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HomeMy WebLinkAbout01-0180 PETITION FOR PROBATE and GRANT OF LETTERS Estate of KoSE" E ~l<~El-- No. ~\-O\- \9'~ also known as To: Register of Wills for the County of CUMBERLAND in the Commonwealth of Pennsylvania . Deceased. Social Security No. ~tl-I .2. - 3 t l. G. The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut ~'L)( in the last will of the above dec~nt, dated a....... ~~....~ C( and codicil(s) dated /V.. A- , named , 19~ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in C~~ l ^.......... J.. County, Pennsylvania, with i~ last family or principalJesidence at '\l~ ~,. "(;;1 '- 4.. .~~ C'~..Lcl~. I ~ (list street, number and muncipality) Decendent, then q z... years of age, died ~~ -:1-<' , ~6 0 I, at ~~ l.tO Qrl *""- · _ 1) . Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will 0 fe ed for probate; was not the victim of a killing and was never adjudicated incompetent: h Oecendent 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 Penns;;;Jia situated as follows: N ,;' $.1..-0 I O~ D $ $ $ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters r.t: $-l-d.m ~~/'2 ~~ (testamentary; administration c. La.; administration d. b. n. c. La.) theron. J: u ~3 M~"'*I~/'''' ~t,4 CJ '- ::G~ -00 ~~ .'~~~&:;:~~~~~7 ~ 0 ~ 51 VJ ~~7~~..o.l~.) OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I s" 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 petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will id truly ~h.:cte ac:or~ing to law. ~~~~ ~~ ~~~~~~~1~~Hand~~~~~~'-p:~~~~ I /Jj jl.Jl J L J2...l..UL-.D RJ.A... ~_I~ ~ ~ MA~Y CLEWIS u Register ~ \lo-~ID- ( No 21 - 01 - 180 . Estate of ROSE E MEKEEL , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW FEBRUARY 15, 1~2001 , 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 AUGUST 4, 1999 described therein be admitted to probate and filed of record as the last will of ROSE E MEKEEL TESTAMENTARY MARY ROMIG FANIDI a/k/a MARY THEOFANIDIS and Letters are hereby granted to FEES Probate, Letters, Etc. ......... $ ~O. 00 Short Certificates( 1 (}) . . . . . . . . .. $---3D-.-QQ- Renunciation ................ $ X-Pages $ 24.00 JCP T~TAL -= $109'.8~ Filed.... .F.~~~~.~~Y. .1.~~. ?qq!.......... Picked up by Executrix on 2-15-01 ATTORNEY (Sup. Ct. J.D. No.) ADDRESS PHONE ~. t 'hi" 1\ l'- d\ th~ll 11 r-iun h~_-'rt ~_~!\-(.~n 1.'" \ I 1\(.,:1',[:,1] Tile' lHIL:il1.l1 ,_..rnl!c,llt \\]il hl' fe':\ii 'i! ! t;JI .,1 (f! j" \ ) 1,.1, " fLl!' tikd \\Itll ;Jl\ oJ' ;. rll~ j'-I-. ,_ 'v'V ARNING: It is illegal to duplicate this copy by photostat or photonraph, dli\ '" 1 ( {J(. :(~~i~;,\- \~~;~~::;).~\~>~t" ~ '~' '.~~_<-:"7-~, "'" m / .;,~4t, i }(.!lr' U a p 7121139 9'U""-<<(/1 f(~ A~'52_ L Hl0~ ;4J Rev 2187 COMMONWEALTH Of PENNSYlVANIA. DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH j'(PEif.'RINl IN PERMANENT al ACK 'NI< ~ ~ () ~ Z Zf..: lc< BIRTHPLACe :e-Iy ..rod Stale 0.- f Cfeog.n Counlry) '-:1 L Yra S. COUNTY Of' [)E,fJH =",;,0 .. RACE. AI -, n. 8IKk. _.. Ole ISpo<;"';I 10. lL: ,ft SURVIVING SPOUSE In .... ~ IT'laIden nMne~ - C"Y'-" (~"3 ~'D DUE 10 (OR AS A CONSEOUENCE Of)' 21. t AporOlCV1\aI. : inl8fVIII beCween .--- !lJr-.~~ r PART D: '- b I :-- ::,:;:=;;:::------ ." WERE AUTOPSY F\NDlNGS AIlA'lAlll.E PRIOR 10 COMPLETION OF CAUSE OF DEATH? MANNE.R OF DEATH DATE OF INJURY (Month Day. ~atl TlIolE OF INJURY INJURY IiI WOAl<? DESCRiBe HOw INJURY OCCURRED N.lurlll a.. [] [] HomICOI [] [] [J ~CE OF INJURY. Al ""me, ,.,'::;_. IKtooy. olfic:. bu.6Idtng. .'e ISptiC,lv) 30e [] NoD Pendfng InveshgallOn M. JOe. V.a 0 NoD Suoc... Could not be determloed ry\.- J". 2eb. QRTlftER tCt'ecil. OI'\ly~) .CERTtFYING PHYSICIAH IPhvs.cldln Cefll'ylllg cause 01 Gedoltl when .lovlt"lm ~/llt~.an h,)~ PfQ(lQ\,lXeO (:kdltl ..ulO cOlll~I~I~ ltem 2J) To thre beal of "'w kno*l4tdge. death OCC1oIrred due to the cause(l) at\d m,ahn.,.. ".'ed. . . ~f4;.--_. t~ 1/1<.J.1 I,d-! HED,_ Day,_1 3'c. J'd. ..l Rl'f-> ~ ~ ~~c:.:. ) NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OF DEATH (lIem 2~ Type Of Pnnl C.J. .... ~ <:. JfI ^--- r'\ 610 (j ""1'-- fJ , '\J I (;... t'\ oJ l,u rn Of' V [] J2. e'S\,) W""ZL- I>v-,t ~tt\loYr-- Q!...D ,--~~4:>1rt DAlE FilED (MQOItl Day, Yeall ~, . PRONOUNCING AND CERTIFYING PHYSICIAN (Ph"scILll1 hOlh >.)ronw'iC,nglJedlh dnd cer-llfv,~ 10 CduStl 01 (j*"oJlt,j To the be-al ot mv "no*~gft. de.lh occurred.1 UWI UIn.. da'e. 10<1 place, Jlnd du.lo lh. cause(.~ and manner... $'~Ie-d 'MEDICAL EXAMINER/CORONER On the b..i. ot elllami".Uon and/or inveslig~hon. in my oplnlon. death occurred allhe time. dale. .and place, .and due 10 Ihe c.use(a).nd menn... a. slilted. . . . . . . . .. .' _..... _ . . . . . . . . _. ................. _ . . . .' . .' . . . . . . . . . . . . . . . . . . . . . . .. ........ ,.. ~.J U /J Il...f J 0, -l {j () I , . LAST WILL AND TESTAMENT OF ROSE E. MEKEEL I, ROSE E. MEKEEL, now of355 South Sporting Hill, Apartment #54, Mechanicsburg, Cumberland County, Pennsylvania 17055, do publish and declare this to be my Last Will and Testament, hereby revoking all other prior wills and codicils made by me. FIRST: Famity Backeround and Appointment of Executor. (A) Family and Backeround Information. I am a single woman, I have no living children. I have a niece, MARY ROMIG FANIDI AfKJA MARY THEOFANIDIS and I have a nephew, RICHARD ROMIG, whose wife is MARLENE ROMIG. (B) Appointment of Executor. I appoint as my Executrix and successor Executor (all hereinafter referred to as Executor or Executors) under this Will, the following named persons to serve without bond and without being required to account to any Court: Executrix: My neice, MARY ROMIG FANIDIA/K/A MARY THEOFANIDIS. Successor Executor: My grand-nephew, my niece's son, PARIS THEOF ANIDIS. SECOND: Funeral and Last fitness Expenses: Taxes. (A) Expenses ofFunerat and Last fitness. Notwithstanding that my spouse survives me, I direct my Executor to pay my funeral expenses and the expenses of my last illness from my estate. (B) Taxes. I direct my Executor to pay any and all estate, inheritance, succession, legacy, transfer and other death taxes or duties, by whatever name called, including any and all interest and penalties thereon, imposed under the laws of any jurisdiction by reason of my death, upon or with respect to any and all property included in my gross estate for the purpose of such taxes, whether such property passes under or outside of this Will, out of my residuary estate, without being prorated or apportioned among or charged against the respective devises, legatees, beneficiaries, transferees, or other recipients of any such property or charged against any property passing or which may have passed to any of them. The Executor shall not be entitled to reimbursement for any portion of any such taxes from any such person. ~~~ . L ~ (/11 '" . cSK Yave LAST WILL AND TESTAMENT OF ROSE E. MEKEEL PAGE 2 THIRD: Tan~ible Personal Property. Except for those items excluded below and those items enumerated in the Letter of Instruction, I bequeath to my niece, MARY ROMIG FANIDI, and to my nephew, RICHARD ROMIG, to be divided between them as equally as is possible, all tangible personal property, including but not limited to clothing, jewelry, heirlooms, furniture, personal effects, motor vehicles, and all other similar articles, which I own, and the insurance thereon, ifmy spouse survives me by sixty (60) days. Tangible personal property shall not include: (1) any and all property used by me in any business, (2) cash on hand or on deposit in banks, (3) stock or securities, (4) any type of evidence of indebtedness, and (5) any life, health or accident insurance policies. If my niece and nephew do not survive me, I leave such tangible personal property to my grand nephews, my niece MARY ROMIG FANIDI'S sons, PARIS THEOFANIDIS