.... given in PART I. (1 , /)/1" _.A '.. ~? r-~ ~ {; ~~ ~ ~ <(....-"/4rl.J ~~r' TIME Of INJURY INJURY AT INORK7 OESCRIBE HOW INJURY OCCURRED. Pending In..shgal.,n D D o ~CE Of INJURY, Al home. lan~~;eel.laC1ory, office M. bUlkJing, .tc. ,SpOCllv) Joe. JOe. Nalural _0 Yes 0 Could nol be determined No No He. 281>. CERTIFIER IC~1lCk OOIy onel .CERTIFYING PHYSICIAN CPhystC1an cef\lfYlng cause oJ death when ,Jr'lOIl"ef phY$JClan has pfOl1OVflCecl death ana COO1pleled Ilem 23) To the beat 0' my know'-dge. death occurred due to the cause(s) and manner.. ,tated. 29. ~ ~ . PRONOUNCING AND CERTIFYING PHYSICIAN (Phy5lC.an bot~ ,,'onounc'ng dealh and e8l1,Iy'ng 10 cause 01 <leathl To the beat of my knowledtil", de..th occurred ilt the time, date, ,nd pllc;e, And due 10 the cluse(.J Ind manner .111.ted. ,~ 'MEDICAL EXAMINER/CORONER On the b..i. of .xamination and/or investigation. in my opinion, death occurred allhe time, dat., and place, and due to the cause(s) and mann., as st.'ed,. , . . . . . . . . .. .................,.......'.......,.......... .. ...........................,..,.,... 31a. l33 REGISTRAR'S SIGNATURE AND NUMBER ~ ./?C~~~f? . l.q/I~/I/I Yes 0 NoD "'tt). .., . r DATE SIGNED (MoolI1, Day. _I D 31e. A1/ltCJ2 7iJ~L-_131d.t::'/-7c;~OI NAME AND ADDRESS OF !n~0~ ~H~ COMPLETED CAUSE OF DEATH (IIem 27) Type Of Print ~~r~t';(;z..r ~ o e;7O 4r:'14~ C./.,k//?,p~O~LJ 32. C! ~ ,'L-c- ::TEFILED7j;2~ I , , 21-01-163 LAST WILL AND TESTAMENT OF DAVID S~ NACE I, DAVID S. NACE, having my legal residence at 26 Cedar Cliff Drive, Camp Hill, Cumberland County, Commonwealth of Pennsylvania, do hereby declare this to be my Last Will and Testament, revoking all other Wills and Codicils heretofore made by me. I declare that I am married to VIRGINIA B. NACE, and that I have two (2) children born to me; Juliet D. Nace and Barbara N. Kelsey. ITEM ONE: I direct that all my valid debts and the expenses of my last illness and funeral be paid from my estate as soon as practicable after my death. ITEM TWO: I may leave a Memorandum listing some of the items of my tangible personal property which I wish certain persons to have and request (but do not require) that my wishes as set forth in the memorandum be observed by my executor. ITEM THREE: I gIve all the residue of my estate, of whatsoever nature and wheresoever situate, to my wife, VIRGINIA B. NACE, provided she survives me by thirty (30) days. If my wife does not so survive then I give the residue of my estate as follows: A. To my Trustee, hereinafter named, I give any stock interest I may own in FNB FINANCIAL CORPORATION, presently located at 101 Lincoln Way West, McConnellsburg, P A 17233, to be held IN TRUST, in separate shares for each of the THEN LIVING ISSUE OF JULIET D. NACE, to use the income and principal for the college education of my said grandchildren. Income not used for such purposes shall be accumulated and added to principal. Upon each beneficiary attaining the age of twenty-five (25) years of age, my Trustee shall pay any remaining principal of their trust share to such beneficiary, free of trust. If any beneficiary under this paragraph should die before the complete distribution of his or her trust share, such share shall be distributed equally among the remaining beneficiaries under this paragraph. B. To my daughter, JULIET D. NACE, I give the balance of the residue of my estate, per stirpes. C. I have purposefully not provided for my daughter, BARBARA N. KELSEY, or her heirs, not for any lack of affection but because she is already well provided for. ITEM FOUR: I appoint my wife, VIRGINIA B. NACE, Executrix of this my Will. If, VIRGINIA B. NACE, is unable or unwilling to act or continue to act as my Executrix, I appoint my daughter, JULIET D. NACE, my Executrix. If, JULIET D. NACE, is unable or unwilling to act or continue to act as my Executrix, I appoint my niece, CYNTHIA NACE BARNES, currently of 3266 Limestone Road, Cochransville, P A 19330, as my Executrix. I appoint my daughter, JULIET D. NACE, Trustee, of any trusts created under this my Will. If JULIET D. NACE is unable to serve or to continue to serve as my Trustee, I appoint my niece, CYNTHIA NACE BARNES, Trustee of any trusts created under this my Will. I give to my said Executor and Trustee, in addition to the authority conferred by law, the power to sell any or all of my personal and real property at public or private sale, at such time and for such price and upon such terms and conditions as my Executor or Trustee may see fit, or in their discretion to retain the same for distribution in kind, and the power, but not the duty, to invest any cash without being limited to "legal" investments. No bond shall be required of any fiduciary hereunder in any jurisdiction. No fiduciary hereunder shall have any liability for any mistake or error of judgment made in good faith. 2 ITEM FIVE: I realize that Executors and Trustees are given discretion by law to make various elections which affect the income and estate taxes payable by estates and beneficiaries, as well as the relative shares of beneficiaries, such as taking administration expenses as deductions for either estate or income tax purposes, selecting options for the payment of employee death benefits, electing to take a qualified terminable interest as part of the marital deduction, selecting alternate valuation dates, postponing the payment of taxes, filing joint income tax or gift tax returns and redeeming corporate stock. The decisions made by my fiduciaries in any of these matters shall be binding upon, and not subject to question by, any affected persons. I rely upon my fiduciaries to take into consideration the total income and estate taxes payable by reason of their decisions including those payable by my survivors, and they are authorized in their discretion, but not required, to make adjustments between income and principal as a result thereof. ITEM SIX: I direct that all estate, inheritance and other taxes in the nature thereof, together with any interest and penalties thereon, becoming payable because of my death with respect to the property constituting my gross estate for death tax purposes, whether or not such property passes under this my Last Will and Testament, shall be paid from the principal of my residuary estate, and no person receiving or having a beneficial interest in any such property, whether under this my Last Will and Testament or otherwise, shall at any time be required to contribute to or refund any part thereof; PROVIDED, however, that this direction shall not apply to the taxes on any property included in my estate solely because of a power of appointment thereover which I possess but have not exercised or on any qualified terminable interest or to any generation- skipping