and CHRISTOPHER THEOFANIDIS, per stirpes. If there is any disagreement as to distribution, I direct my Executor to make such distribution. The decision of my Executor shall be final and binding. Any items not selected or any items which my Executor considers unsuitable for my heirs may be distributed or sold in the sole discretion of my Executor and, if sold, the net proceeds therefrom shall be added to the residue of my estate. Any such article allocated to a minor may, as my Executor deems advisable, either be delivered to the minor or to any person to safeguard on behalf of the mmor. Notwithstanding any other provisions in this Article THIRD, I may leave a separate, dated and unsigned Letter of Instruction, which I shall place with my Will, containing directions as to the ultimate disposition of certain of the property bequeathed under this Article THIRD, and such Letter of Instruction shall determine the distribution of such items. FOURTH: Family Home. [THIS ARTICLE IS INTENTIONALLY LEFT BLANK.] FIFTH: Residuary Gifts. (A) I give, devise and bequeath all the rest, residue and remainder of my estate, of every kind and character, real, personal and mixed, tangible and intangible, and wherever situated, including R. [' ~ fQ~ cCr~(- ;/~ , . LAST WILL AND TESTAMENT OF ROSE E. MEKEEL PAGE 3 any lapsed or renounced legacies, devises or residuary bequests (and including any property over which I may have a Power of Appointment), to be divided in equal shares to my niece, MARY ROMIG FANIDI and to my nephew, RICHARD ROMIG. (B) If my niece and nephew do not survive me, I give, devise and bequeath all the rest, residue and remainder of my estate, of every kind and character, real, personal and mixed, tangible and intangible, and wherever situated, including any lapsed or renounced legacies or devises (and including any property over which I may have a Power of Appointment), to my grand-nephews, my niece MARY ROMIG FANIDI'S sons, PARIS TBEOFANIDIS and CHRISTOPHER THEOFANIDIS, per stirpes. (C) Distributions Durine Administration. Prior to final distribution of my estate, the Executor, in his discretion, may make partial distributions to one or more beneficiaries or Trusts. As a consequence, the Executorship and any Trusts created under this Will may exist contemporaneously. A distribution may be made subject to any indebtedness or liability of my estate. SIXTH: Spendthrift Provision. No beneficiary shall have the power to anticipate, encumber or transfer his or her interest in the estate in any manner other than by the valid exercise of a power of appointment. No part of the estate shall be liable for or charged with any debts, contracts, liabilities or torts of a beneficiary or subject to seizure or other process by any creditor of a beneficiary. SEVENTH: Powers of Executor. In addition to the powers and duties as may have been granted elsewhere in this Will, but subject to any limitations stated elsewhere in this Will, the Executor shall have and exercise exclusive management and control of the Estate and shall be vested with the following specific powers and discretion, in addition to the powers as may be generally conferred from time to time upon him by law: (A) In the management, care and disposition of the Estate, the Executor shall have the power to do all things and to execute such deeds and instruments as may be deemed necessary or proper, including the following powers, all of which may be exercised without order of or report to any Court: /&f-. s. )IV) ~ ~t( y~ LAST WILL AND TESTAMENT OF ROSE E. MEKEEL PAGE 4 (1) To sell, exchange or otherwise dispose of any property, real, personal or mixed, at any time held or acquired hereunder, at public or private sale, for cash or on terms, without advertisement, including the right to lease for any term notwithstanding the period of the Estate, and to grant options, including any option for a period beyond the duration of the Estate. (2) To invest all monies in such stocks, bonds, securities, mortgages, notes, choses in action, real estate or improvements thereon, and any other property as the Executor may deem best, without regard to any law now or hereafter enforced limiting investments of fiduciaries. (3) To retain for investment any property deposited with the Executor hereunder. (4) To vote in person or by proxy any corporate stock or other security and to agree to or take any other action in regard to any reorganization, merger, consolidation, liquidation, bankruptcy or other procedure or proceedings affecting any stock, bond, note or other security. (5) To use attorneys, real estate brokers, accountants and other agents, if such employment is deemed necessary or desirable, and to pay reasonable compensation for their servIces. (6) To compromise, settle or adjust any claim or demand by or against the Estate and to agree to any rescission or modification of any contract or agreement affecting the Estate. (7) To renew any indebtedness, as well as to borrow money, and to secure the same by mortgaging, pledging or conveYing any property of the Estate, including the power to borrow at a reasonable rate of interest. (8) To retain and carry on any business in which the Estate may acquire an interest, to acquire additional interest in any such business, to agree to the liquidation in kind of any corporation in which the Estate may have an interest and to carry on the business thereof, to join with other owners in adopting any form of management for any business or property in .rR~ ZL Yvl, ~Cl( { ~ . . LAST WILL AND TESTAMENT OF ROSE E. MEKEEL PAGE 5 which the Estate may have an interest, to become or remain a partner, general or limited, in regard to any such business or property and to hold the stock or other securities as an investment, and to employ agents and confer on them authority to manage and operate the business, property or corporation, without liability for the acts of such agent or for any loss, liability or indebtedness of such business if the management is selected or retained with reasonable care. (9) To register any stock, bond or other security in the name of a nominee, without the addition of words indicating that such security is held in a fiduciary capacity, but accurate records shall be maintained showing that such security is a Estate asset and the Executor shall be responsible for the acts of such nominee. (B) Whenever the Executor is directed to distribute any Estate assets in fee simple to a person who is then under twenty-one (21) years of age, the Executor shall be authorized to hold such property in Trust for such person until he/she becomes twenty-one (21) years of age, and in the meantime shall use such part of the income and the principal of the Estate as the Executor may deem necessary to provide for the proper support and education of such person. If such person should die before becoming twenty-one (21) years of age, the property then remaining in trust shall be distributed to the personal representative of such person's estate. (C) In making distributions from the Estate to or for the benefit of any minor or other person under a legal disability, the Executor need not require the appointment of a guardian, but shall be authorized to payor deliver the same to the custodian of such person, to payor deliver the same to such person without the intervention of a guardian, to payor deliver the same to a legal guardian of such person if one has already been appointed, or to use the same for the benefit of such person. (D) In the disbursement of the Estate and any division into separate trusts or shares, the Executor shall be authorized to make the distribution and division in money or in kind, or both, regardless of the basis for income tax purposes of any property distributed or divided in kind, and the distribution