transfer taxes. ITEM SEVEN: If any beneficiary or remainderman under this Will in any manner, directly or indirectly, contest or attacks this Will or any of its provisions, or objects to the accounts or actions of my fiduciaries, without probable cause, such beneficiary shall pay all costs, including but not limited to attorney fees, arising in connection with such contest, attack or objections incurred by my estate, such trust or such fiduciary personally. In the event that such beneficiary does not prevail in such action, any share or interest in my estate or such trust which 3 would otherwise pass to such beneficiary or remainderman under this Will shall be revoked and the property consisting of such share shall be disposed of in the manner provided herein as if that contesting beneficiary or remainderman had predeceased me without surviving issue. IN WITNESS WHEREOF, I have at Harrisburg, Pennsylvania, this 18th day of March, 1997, set my hand and seal to this my Last Will and Testament consisting of four (4) pages. /7 . Li v~~p/ c:: '-ft.--- ,."'" DAVID S. NACE (SEAL) SIGNED, SEALED, PUBLISHED AND DECLARED BY DAVID S. NACE, the above named Testator, as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence, and in the presence of each other, have hereunto subscribed our names as witnesses. Residence ~L~/t Residence ~t:lt \..)'3> ..'"L~ * 4 . . ACKNOWLEDGEMENT We, DAVID S. NACE, ROBERT P. GRUBB and _~ \(.,\tJf\6'L ~~~rz.... the Testator and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and Testament that he had signed willingly (or willingly directed another to sign for him), and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witness and that to the best of their knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraints or undue influence. / " / /' _?7 L-;7 /'1. ( ~ (~-t..,:; ;:5. /1--.....--- DAVID S. NACE ~,LQ ~~q WITNESS I On this, the 18th day of March, 1997, before me a Notary Public personally appeared ROBERT P. GRUBB, known to me (or satisfactorily proved) to be a member of the bar of the highest court of the Commonwealth of Pennsylvania and a subscribing witness to the within instrument, and certified that he, together with, J'\~ c...-\~ t-'- S ,=",,~n. the other subscribing witness to the within instrument, were personally present when DAVID S. NACE" whose name is subscribed to the within instrument executed the same, and that said person acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~ ' C " C-... ... p. .... .... I, /v,,"- .u--...- .~) \ I )/AT~ NOTARY PUBLIC Notarial Seal liMa D, Waite rick, Notary Public Harrisburg, Dauphin County . My Commission Expires Oct. 20, 1997 em er. ftnnsylvania Association of Notaries 5 e.. CERTIFICATION OF NOTICE UNDER RULE 5.6(a) NameofDecedent: I1vid S. IIloce Date of Death: () lias !/1W I f I Will No. c-XC)C} f - CO I ( 013 Admin. No. :9) - 0 J - 0 J {j?,j To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) 0 served on or mailed to the following beneficiaries of the above-captioned estate on Name Address QJ& (}dore/;ffDr I Cbmp)/JJjfJA /701 (~+ Noc.e,J)OI1)r\.CS Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: ,SIl7/0J / I -............. ..' ....... -_..".~ .' ../- . -- 10.- ~~ '" " Signature Name mar k T 0i I II keTj C.S?U~re Address ,5CJdd Li ~3Je~falm Rd. HClrn\sbu~9 J PA /7//J Telephone (717 GJ 7/- /5 ()Cj Capacity: _ Personal Representative L Counsel for personal representative W I- l(:!tn 0.'" w"O ",00 0"'''' ..., .. " z o i= ~~ ",,::::l Q. :& o U / REV1SOOEJ(+(1-91)~ COMMON~:YLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME (LAST, ARST, AND MIDDLE )NITIAL) use a blank bIock.kl S8Pnte words REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT ,j ~.t: ::J\L \' ..... <~~~ o...~. .~..~ . fiiHliJiiiiER..... ... .... .. .... ... ... 02 I 0 I .".._......._...m.....H.'_....~ .."_.,~,,._~_....'~'" llo3 COUMlYCODE """ """'" l- N D i d S Z a c e a v W SOCiAl SECURITY NUMBER DATE OF DEATH C 12 12 w 2 0 4 -0 3 -1 2 1 6 0 1 5 0 0 1 0 W (IF Af'fILlCABLE) SURVIVING SPOUSE'S NAME (lAST, FIRST, AND MIDDLE INITIAl) SOCIAL SECURITY NUMBER C DATE OF BIRTH 07/31/1915 THIS RETURN MUST BE FILED IN DUPUCATE WITH THE REGISTER OF WILLS I- Z W o z o .. ., w '" '" o o 'U 1. Original Return D 2. Supplemental Return 0 3. Remainder Return (daleofdeath prior to 12-13.&2) o 4. limited Estate 0 4a. Future Interest Compromise (dateofdea\tl altsr 12-12.82) 0 5. Federal Estate Tax Return Required o 6. Decedent Died Testate (AltachcopyotVl'lIl) 0 7. Decedent Maintained a Living Trust (Attach copy of Trust) _ 8. Total Number of Safe Deposit Boxes D 9. Litigation Proceeds Raceived D 10. Spousal poverly Credil 1"'''_''''''' 12.31.91 ,,,,,,.1.551 D 11. Election to tax under Sec. 9113(A) _"""01 THlSSECTIONIIo1UST'BECOIlo1PI.ETED, ALl.;'CORRESPQNDENCEAND'CONFlDENTIAIc TAX INFORMATION'. SHOULD BE DIRECTED TO: NAME COMPLETE MAlUNG ADDRESS Mark T. Silliker, Es uire FIRMNAAlE (IfAil9Iicab1e) Silliker & ReinhOld TELEPHONE NUMBER 5922 Linglestown Road Harrisburg, PA 17112 1. Real Estale (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mangages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) Z (Schedule E) 0 6. Jointiy Owned Property (Schedule F) (6) 5 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) ::J (Scheduie G or L) I- 8. Total Gross Assets (total Lines 1.7) a:: 0( 9. Fune",1 Expenses & Administrative Cools (Scheduie H) (9) 0 W II:: 10. Debls of Decedent Mongage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) . N/A 70,502.38 . N/A . N/A 1 6 5 4 1 2 9 9 7 2 6 7 . N/A ~^~ .~^^~^ M" ^ (8) 2 3 6 6 4 1 .0 4 1 1 ',; 4 8 1 . 6 5 3 3 9 6 .0 7 (11) 1 4 , 8 7 7 7 2 2 2 1 7 6 3 3 2 .. , 2 2 1 7 6 3 3 2 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and GovemmentalBequestslSec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 15. Amount of line 14 taxable at the spousal tax rate J J See instructions on reverse skje for applicable percentage 16. Amount of line 14 taxable a16% ",Ie 17. Amount of line 14 taxable at15%rate x .0 (15) ,221,763 3 2 x .06 1 3, 3 0 '5 x .15 (16) (17) (18) 8 0 8 0 18. Tax Due 1 3, ;3 0 5 19. 0(( DATE . / / cS: /t.-c./O ( DATE I I f/n( '/ c f'..-' f':J~ rz,. ( '(sal)Alep~auaq Japu!ewaJ alii pue asnods 6UI^'AJnS alii uaaMjaq luawa6ueJJe JeHwIs JO ISnJl alii jO luawuolllodde alii MOllS 01 JapJo 1'1 l1li Jo/pue >I (s)alnpall~S 1l1!M 6uole 'wnlaJ xel pal~-^laWII e 01 0 alnpall~S 4~elle Isnw no^ 'uolpala alii a~ew 01 aso04~ no^ jl '(sa!)Alep~auaq JapUleWaJ a41 01 &Iq~!!dde (s)aleJ alii Ie paxel S! Japu!ewaJ a41 pue 'aleJ xel OJaz a41le paxel sl asnods 6u!