and division made and the values established by the Executor shall be binding and conclusive on all persons taking hereunder. The Executor may in making such distribution or division allot undivided interests in the same property to several trusts or shares. ~~ s ,'y\\- c-C'-C. -2bR LAST WILL AND TESTAMENT OF ROSE E. MEKEEL PAGE 6 (E) The Executor shall have discretion to determine whether items should be charged or credited to income or principal or allocated between income and principal as the Executor may deem equitable and fair under all circumstances, including the power to amortize or fail to amortize any part or all of any premium or discount, to treat any part or all of the profit resulting from the maturity or sale of any asset, whether purchased at a premium or at a discount, as income or principal or apportion the same between income and principal, to apportion the sales price of any asset between income and principal, to treat any dividend or other distribution of any investment as income or principal, or apportion the same between income and principal, to charge any expense against income or principal or apportion the same, and to provide or fail to provide a reasonable reserve against depreciation or obsolescence on any assets subject to depreciation or obsolescence, all as the Executor may reasonably deem equitable and just under all the circumstances. (F) If at any time the total fair market value of the assets of any trust established or to be established hereunder is so small that the corporate Trustee's annual fee for administering the trust would be equal to or less than the minimum annual fee set forth in the Trustee's regularly published fee schedule then, in effect, the Trustee in its discretion shall be authorized to terminate such trust or to decide not to establish such trust, and in such event the property then held in or to be distributed to such trust shall be distributed to the persons who are then or would be entitled to the income of such trust. If the amount of income to be received by such persons is to be determined in the discretion of the Trustee, then the Trustee shall distribute the property among such of the persons to whom the Trustee is authorized to distribute income, and in such proportions, as the Trustee in its discretion shall determine. (G) Unless the context clearly states otherwise, when the authority and power under this Will is vested in two (2) or more Executors, the authority and powers are to be held jointly by the Executors. A majority of the Executors may exercise any authority or power granted under this Will or granted by law, and may act under this Will. Any attempt by one such Executor to act under this Will on other than ministerial acts shall be void. The action of one such Executor under this Will may be validated by a subsequent ratification of the act by a majority of the Executors. EIGHTH: Ri~hts and Liabilities of Executor. No bond or other security shall be required of any Executor. This instrument always shall be construed in favor of the validity of any act or omission by any Executor, and any Executor shall not be liable for any act or omission except in the R ' z: ~ 111. At'~ --w LAST WILL AND TESTAMENT OF ROSE E. MEKEEL PAGE 7 case of gross negligence, bad faith or fraud. Specifically, in assessing the propriety of any investment of the estate, the overall performance of the entire estate shall be taken into account. Each Executor shall be entitled to receive reasonable compensation for services actually rendered to my estate, in an amount the Executor normally and customarily charges for performing similar services during the time which he/she performs the services. NINTH: Tax Elections. In determining the estate, inheritance and income tax liability relating to my Estate, the Executor's decision as to all available tax elections shall be conclusive on all concerned. If the Executor joins with my spouse in filing income tax returns, or consenting for gift tax purposes to having gifts made by either of us during my life considered as having been made one-half by each of us, any resulting liability shall be borne by my Estate and my spouse in such proportions as they may agree. In accordance with IRe Section 2632(a) and without regard to whether a Federal estate tax return is actually filed, my Executor shall allocate so much of the Federal Generation Skipping Transfer (GST) exemption amount as will fully exempt any generation skipping transfer which may occur under this Will. TENTH: Definitions and General Provisions. (A) Survival. Any beneficiary, including my spouse, who dies within sixty (60) days after my death shall be considered not to have survived me. (B) Trust Estate. "Trust Estate" means all assets, however and wherever acquired, including income, which may belong to a Trust at any given time. (C) Children. Except for discretionary distributions which may be made unequally among a group of persons and distributions pursuant to a valid exercise of a Power of Appointment, in making a distribution to the children of any person, the property to be distributed shall be divided into as many shares as there are living children of the person and deceased children of the person who left children who are then-living. Each living child shall take one share and the share of each deceased child shall be divided among his then-living descendants in the same manner. A posthumous child shall be considered as living at the death of his parent. (D) Code. Unless otherwise stated, all references in my Will to section and chapter R, [ ,YVL ' ~(( -y~ LAST WILL AND TESTAMENT OF ROSE E. MEKEEL PAGE 8 numbers are to those of the Internal Revenue Code of 1986, as amended, or the corresponding provisions of any subsequent federal tax laws applicable to my estate. (E) Other terms. The use of any gender includes the other genders, and the use of either the singular or the plural includes the other. (F) Captions. The captions set forth in this Will at the beginning of the various divisions hereof are for convenience of reference only and shall not be deemed to define or limit the provisions hereof or to affect in any way their construction and application. (G) Powers of Appointment are Exercised. By this Will I exercise any Power of Appointment which I may possess at my death. IN WITNESS WHEREOF, I, ROSE E. MEKEEL, the Testatrix, have to this my Last Will and Testament, type.rritten on ten (10) pages, including the Acknowledgment and Affidavit, set my hand and seal this --t- day of August, 1999. .~~/~. ~Al ROSE E. MEKEEL Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who have hereunto subscribed our names at her request, as witnesses hereto, in the presence of the said Testatrix, and in the presence of each other. Each of us further declares that he or she believes the Testatrix to be of sound mind and memory. The preceding instrument consists oftrus and nine (9) other consecutively numbered typewritten pages including the Acknowledgment and Affidavit. 'i c:::. . residing 0~\Q/vy\~~ >-A J ~ residing at (}~ JLu:;1/ ACKNOWLEDGMENT AND AFFIDAVIT CO:MMONWEAL TH OF PENNSYLVANIA ss: COUNTY OF CUMBERLAND The Testatrix and the witnesses whose names are signed and subscribed to the attached or foregoing instrument, being first duly sworn and qualified according to law, do hereby acknowledge, depose and say to the undersigned authority, that the Testatrix signed and executed the instrument as her Last Will in the presence of the witnesses; that she signed it willingly or willingly directed another to sign it for her; that she executed it as her free and voluntary act for the purposes therein expressed; that each of the witnesses were present and saw the Testatrix sign and execute the instrument as her Last Will; that each subscribing witness in the hearing and sight of the Testatrix signed the will as witnesses; and that to the best of their knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. , .