^IAJnS a41 smauaq 4~14M luawa6ueJJe JellWIs JO ISnJI a41 jO UO!1l0d a41 'asnods luap~ap ISJ~ a41 jO alelsa alii 1'1 paxel slluawa6ueJJe Jel!WIS JO ISnJI a41 'apew sl uOlpala alii jl 'f: ~ ~6 uOIpas Japun a/qelle^e uOlpala a41 a~ew 01 JapJo U! 0 alnpa4~S al~ 014S!M ^ew nOA 'alelsa Sl41 1'1 anp xel a4lJo uOlleln~l~ a41 WOJj I! aMWaJ 01 JapJO 1'1 'J! Iled 'r alnpa4~S 1'0 ISnJI a41 jO anle^ alii Jalu3 '(sal)Alep~auaq Japu!ewaJ a41 01 alqeolldde (s)aleJ a411e a/qexel ^lInj aq 111M I' aWl14014M Ie 'as nods puo~as a41 jO 41eap a41Hlun pauodlsod S! luawa6ueJJe JeHwIs JO ISnJI a41 1'0 xel a41 'uoIlsanb a^oqe a41 01 sa^ paJaMSUe no" jl o ON 0 saA (.aw!~aj!l aJ!IUa Jail JO S!ll JOj l!Jauaq s,asnods 6u!^!AJns alii JOj ^IalOS S! llolllM luawa6ueJJe JeIlW!S JO ISnJI e 9leaJO luapa~ap alii P!O 'aoeds alepdoJdde a41 U! "x" ue 6upeld "q uOllsanb 6u!MOIIOj a41 JaMSUe aseald - S66 ~ '~ A~'<fnN'<fr l:I31~'<f l:IO NO H1 '<f30 ~O S31 '<fa ~O~ . Alep~auaq "11'0 a41 sl asnods 6UI^!AJnS a41 j! ua^a alqe~!!dde 1I!IS aJe ulOlaJ xel e 6UII~ pue Slasse jO aJnsopslP JOj SluawaJ!nbaJ AlOlnlels a41 pue 'xel WOJj asnods 6UI^!AJnS e 01 JajSUeJl e lowaxa IOU saop alnlels a41 '966 ~ '~ AlenUer Jalie JO 1'0 41eap jO salep JOj %0 01 %f: WOJj asnods 6u!^IAJnS a41 jO asn a41 JOj JO 01 sJajSUeJI jO anle^ lau a41 1'0 pasodwI aleJ a41 jO Uo!pnpaJ a41 JOj pap!MJd (I!) (~.~) (e) 9 ~ ~6S 'S'd U '966 ~ '~ AlenUer aJojaq pue 1766 ~ '~ Alnr Jalie JO 1'0 41eap jO salep JOj %f: 01 %9 WOJj asnods 6UI^IAJnS a41 jO asn a41 JOj JO 01 sJajsueJI jO anle^ lau a41 uo pasodw! aleJ xel a41 jO uOlpnpaJ a41 JOj papI^oJd (iJ (~. ~) (e) 9 ~ ~6s 'S'd ZL Nl:In13l:1 3H1 ~O ll:l'<fd S'<f 11 311~ ON'<f E> 31n03H:>S 3131d1lll0:> lSnllll nOA 'S3A SI SNOI1S3nO 3A08'<f 3H1 ~O AN'<f 01l:l3MSN'<f 3H1 ~I o 0 .... <.^lladoJd aleqoJd-uou Ja410 JO '''llnuue 'luno~~e lUaWaJllaJ lenpI^!puI ue UMO luapa~ap PIO '17 o 0.... ........................ .............................................................................. ......... <.41eap Ja4 JO sl41e ^lpn~aS JO luno~~e ~ueq 41eap uodn alqe"ed JO ....OJ ISnJI U!. ue UMO luapaoap PIO 'f: o 0 ..... ..... .................., ......... ............ ...................................... ...... l,uollBJep!Suoo 9Jenbape 6u!^!a~aJ ln041lM 41eap jO Jea" auo ul41lM AIladoJd JajSUeJlluapa~ap PIP 'ZB6 ~ 'z ~ Jaqwa~ao Jalie paJJnooo 41eap jl <.uolleJap!Suo~ alenbape 6UI^la~aJ In041lM AIladoJd JajSUeJl 41eap 6u!p~aJd sJea^ OMj ul41lM luap~ap PIP 'ZB6 ~ 'z ~ Jaqwa~ao aJojaq JO uo paJJno~o 41eap jl 'z o 0 ......................................... <.aJe~ JO smauaq 'sluaw"ed Ja41la jO ajll JOj aSIWOJd a41 a^la~aJ 'p o 0 .............................................................................................JO :lS9JalU! h.iBUD!SJaA8J e U!Bl8J '0 o 0 ................ :awo~ul Sl! Jc1 paJJajSUeJI AIladoJd a41 asn lIe4s 04M aleu6!sap 011461' a41 ulelaJ 'q o 0 ............................................................. :paJJajSUeJl ^lladoJd alllJo awo~u! JO asn a41 ulelaJ 'e ON saA :pue JajsueJl e a~ew luapa~ap P!O . ~ S>I:>018 31'<fll:ldOl:ldd'<f 3H1 NI ..X.. N'<f E>NI:>'<f1d A8 SNOI1S3no E>NIM0110~ 3H1 ~3MSN'<f 3S'<f31d lN3fJ'I 'SiilM :10 ~3lS/fJ3~ :01 EJ/qeAed >/OEJI./J EJ>/ew -OB 'SOE-'TTt' (89) '3no 30N'<f1'<f8 a41 S! S!41 ",9 + 9 aU!l 10 lelOIa41Jelu3 '8 (\19) 'enp xel a41 uo ISWelU! a41 JelU3 '\1 ----0 S ' SO E ' t. 1 $ (9) '3no X'<f 1 e41 S! S!41 'aouwe~!p a41 JelUe 'l eu!! ue41 Je)eeJo S! 8 au!! + ~ eU!1 II '9 (v) punjOJ Ils.nb.. 016~ .ul1 ~ aBld uo xoq ~o.q:l 'lN31111A '<fdl:l3AO a41 S! S!41 'aoueJa~!p a41 JelUe '8 eu!! + ~ eu!! ue41 JeleeJD S! leu!! II 'v (8) (3 + a) AI!eUed~SeJaIUllelol Alleued '3 ISaJalUI '0 alQeO!ldde j! AlleUad~SeJelUI T (ll (;) + 8 + \I) SlIpeJ;) lelOl )UnOOS!a ';) sluewAed JO~d '8 I!pa!;) A~a^Od lesnods '\1 sluew"ed/S)!paJ;) 'l (B~ aun ~ eOOd) ana xel " :Sl!paJ:) pue Sluaw~ed xel OS'SOE'U$ (~I dlZ 31'1>'18 Am JJ11;) .:repa;) 9Z SS3'l:JOaV 133'l:J1S :ssaJPP'1 aJ9ldwo:) s,Juapaoaa REV.1S03 EX + (4-861 ~ SCHEDULE B STOCKS AND BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF David S. Nace FILE NUMBER (All property iointly~owned with Right of Survivorship must be disclosed on Schedule F.) ITEM NUMBER DEseRI PTION VALUE AT DATE OF DEATH 1. FNB Financial Stock $70,000.00 2 . AXA Financial Stock $ 502.38 TOTAL (Also enter on line 2, Recapitulation) (If more space is needed, insert additional sheets of same size.) s 70,502.38 REV.1508EX.(1-97) '*' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF David S. Nace 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. 2. 3. 4. 5. 6. 7. DESCRIPTION PNC Checking Account (51-4004-5959) PNC Estate Account (50-0105-2975) PNC Certificates od Deposit 1998 toyota RAV4 Furniture Electron ;.("s Miscellaneous Personal Property VALUE AT DATE OF DEATH $ 2,497.67 $ 22,296.00 $128,649.32 $ 10,000.00 $ 1,320.00 $ 450.00 $ 200.00 TOTAL (Also enter on line 5, Recapitulation) $ 165 , 41 2 . 99 (If more space is neeced, insert additional sheets of the same size) RfV.1509fX+(l2.88) . SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF David S. Nace I FILE NUMBER Joint tenant(s): ADDRESS 26 Cedar Cliff Drive Camp Hill, PA 17011 RELATIONSHIP TO DECEDENT Son-in-Law NAME A. Kevin T. Downs B. C. Jointly-owned property: LETTER DATE ITEM FOR TOTAL VALUE DECO'S DOLLAR VALUE OF NUMBEI JOINT MADE DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTEREST TENANT JOINT 1. A PNC P.Ccf: 4 50-0092-8784 $1,451.34 50% $725.67 TOTAL (Also enter on line 6, Recapitulationl $72 5 . 67 (If more space is needed insert additional sheets of same size) REV.1511 EX+ (7.SSI ESTATE OF ITEM NUMBER ~;ti SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES COMMONWEALTH OF PENNSYLVANIA INHEf\lTANCE TAX RETURN RESIDENT DECEDENT Please Print or Type FILE NUMBER David S. Nace DESCRIPTION A. Funeral Expenses: 1. Myers-Harner Funeral Home 2. Rolling Green Cemetary 3. Miscellaneous Funeral Expenses B. 1. 2. Administrative Costs: Personal Representative Commissions Social Security Number of Personal Representative: Year Commissions paid Attorney Fees 1 % 3. Family Exemption Claimant Address of Claimant at decedent's death 4. C. 1. 2. 3. 4. 5. 6. 7. 8. Relationship Street Address City State Zip Code Probate Fees Miscellaneous Expenses: TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of same siz.e.) AMOUNT $1,080.00 $ 885.00 $ 938.20 $2,343.45 $ 235.00 511,481.65 'it~.\$\lEX"\\.g'1\ '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANlA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER David S. Nace Include unreimbursed medica! expenses. ITEM NUMBER DESCRIPTION AMOUNT $1,103.62 $ 110.31 $ 103.77 $ 57.43 $ 42.40 $ 35.11 $ 29.75 $ 9.80 $1,254.52 $ 244.50 $ 88.90 $ 315.96 1. Citibank Visa 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12, PP&L UGI Borough of New Cumberland (trash!swwer) AT&T Wireless PAWC Verizon Cable Robin Gasperetti, Tax Collector 2000 Federal Taxes 2000 state Taxes Medical Bill Reimbursement to State Retirement TOTAL (Also enter on line 