~, (. ~oQ.. Testatrix (~J~~ - ~nss .~~ Sworn to or affirmed, subscribed to, and acknowledged, before me by the above-named Testatrix and witnesses, this ~ day of August, 1999. -0QH)cuiv1 1 Notary Public My Commission Expires: Notarial Seal Teri L. Walker, Notary Public Lemoyne Boro, Cumberland County My Commission Expires Jan. 20, 2003 Member, Pennsylvania ASSOciation ot ~~otaries ,- ~ ~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) 5<<?-. S.e ~ :5'10- t2- Name of Decedent: DateofDeath: ~U.1- ~~ I ::Loe> I Will No. To the Regist~Ast' .:n -D I ~ Df,; 0 (il). .-, Admin. No. o<t ~ ~ ()o~<Co I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on (;1-/51'-01 : Name Address 'R1~~J B> '~~W\a ~~~~'Fl~fD · L?-W ~~ Rei, ~14 I {4 17~/1 Lt ( ~ 'Ben~ I'll' _ -i4:: t S- ~ e)(R.S 77oS"/ 1 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: A act d- 'i I ~O) Signature Address -~~ -tibLL5T7J:h l ~ f 705 7 Telephone (7('8 ~ 7 t - ~~ 7 9 Capacity: ~Personal Representative _Counsel for personal representative "- /6- 1S6--~ 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-1'07 EX AFP (01-05) GEORGE F DOUGLAS III ESQ 27 W HIGH ST CARLISLE PA 17013 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-06-2003 DREISBACH 02-23-2000 21 00-0180 CUMBERLAND 101 WILLIAM W 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 ~ REv=i6cfj-Ex-AFP--co-f:oiY------...-XNHERIYANc"E-fAx-sT"A-fEMENf-ifF"-Accouiff--...---------------- - - --- ESTATE OF DREISBACH WILLIAM W FILE NO.21 00-0180 ACN 101 DATE 01-06-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-22-2002 PRINCIPAL TAX DUE: ................................................. 35,907.67 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) *** SUMMARY OF ALL 006 PAYMENTS *** 12-16-2002 2,885.28- 38,792.95 TOTAL TAX CREDIT 35,907.67 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l \ /6 - 02/0 .. 7 5/ :/ (/ 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 GREGG HAMM BOVER & RITTER PO BOX 8300 CAMP HILL DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-05-2001 MEKEEL 01-26-2001 21 01-0180 CUMBERLAND 101 REV-1547 EX AFP (12-00) ROSE E Amount Remitted PA 17001 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 ~ iifv=is4j-Ex-AFP--fl"2':-oo-r-NcfficE--oF--ftiHEiiiTANci-;--Ai-APPRAisEifEN:r,--Ail-owANci-crR"----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MEKEEL ROSE E FILE NO. 21 01-0180 ACN 101 DATE 06-05-2001 TAX RETURN WAS: (X) ACCEPTED AS fILED ) CHANGED NOTE: IT an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reTlect Tigures that include the total oT 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 .00 X 045 = .00 .00 X 12 = .00 22,029.00 X 15 = 3,304.00 (19)= 3,304.00 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 n) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 25,426.00 .00 .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) nO) 2,434.00 963.00 (11) (12) (13) (14) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 25,426.00 3.397 00 22,029.00 .00 22,029.00 . PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 04-17-2001 AA496508 165.20 3,139.00 TOTAL TAX CREDIT 3,304.20 BALANCE OF TAX DUE .20CR INTEREST AND PEN. .00 TOTAL DUE .20CR * 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" (CRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) -- fi) 0;> >< u.l (\) to it 0:. d) o to (0 v} q o z ~ l- Ul t- 4-4- _l- z.(/) <(Ul ~O ,..Z (/)4- ZUl ZO UlZ 0..4- l- ~ Ul :r:. ~ l- 0- - uJ (.) uJ CC ...1 4. - (.) - U- U- o <l: Z <l: 3 (f) >- III ~uJ~ z::J1- w:2...l o...W<t o(D3 :J:- :r:u...'2:. <l: ~oo 0... <l:I-Z . wz-"-~ ;;w't;gS z:2;:)OCO ~~<t~~ :z;~~~~ ou...;:)u.l<l: (.)o!X)o:r: o co o dJ oJ S --~ \- Z =' o ~ <( 'Z wc)a: z~a:w 0(/)\-0) <((/)z~ wo:J 'fAoz <( ~ o cc u.. o u.1 2: u.1 (.) u.1 0: L z o ~ ~ 0: o U- ~ffi u.J~ ~::J \-z uJ (f) ~ ::5 u.J u:. :r: S 2 ,.:.~ r-- ~_.-' ~ ~ (j) a: ~ t7; .-, <l: ~ I- Z W o ;.~..; UJ (.) uJ o u... o uJ :2 <l: Z <::> t:' ~ . .~ ~ ~~n.-" ~('~. ~'?s ~.)l_, ~ " ~~1 '\ \ "-: o~ tf1 .,-l \....., ;it o :;;{ 0- 'Z =' o ~ <( ;t '0 \- " ~ -l OC .w r lJ) >->-...... coet:(!) o 4. I.l.J uJ!:O::: "2- uJ <..:> uJ a: cfJ :j $ U- o a::. Ul ~ ffi a: " tn 1-4 o l'""4 .t:- O u.. o w w .,-.i:t 7' 0 f- a C1 I CU >- ;i .......0: d :I:'.JJ (t ;lJ ~ n.\ 1': 1: III "-. ::'t 0 .,....t (/) ~;_J'B ~ z uJ <( 6 ~ m (.) 0 a: .. -:x: u w :t. U :t uJ (/) ..... o ...-I I- Z w ::z ~ 0... - u... o w ~ o III ~ o ';(. a: <l: :2 r- (j) o D- C. .... . "," oK STATUS REPORT UNDER RULE 6.12 / S6C, S-c)~ N~- ) C A1~kt' ~ (3QO-/Z:-;$ i b bY. ~(}o I I:::; (),S ~ fd/Yl rl r; "7 I Will No. l Admin. No. :2 00 1- ()(j J 5t() ) 11 c:2-1- 0 / - 0 /8'0 ' P~/P~~ 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: Name of Decedent: Date of Death: 1. State whether administration of the estate is complete: Yes I.~ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? y~S ~/ 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 L// 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 this report. Date: /{)-- 2iJ -O""Z- . ~ '" ('vlAK. Y / I+E() FAtV' D IS --"- .~~ SignaLu e At<F fJ1~ ( ;J{Jv~ MA~ tDm1rt FAN I'D, V' Name ( lease ty e or print) III (., B etf'Lflj Dr H I ~ Address ~ +7{!' NOJ- 7 3- A?\ 11 ,4Ktl- Capacity: ~ersonal Representative Counsel for personal representative (MAH:rmf/AM3) t- REV-1500 EX + (6-00) OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA REV-1500 /~ :2/6 7 - - DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER /i'o HARRISBURG, PA 17128-0801 RESIDENT DECEDENT ..;.:,/ 0 I I CQUNTYCODE YEAR NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER MEKEEL, ROSE E 390-12-3166 DECE- DATE OF DEATH (MM-DD-YEAR) l DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 01/26/01 01/18/1909 WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 3. Remainder Return CHECK r Original Return ~' Supplemental Return B (date of death prior to 12-13-82) APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required ~ateofdeathafter12-12-821 PRIATE 6. Decedent Died Testate 7. ecedent Maintained a living Trust 0 8. Total Number of Safe Deposit Boxes (Attach copy of Will) (Attach a copy of Trust) BLOCKS 9. Utigation Proceeds Received 10. Spousal Poverty Credit (date of death between 0 11. Election to tax under Sec. 9113(A) 12-31-91 alld 1-1-9S} (Attach Sch OJ itll!$',~ijMll\ljjlilll:iiM!Mf~j~ipQijI.19..Hi;~tj\ilil1!)".MA_~lIQl!ijKlll!li!:i~p'tj:jI NAME COMPLETE MAILING ADDRESS COR- GREG3 HAMM P.O. BOX 8300 RE- FIRM NAME (If Applicable) CAMP HILL, PA 17001-8300 SPON DENT BOYER & RITI'ER TELEPHONE NUMBER 717-761-7210 Noo~ . OFFICIAL USE ONLY 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule 8) (2) Nahe 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) Nooe 4. Mortgages & Notes Receivable (Schedule 0) (4) None 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 25,426.00 6. Jointly Owned Property (Schedule F) D Separate Billing Requested (8) None RECA- PITULA- ? Inter-Vivos Transfers & Miscellaneous '. TION Non-Probate Property (Schedule G or L) (7) Nooe 8. Total Gross Assets {total Lines i -7} (8) 25,426.00 9. Funeral Expenses & Administrative Costs (Schedule H)(9) 2,434.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (iO) 963.00 11. Total Deductions (total Lines 9 & 10) (11) 3,397.00 12. Net Value of Estate (Line 8 minus Line 11) (12) 22,029.00 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax (13) None has not been made (Schedule J) 14. Net Value SUbJect to Tax (Une 12 minus Una 13) (14) 22,029.00 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLIE RATES 15. Amount o~ Line 14 taxable at the spousal tax rate,ortransfersunderSec.9116(aX1.2j x.O (15) TAX 16. Amount of Line 14 taxable at lineal rate 0.00 X.O ~ (18) 0.00 COMPU- 17. Amount of Line 14 taxable atsibling rate 0.00 X .12 (17) 0.00 TATION 18. Amount of Line 14 taxable at collateral rate 22,029.00 x.15 (18) 3,304.00 19. Tax Due (19) 3,304.00 20. D 1&Il~~i<jjj!