10, Recapitulation) $ 3 , 396 .07 (If more space is needed, insert additional sheels of the same size) REV.1513EX+(2-871 .. COMMONWEALTH OF P~NNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF David S. Nace FILE NUMBER ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR NUMBER SHARE OF ESTATE A. Taxable Bequests; 1. Juliet D. Nace Daughter 100% 26 Cedar CI iff Drive Camp Hill, PA 17011 , , , i ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOliNT OR SHARE OF ESTATE B. Charitable and Governmental Bequests: 1. TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (AI,a ente, on I;no 13, Rocopii,I".c.'., , I:) I (If more space is needed, insert additional sheets of same size) / Register of Wills ofc:~r;,1"~':-l? . ,~_ County, Pennsylvania INVENTORY Estate of Da vi d S. Nace No. 21-01 -01 01 also known as Date of Death 1/25/2001 , Deceased Social Security No. 204-01-1210 Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Personal Representativf': Name of Attorney: Mark T. si lliker, Esquire Juliet D. Nace 1.0. No.: 33671 Address: 5922 Linqlestown Road Dated Harrisburg. PA 171~_____ Telephone: (717) 671 1500 Description Value 1 . 2. 3 . 4. 5. 6. 7. 8. 9. 10. PNC Checlc i h;.-' ACC')lin t ( 51-4004- 59 59) PNC Estate Account (50-0105-2975) PNC Joint Account (50-0092-8784) PNC Certificates of Deposit FNB Financial Stock AXA Financial Stock 1998 Toyota RAV4 Furniture Electronics Miscellaneous Personal Property $ 2. , 497 . 67 $ 21,296.00 $ 725.67 $ 128,649.32 $ 70,000.00 $ 502.38 $ 10,000.00 $ 1,320.,00 $ 450.00 $ 200.00 Total: $ 236,641.04 (Attach Additional Sheets if necessary) NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may. at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Invelltory. RW-8 - 9 0 if; () -0 0 Z "1l m ::0 0 0 ~ )> r (j) fT1 C (f) s: m -i I ::D :I:00300 Z -j m m z )> )>mc:mo -j s: 0 cO c rn ~~~~~ (fJ ,- ,-< )> "1l ' ~ - ..,., ':s; -i U1 0 m .:0 f" -0 :)0 OJ m ,,4 rn @~~:::g J> '" )> m Z r <: r 0 ' --< ;1m ::0 CO>O~~ : :0 f- rn )> >s: m 11 C ::og."'zm :, -j " rn 0 0 p"""" o z-j)> m -z : ~m ::D .- .-:t:: "T1 -j .. z :D -0 co~ .~,-j s: fn 0 )> :<"':I: )> )J ?; ::! 6::00 -i c:m." "'cr 0 N )><-0 '.;fD 3 CD r-mm Z : :> b -4zZ -j 0> )>cz :"'J g. )(m(J) ~ m -< (J) ~ -.; )> z ;; \ ..J -::n 55 (fJ .:j Z 0 :t :D ." m m :D (j) .." =4 ~ - )>"0 (") zm m - C')z :D )> mZ 0 ~ ..... )>(/) " z-< ~ :XI o~ r m m)> ~ (") (/)Z .....- JJ -l \ m )>)> m 0 () -l - -t m J> -a m <: r J> m J> zo~ -I ..... i '0 g cOm)> )> 0 )( t OJ c sZCf)o -< z \ ro~(f)z -l mo3: "1J JJr~ J> -l Z 6 0 )> )> ..p. <.D )> 0'> s: en 0 c -J z -l ..... "'. :0 t;.~~ \ ....~ m :: ~ m ~ x 0 :I: '" en $ ::0 rn , /6 -c:209- Y BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-16D7 EX AFP tlZ-DDl Rec'~; HE< DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-26-2001 NACE 01-25-2001 21 01-0163 CUMBERLAND 101 DAVID S MARK T SIllIKER ESQ-Ol DIG 17 1~2:02 SIllIKER & REINHOLD 5922 lINGlESTOWN ~IE'iK HBG F<<uJtll:1;jj~_, Amount Remitted 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, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-Y- = i 60,-EX--AFP--fl'2-:ooY------...-iNifERZ'fANc'E--TAx--STA-TEH'E-NT-O"F-itC-COl;N-f--.-..