(~'FWlmAij!ljIil~ij!i.jjli~i!l~ij!l!iWMe~liA_wtl .. ........ ...........................i...?i?~iia!;lllilll1rQA!I$iNliRlli$lI:i!'!!($TI(lN$.PI!!'l!'~eIO\i'lI)l!ePfi~MA1il#{: o PA151101 NTF 29755 Copyright 2000 Greatland/Nelco LP- Forms Software Only :.:-:.:::.:.:::.:.:.:-~:.:.:::.,.:.:.:-:::".:::.:.:.:..-..,.,.... . :':::::':::::.::':::::~:;:::.::.:.:.....' .' . Estate of: ROSE E MEKEEL SUMMARY OF ALLOCATIONS TO BENEFICIARIES Taxable at collateral rate MARY THEOFANIDIS RICHARD ROMIG 11,015.00 11,014.00 22,029.00 PA REV-1500 EX (6-00) Page 2 Decedent's Comolete Address: STREET ADDRESS 355 S. SFQRTING HILL ROAD CITY I STATE I ZIP MEOJANICSBURG PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 3,304.00 165.00 Total Credits (A + B + C) (2) 165.00 3. Interest/Penalty if applicable D. Interest E. Penalty 5. TotallnterestJPenalty (0 + E) 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 If Line 1 + Line 3 is greater than Une 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Une 5 -t' 5A. This is the BALANCE DUE. Mak>;.c~~"~."~~y~~I;\~:~~~I~TE'R OF WIUS, AGENT . . ...... ........- ."'-":';':':"'-':':"::::.::,::::,,::::,::.::::::::,:,:::::::::::::::::::::;;:::::;::::;:;;;:;:;;::::~;:;:;: ;;;;;:;:;:;;;;:~;;:;;;: tit~itiJtt)(i}{mtH (3) 0.00 4, (4) (5) (SA) (5B) 3,139.00 0.00 3,139.00 PI..EASE"ANSWER'it-lEFOI..1..0WING' oUEsiiONS"By'PI..ACiNG'AN";;X';"iN'i'HE'APPROPRIATE"BLOCKS ...';<.'....,. :~;~:f~:::/f~t{{::;;:;::;:;;;:;:.:.;...;...,... , ;.:.;.:.:.>;':.;.;........ 1. Did decedent make a transfer and: a. retain the use or income of the property trans1erred; .........................,..,..,..,..,. b. retain the righllo designate who shall use the property transferred or its income; .,..,..,..,...... c. retain a reve\"ioIl3lY interest; or. . . . . . . . . . . . . . , . . . . . . . . , . . , . . . . . . . . . . . . . . . . . . . ' . . , . . . . . . d. receive the protllise for life of either payments, benefits or care? . . . , . . . . , . , . . , . . . . . . . , . . , . 2. 11 death occurred atter December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . , . . . . . . , . . . . . . . . , , . . . . . . , . . . . , . , . . . . , . . . . . . , . , . . . 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . , . . . . . . , . . . , . . , . . . . . . . , . . , . , . . . . . . . " 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return\ including accompanying schedules and statements, and to the best of my knowledge and belief, II is true, correct and complete. Declaration 0 preparer other tlian the personal representative is based on information of which preparer has any knowledqe SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE . J,l;' 'Z~ew....tnJ.:y L{-I(,,-Ol I Yes No ~ I 8 ~ ~ f,ATj 'i; 13. "I <..... A DRESS P.O. BOX 8300, CAMP HILL, PA 17001-8300 FfJr 'd ;lies' 0 f" 'd 'eat'h' 0 ~ '0 ~"~fip. r'Ju Iy , '1,'1'8 U<1 . a\ ~i"b ~ \ ()~'e' jan~~;y' '<-";3"9'5': ~:~:~:.t::::~~~::::i:::;~:::::~':~:~::~:~:::~~~;Ji:I:~~:;~~~~~::~:~::tl\~(~:fi~~:::~~r~; :~:~i~~\,~.:~:~%ig~:~ .l~t~:~:~::j~\I~2.:: . :':::""':;::,""::::';.:::,',,:,::>.'. [72 P.S. ~ 9116 (a) (1.1) (iJ]. For dates of death on or after January 1, 1 Y95, the lax rate is imposed on the net value of transfers to orfor the usa of the surviving spouse Is 0% 172 P.5. Ii 9116 (a)(1.1) (ii)l, The statute rln!'!;; not exp.mf;: Zl transfer 1l '1:rviving spOuse from tax, and the statutory requirements for disclosure of assets and filing a tax return are $till applicable even if the surviving spouse is the orrly benetlLI For dates of death on orafterJulv t, 2C The tax rate imposed on the ",.,tviJ,lue <.>1 ora stepparent of the chiid IS 0% [72 P.': a de~eased c:hild twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, The tax rate Imposed on the net value ()j ",-HI5~ers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72.P.S, Ii 9116(1,2) (72 P.S, Ii 9116(a)(1)], The tax rate imposed an the net value 01 transfers to or for the use of the decedent's siblings is 12% [72 P.S. 19116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in cammon With the decedent, whether by blood or adoption. o PA15002 N1F 2B756 CGpyright 2000 GreatlandfNelco LP- Forms Software Only ","~ ,on~ n,y ",',"f, This. is to certity that the information here given is correctly copied from an original certificate of death duJy filed with me as 'Local ~egistrar. The original certificate will be fOlwarded to the State Viral Records Office for permanenr tIling, WARNING: It is illegal to duplicate this copy by photostat or photograph. No. /~7N;,,- ",<~\i" OF pl;,-----_ "'~V~~'- l~ '. :.J::\. l~_v' .'" . ~\ ,""I.. ~"" ~Q ,;-' -~ ~ '-' .11:-,' :b~ \*~ ." :.~.~. ,"*/ \*~., ~l '"=.~~ '~\\ ~...##~l~-~\ ~~Ill/ ->...."""""....##11#1111". f~~l Ri~~di- Fee for [his certificate, $2.00 P 7121135 9d~-'U-L 'jO.~OI {IDate . H105143~2J87 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH TYPE/PAINT " PEAM"NENT 8l..CKlHK o ~ , ~ , 8lf1'TNI'I..ol.Cf.IC.ty;wl(l ~OIfc'"9"'C""""'Il ~t:EI1 PlACEO#OENK4C_""'Y.,....--_.....'-""""'...,..__ -- 1.,..,_0 tc<: ~lO .,. - FNtEI'l'SNAtolE1F...M"'<Ie,ta.1 ,.. Lu,',I/,.p _~'s~(fypeo1'r""l -.. nKll\..<e....' &,>,1. ME"TNOOOf'DISPOSlTION O _D Ct_....8 __51.,.0 _ ou...~' , SlGNAJUREOffU ,.- !-N- I;), wo.sCASEAEfEAN:DlOMEOlCALEIl.lMINEIIICOAONEfI'I ~O ...p:: r~'5fl'D DUf.lOlOAASACQNSf.OUENCEOF): a ,- '-- 1--- !ur.~ .....,..: cw..1igniIcMI_-........._,tIuI ....-....in..~_g;....inFNITI [: DtJElO/ORASACOOSEOUENCEOFI' OIJElOlOAASAcoNsEOUENCtOFl WEFlEA.U'IOf'SYFINOINQS _lAlIlE PRlDfI TO COMPI.ETION.DFCAUSE Of'OERHl t,lAHNEI'lOF OEAIH _.. u- n n DArEOFWJURY I"""''' Day,,",,.., TINEO#INJUR'l' INJUR'I'R'M)AKl DESCAIIIE NOW INJURY OCCUARlEO -- o o .. [] Pl..ACEOI'If'lJURY'A1_.__.~_ t>u<ldinli._"SpoocM - ... 0 NclD NC_'" P.-ne'..-...'..... _0 ~n - Could""'.".'."'"''"''' n...... o 0;.......,0.'1'._. ~lc. ~"L J~y... :;:l c:, d.J.;;N} NAME AND ADOAf:$S OF PEI'lSON WHOCOMPlETfD CAtJ6E 0# OEATK (h""6€:~~::- P. ~I" ~Y\~t..,,",n--. JI'l thO 0" e:su W,,- ""'t eutt.... "-0 <:.n'-l~" DREFIlEO(""""',o.V, "'"'I p, Q, "X - - COITIFIoEI'l,CNock_"""1 .CEATIfYlNGPHYSICIAH(l'tly__....,'-..,"..-:l"""'...;)..............'".-."~..,"w""...,~......,.\Uu<.......,,""",.,,~c"',,"'"'''''It..,,2Jj ,.__ol...V_"'*"'"'........oc.".,,"_......~...~.Iar>dm..,n..........., , ". , . o . ~ o o ~ ...NltrlQUHc:lN(lANDClRl"'VING..KVSICI4NI~..n_"''"'''''.-.c."<J,,........\d~..Id_'Oc......OI'..'''.', lolM_......V_.................""C..._....._. ".'.._plot:...nd "... to.n.u..HIII..... "'.n..., ......oHI 't.lEDlC.tLIEX"Y'NlRJCORONEA Ortlh.b..i.gIU....I".'Io.....dfori"'I'..lIg...llon.'''mvgpm'gn.d..'hOCcu''.d.1 Ih. 11m.. d.I.. andp'.CO. onddu.lg"'.C.UHl.'."" m...".......loHI"... .... ... ....... ... .... ............... .. .............................., '" REG'ST "~.M"M~'."."~ ~+<<'A<-' l'/..&'--r1: [;,,1 '><l/,dL ".J liAr 'do, ;/00 I OF COpy LAST WILL AND TEST AMENT ROSE E. MEKEEL I, ROSE E. MEKEEL, now of355 South Sporting Hill, Apartment #54, Mechanicsburg, Cumberland County, Pennsylvania 17055, do publish and declare this to be my Last Will and Testament,. hereby revoking all other prior wills and codicils made by me. FIRST: Familv Backl!round and Appointment of Executor. (A) Familv and Backl!round Information. I am a single woman, I have no living children. I have a niece, MARY ROMIG FANIDI A/KfA MARY THEOFANIDIS and I have a nephew, RICHARD ROMIG, whose wife is MARLENE ROMIG. (B) Appointment of Executor. I appoint as my Executrix and successor Executor (all hereinafter referred to as Executor or Executors) under this Will, the following named persons to serve without bond and without being required to account to any Court: Executrix: My neice, MARY ROMIG FANIDIA/KfA MARY THEOFANIDIS. Successor Executor: My grand-nephew, my niece's son, PARIS THEOF ANIDIS. SECOND: Funeral and Last llIness Exnenses: Taxes. (A) Exnenses of Funeral and Last IDness. Notwithstanding that my spouse survives me, I direct my Executor to pay my funeral expenses and the expenses of my last illness from my estate. _... .1;. (B) Taxes. I direct my Executor to pay any and all estate, inheritance, succession, legacy, transfer and other death taxes or duties, by whatever name called, including any and all interest and penalties thereon, imposed under the laws of any jurisdiction by reason of my death, upon or with respect to any and all property included in my gross estate for the purpose of such taxtS, whether such property passes under or outside of this Will, out of my residuary estate, without being prorated or apportioned among or charged against the respective devises, legatees, beneficiaries, transferees, or other recipients of any such property or charged against any property passing or which may have passed to any of them. The Executor shall not be entitled to reimbursement for any portion of any such taxes from any such person. ~ L )4[. d'tC: -y~ LAST WILL AND TESTAMENT OF ROSE E. MEKEEL PAGE 2 THIRD: Tanl!ible Personal Property. Except for those items excluded below and those items enumerated in the Letter of Instruction, I bequeath to my niece, MARY ROMIG FANIDI, and to my nephew, RICHARD ROMIG, to be divided between them as equally as is possible, all tangible personal property, including but not limited to clothing, jewelry, heirlooms, furniture, personal effects, motor vehicles, and all other similar articles, which I own, and the insurance thereon, ifmy spouse surVives me by sixty (60) days, Tangible personal property shall not include: (1) any and all property used by me in any business, (2) cash on hand or on deposit in banks, (3) stock or securities, (4) any type of evidence of indebtedness, and (5) any life, health or accident insurance policies. If my niece and nephew do not survive me, I leave such tangible personal property to my grand nephews, my niece MARY ROMIG FANIDI'S sons, PARIS THEOFANIDIS and CHRISTOPHER lHEOFANIDIS, per stirpes, Ifthere is any disagreement as to distribution, I direct my Executor to make such distribution, The decision of my Executor shall be final and binding. Any items not selected or any items which my Executor considers unsuitable for my heirs may be distributed or sold in the sole discretion of my Executor and, if sold, the net proceeds therefrom shall be added to the residue of my estate, Any such article allocated to a minor may, as my Executor deems advisable, either be delivered to the minor or to any person to safeguard on behalf of the minor. ~ .. Notwithstanding any other provisions in this Article THIRD, I may leave a separate, dated and unsigned Letter of Instruction, which I shall place with my Will, containing directions as to the ultimate disposition of certain of the property bequeathed under this Article TIllRD, and such Letter of Instruction shall determine the distribution of such items, . . FOURm: Familv Borne. [THIS ARTICLE IS INTENTIONALLY LEFT BLANK,] l''ll'lH: Residuary Gifts. (A) I give, devise and bequeath all the rest, residue and remainder of my estate, of every kind and character, real, personal and mixed, tangible and intangible, and wherever situated, including R,( ~, illC 1M LAST WILL AND TESTAMENT OF ROSE E. MEKEEL PAGE 3 any lapsed or renounced legacies, devises or residuary bequests (and including any property over which I may have a Power of Appointment), to be divided in equal shares to my niece, MARY ROMIG FANlDI and to my nephew, RICHARD ROMIG. (B) If my niece and nephew do not survive me, I give, devise and bequeath all the rest, residue and remainder of my estate, of every kind and character, real, personal and mixed, tangible and intangible, and wherever situated, including any lapsed or renounced legacies or devises (and including any property over which I may have a Power of Appointment), to my grand-nephews, my niece MARY ROMIG FANlDI'S sons, PARIS THEOFANIDIS and CHRISTOPHER THEOFANIDIS, per stirpes. (C) Distributions Durin!! Administration. Prior to final distribution of my estate, the Executor, in his discretion, may make partial distributions to one or more beneficiaries or Trusts. As a consequence, the Executorship and any Trusts created under this Will may exist contemporaneously. A distribution may be made subject to any indebtedness or liability of my estate. SIXTH: Spendthrift Provision. No beneficiary shall have the power to anticipate, encumber or transfer his or her interest in the estate in any manner other than by the valid exercise of a power of appointment. No part of the estate shall be liable for or charged with any debts, contracts, liabilities or torts of a beneficiary or subject to seizure or other process by any creditor of a beneficiary. SEVENTH: Powers of Executor. In addition to the powers and duties as may have been -. .i. granted elsewhere in this Will, but subject to any limitations stated elsewhere in this Will, the Executor shall have and exercise exclusive management and control of the Estate and shall be vested with the following specific powers and discretion, in addition to the powers as may be generally conferred from time to time upon him by law: (A) In the management, care and disposition of the Estate, the Executor shall have the power to do all things and to execute such deeds and instruments as may be deemed necessary or proper, including the following powers, all of which may be exercised without order of or report to any Court: /fft. L)'V\. ~~( ;/~ LAST Wll..L AND TESTAMENT OF ROSE E. MEKEEL PAGE 4 (1) To sell, exchange or otherwise dispose of any property, real, personal or mixed, at any time held or acquired hereunder, at public or private sale, for cash or on terms, without advertisement, including the right to lease for any term notwithstanding the period of the Estate, and to grant options, including any option for a period beyond the duration of the Estate. (2) To invest all monies in such stocks, bonds, securities, mortgages, notes, choses in action, real estate or improvements thereon, and any other property as the Executor may deem best, without regard to any law now or hereafter enforced limiting investments of fiduciaries. (3) To retain for investment any property deposited with the Executor hereunder. (4) To vote in person or by proxy any corporate stock or other security and to agree to or take any other action in regard to any reorganization, merger, consolidation, liquidation, bankruptcy or other procedure or proceedings affecting any stock, bond, note or other security . (5) To use attorneys, real estate brokers, accountants and other agents, if such employment is deemed necessary or desirable, and to pay reasonable compensation for their services. ~ ". (6) To compromise, settle or adjust any claim or demand by or against the Estate and to agree to any rescission or I;I1odification of any contract or agreement affecting the Estate. (7) To renew any indebtedness, as well as to.borrow money, and to secure the same by mortgaging, pledging or conveying any property of the Estate, including the power to borrow at a reasonable rate of interest. (8) To retain and carry on any business in which the Estate may acquire an interest, to acquire additional interest in any such business, to agree to the liquidation in kind of any corporation in which the Estate may have an interest and to carry on the business thereof, to join with other owners in adopting any form of management for any business or property in .0<... E.. YvL . ~V( ~{J . LAST WILL AND