--------------- - -- - -- ESTATE OF NACE DAVID S FILE NO.21 01-0163 ACN 101 DATE 11-26-2001 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF lAST ASSESSMENT OR RECORD ADJUSTMENT: 07-16-2001 P R I NC I PAL TAX DU E : ........................................................................................................................................................................................................................... 9,979.35 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-04-2001 AA496671 .00 13,305.80 11-08-2001 REFUND .00 3,326.45- TOTAL TAX CREDIT 9,979.35 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 if IF PAID AFTER THIS DATE~ SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $l~ NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)~ YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) \,( ') /h -c:;J,oj?- ? COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX MARK T SILLIKER ESQ SILLIKER & REINHOLD 5922 LINGLESTOWN RD HBG PA 17112 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-16-2001 NACE 01-25-2001 21 01-0163 CUMBERLAND 101 REV-1547 EX AFP el2-DDl DAVID S 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 ~ rf{y=is'4-j-EY-AFP--fi2":oeiY-NO':ficE--Oi=--ftiHEifiTANCE-,.-A"irAppRAisEMENT-,--Aii-oWANCE-O-R----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF NACE DAVID S FILE NO. 21 01-0163 ACN 101 DATE 07-16-2001 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: .00 X 00 = .00 221,763.32 X 045 = 9,979.35 .00 X 12 = .00 .00 X 15 = .00 (19)= 9,979.35 RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule 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) .00 70,502.38 .00 .00 165,412.99 725.67 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 11,481.65 3,396.07 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 236,641.04 (11) (12) (13) (14) 14.877 72 221,763.32 .00 221,763.32 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-04-2001 AA496671 .00 13,305.80 TOTAL TAX CREDIT 13,305.80 BALANCE OF TAX DUE 3,326.45CR INTEREST AND PEN. .00 TOTAL DUE 3,326.45CR * 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) ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME INHERITANCE TAX EXPlANA TION OF CHANGES David S. Nace FILE NUMBER John Kuchinski ACN 2101-0163 101 REVIEWED BY SCHEDULE ITEM NO. EXPLANA TION OF CHANGES J 1 Lineal heirs are taxable at the rate of 4.50/0 for dates of death on or after 7-1-2000. ROW Page 1 '\ .. ~ STATUS REPORT UNDER RULE 6.12 Date of Decedent: f:sl./ I~ S . Death: ---1 II tJ art> Name of Will No. Admin. No. c7{T) I - OD Ib 3 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: Stat>cWhether administration of the estate is complete: Yes No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 1 . 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)C No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes ~ No / d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to is report. .~ Date: 1~.Jr 71o.:J- 5i ~d< T S;IIJ\F(,0;~/(Ye ame (Please type or pr nt) lSClJ-)- U Y!)lestvltly\ RofJ, ~ms~Ii/JO. Addres s , . ( 7/ (l YIAf} (7/7) 07/- (5Ut) Te 1. No. Capacity: Personal Representative ~counsel for personal representative (MAH:rmf/AM3) t .. Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (71 7 ) 240 - 6345 Date: 12/06/2002 JULIET D NACE 26 CEDAR CLIFF DRIVE CAMP HILL, PA 17011 RE: Estate of NACE DAVID S File Number: 2001-00163 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 will become delinquent on: 1/25/2003 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, MARY C. LEWIS REGISTER OF WILLS cc: ~/File Counsel Judge