TESTAMENT OF ROSE E. MEKEEL PAGE 5 which the Estate may have an interest, to become or remain a partner, general or limited, in regard to any such business or property and to hold the stock or other securities as an investment, and to employ agents and confer on them authority to manage and operate the business, property or corporation, without liability for the acts of such agent or for any loss, liability or indebtedness of such business if the management is selected or retained with reasonable care. (9) To register any stock, bond or other security in the name of a nominee, without the addition of words indicating that such security is held in a fiduciary capacity, but accurate records shall be maintained showing that such security is a Estate asset and the Executor shall be responsible for the acts of such nominee. (B) Whenever the Executor is directed to distribute any Estate assets in fee simple to a person who is then under twenty-one (21) years of age, the Executor shall be authorized to hold such property in Trust for such person until he/she becomes twenty-one (21) years of age, and in the meantime shall use such part of the income and the principal ofthe Estate as the Executor may deem necessary to provide for the proper support and education of such person. If such person should die before becoming twenty-one (21) years of age, the property then remaining in trust shall be distributed to the personal representative of such person's estate. (q In making distributions from the Estate to or for the benefit of any minor or other person under a legal disability, the Executor need not require the appointment of a guardian, but shall be authorized to payor deliver the same to the custodian of such person, to payor deliver the same -, .. to such person without the intervention of a guardian, to payor deliver the same to a legal guardian of such person if one has already bee~ appointed, or to use the same for the benefit of such person. (D) In the disbursement of the Estate and any division into separate trusts or shares, the Executor shall be authorized to make the distribution and division in money or in kind, or both, regardless of the basis for income tax purposes of any property distributed or divided in kind, and the distribution and division made and the values established by the Executor shall be binding and conclusive on all persons taking hereunder. The Executor may in making such distribution or division allot undivided interests in the same property to several trusts or shares. ~- 'i.- .'t'v\- .--eec ~ LAST WILL AND TESTAMENT ill: ROSE E. MEKEEL PAGE 6 (E) The Executor shall have discretion to determine whether items should be charged or credited to income or principal or allocated between income and principal as the Executor may deem equitable and fair under all circumstances, including the power to amortize or fail to amortize any part or all of any premium or discount, to treat any part or all of the profit resulting from the maturity or sale of any asset, whether purchased at a premium or at a discount, as income or principal or apportion the same between income and principal, to apportion the sales price of any asset between income and principal, to treat any dividend or other distribution of any investment as income or principal, or apportion the same between income and principal, to charge any expense against income or principal or apportion the same, and to provide or fail to provide a reasonable reserve against depreciation or obsolescence on any assets subject to depreciation or obsolescence, all as the Executor may reasonably deem equitable and just under all the circumstances. (F) If at any time the total fair market value ofthe assets of any trust established or to be established hereunder is so small that the corporate Trustee's annual fee for administering the trust would be equal to or less than the minimum annual fee set forth in the Trustee's regularly published fee schedule then, in effect, the Trustee in its discretion shall be authorized to terminate such trust or to decide not to establish such trust, and in such event the property then held in or to be distributed to such trust shall be distributed to the persons who are then or would be entitled to the income of such trust. If the amount of income to be received by such persons is to be determined in the discretion of the Trustee, then the Trustee shall distribute the property among such of the persons to whom the Trustee is authorized to distribute income, and in such proportions, as the Trustee in its discretion shall determine. -... ...:. (G) Unless the context clearly states otherwise, when the authority and power under this Will is vested in two (2) or more Executors, the authority and powers are to be held jointly by the Executors. A majority of the Executors may exercise any authority or power granted under this Will or granted by law, and may act under this Will. Any attempt by one such Executor to a\.1; under this Will on other than ministerial acts shall be void. The action of one such Executor under this Will may be validated by a subsequent ratification of the act by a majority of the Executors. EIGHTH: Ril!:hts and Liabilities of Executor. No bond or other security shall be required of any Executor. This instrument always shall be construed in favor of the validity of any act or omission by any Executor, and any Executor shall not be liable for any act or omission except in the R, z:..l'\t1. .6tC -y~ _..:. . . LAST WILL AND TESTAMENT OF ROSE E. MEKEEL PAGE 7 case of gross negligence, bad faith or fraud. Specifically, in assessing the propriety of any investment of the estate, the overall performance of the entire estate shall be taken into account. Each Executor shall be entitled to receive reasonable compensation for services actually rendered to my estate, in an amount the Executor normally and customarily charges for performing similar services during the time which he/she performs the services. NINTH: Tax Elections. In determining the estate, inheritance and income tax liability relating to my Estate, the Executor's decision as to all available tax elections shall be conclusive on all concerned. If the Executor joins with my spouse in filing income tax returns, or consenting for gift tax purposes to having gifts made by either of us during my life considered as having been made one-half by each of us, any resulting liability shall be borne by my Estate and my spouse in such proportions as they may agree. In accordance with IRe Section 2632(a) and without regard to whether a Federal estate tax return is actually filed, my Executor shall allocate so much of the Federal Generation Skipping Transfer (GST) exemption amount as will fully exempt any generation skipping transfer which may occur under this Will. TENTH: Definitions and General Provisions. (A) Survival. Any beneficiary, including my spouse, who dies within sixty (60) days after my death shall be considered not to have survived me. (B) Trust Estate. "Trust Estate" means all assets, however and wherever acquired, including income, which may belong to a Trust at any given time. (C) Children. Except for'discretionary distributions which maybe made unequally among a group of persons and distributions pursuant to a valid exercise of a Power of Appointment, in making a distribution to the children of any person, the property to be distributed shall be divided into as many shares as there are living children of the person and deceased children of the person who left children who are then-living. Each living child shall take one share and the share of each deceased child shall be divided among his then-living descendants in the same manner. A posthumous child shall be considered as living at the death of his parent. (D) Code. Unless otherwise stated, all references in my Will to section and chapter Rl L ,YtL~ ,rYe -y~ LAST WILL AND TESTAMENT OF ROSE E. MEKEEL PAGE 8 numbers are to those of the Internal Revenue Code of 1986, as amended, or the corresponding provisions of any subsequent federal tax laws applicable to my estate. (E) Other tenns. The use of any gender includes the other genders, and the use of either the singular or the plural includes the other. (F) Captions. The captions set forth in this Will at the beginning ofthe various divisions hereof are for convenience of reference only and shall not be deemed to define or limit the provisions hereof or to affect in any way their construction and application. (G) Powers of Annointment are Exercised. By this Will I exercise any Power of Appointment which I may possess at my death. IN WITNESS WHEREOF, I, ROSE E. MEKEEL, the Testatrix, have to this my Last Will and Testament, typeymtten on ten (10) pages, including the Acknowledgment and Affidavit, set my hand and seal this ....i:- day of August, 1999. ~ D/ ~. fv1-R-1en.l ROSE E. MEKEEL -... .... Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who have hereunto subscribed our names at her request, as witnesses hereto, in the presence of the said Testatrix, and in the presence of each other. Each of us further declares that he or she believes the Testatrix to be of sound mind and memory. The preceding instrument consists of this and nine (9) other consecutively numbered typewritten pages including the Acknowledgment and Affidavit. .diO cAl\J ,ell ~n(~,e) :v Il_ /}/ ~ ""d;"." r!cvm.,12 ~ /"-f" ~to...~CL M. K'c<,,~'V' (print name) residing _----D~~ "^ .oil ~~_ Jl"rli_ ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYL V AN1A SS: COUNTY OF CUMBERLAND The Testatrix and the witnesses whose names are signed and subscribed to the attached or foregoing instrument, being first duly sworn and qualified according to law, do hereby acknowledge, depose and say to the undersigned authority, that the Testatrix signed and executed the instrument as her Last WIll in the presence of the witnesses; that she signed it willingly or willingly directed another to sign it for her; that she executed it as her free and voluntary act for the purposes therein expressed; that each of the witnesses were present and saw the Testatrix sign and execute the instrument as her Last Will; that each subscribing witness in the hearing and sight of the Testatrix signed the will as witnesses; and that to the best of their knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ~~, f'. M~c>~ Testatrix -... ...:. Sworn to or affirmed, subscribed to, and acknowledged, before me by the above-named Testatrix and witnesses, this ~ day of August, 1999. ~L()cuiQR ) Notary Public My Commission Expires: Notarial Seal Ted L. Walker, Notary Public lemoyno BOTO, Cumbertand County My Commission Expires Jan. 20, 2003 Member, Pennsylvam8 Association 01 Notanes . REV-1S02 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ROSE E MEKEEL SCHEDULE A REAL ESTATE FILE NUMBER All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged betvveen 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 01 survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH None 7 CPA21 NTF 10904 Copyright Forms Software Only, 1997 Nelco, Inc. TOTAL (Also enter on line 1, Recacitulation) $ (If more space is needed, insert additional sheets of the same size) 0.00 'REV-1500 EX+ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ROSE E MEKEEL SCHEDULE B STOCKS & BONDS FILE NUMBER All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH None 7 CPA31 NTF 10905 Copyright Forms Software Only, 1997 Nelco, Inc. TOTAL (Also enter on line 2, Recacitulationl S (If more space is needed, insert additional sheats of the same size) 0.00 . REV-15<>4 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ROSE E MEKEEL Schedule C-1 or C-2 (Including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-propiertorship. See instructions for the supporting information to be submitted for sole-proprietorships. SCHEDULE C CLOSELY-HELD CORPORATION PARTNERSHIP or SOLE-PROPRIETORSHIP FILE NUMBER ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH None TOTAL (Also enter on line 3, ReC8citulation) $ (If more space is needed, insert additional sheets of the same size) 0.00 7 CPA41 NTF 10906 Copyril;l'1t Forms 50Hware Only, 1997 Nelcll, Inc. REV-1507 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE D MORTGAGES & NOTES RECEIVABLE FILE NUMBER ROSE E MEKEEL All roperty Jolntlv-owned with the rlaht of survlvorshlD must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH None TOTAL (Also enter on line 4, Recsoitulation) $ (If more space is needed, insert additional sheets of the same size) 0.00 7 CPA71 NTF 10907 Copyright Forms Sottware Only, 1997 Nelco, Inc. REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ROSE E MEKEEL Include proceeds of litigation & date proceeds were received by the estate. All DroD.lolntlv-owned with rlaht of survlvorshlD must be disclosed on Sch. F. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER VALUE AT DATE OF DEATH ITEM NO. DESCRIPTION 1 PSECU ACCOUNT #0390-12-3166 20,437.00 2 MET LIFE - lONG TERM CARE roLICY 1,295.00 3 PHARMERICA - REIMBURSEMENT OF MAJOR MEDICAL 451. 00 4 AMP - REFUND 114.00 5 THORNWALD HCME - REFUND 729.00 6 INTERNAL REVENUE SERVICE - 2000 TAX REFUND 2,400.00 TOTAL (Also enter on line 5, Rec8oitulation) $ (If more space is needed, insert additional sheets of the same size) 25,426.00 7 CPA81 NTF 10908 Copyright Forms. Scttware O{\ly,1997 Nelco, Inc. . PSE(~ the finaneia/link March 28, 2001 Account # 0390123166 J. GREGORY HAMM C/O BOYER & RITTER 425 NORTH 21ST ST CAMP HILL, PA 17001-8300 Dear MR. HAMM: The following is the status of ROSE E. MEKEEL's account with PSECU as of the date of death. Joint Owner's Name Date Established Date of Death Date of Birth NONE 11231988 01262001 01181909 Share(s) Regular Shares (S 1) Checking Shares (S4) Money Market (S7) Share 50 12 Month Certificate Balance $ 5.27 1,901.96 4,908.72 13,551.46 Accrued Dividend $ 0.04 6.02 13.80 49.85 Loan(s) Personal Service Loan (L I) VISA (L9) Balance $ 0.00 20.00 Accrued Interest $ 0.00 0.00 The dividend earned from January 1,2001 through the date of death was $69.71. We do not have safe deposit boxes for our members. If you have any questions, please call 234-8484 in Hartisburg or our toll- free number, (800) 237-7328. At the menu prompt, enter 6 and then extension 2227. Sincerely, I Meacie Fair x Member Service Representative Finance Support Unit PENNSYLVANIA STATE EMPLOYEES CREDIT UNION Main Address: 1 Credit Union Place, Harrisburg, PA 17110-2990. (717) 234-8484. (800) 237-7328 Mailing Address", P.O. Box 67013, Harrisburg, PA 11106-7013. (717) 777-2100 (TOO) . (800) 472-1967 (TOO) Web Address: www.psecu.com Sa....ings federally insured up to $100,000 by the National Credit Union Administration. ) ) \ .) o 2001 REV-1509 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ROSE E MEKEEL SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER If an asset was made )olnt within one year 01 the decedent's date of death, It must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR MADE Include name of financial institution and bank DATE OF DEATH DECD'S VALUE OF JOINT account number or similar identifying number. NO. TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST None TOTAL (Also enter on line 6, Recacitulationl $ 0.00 7 CPA91 NTF 10909 (If more space is needed, insert additional sheets of the same size) Copyright Forms Software Only, 1997 Nelco, Inc. REV-1510 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ROSE E MEKEEL SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF EXCLUSION ITEM INCLUDE NAME OF THE TRANSFEREE, THEIR DATE OF DEATH DECD'S (IF TAXABLE VALUE RELATIONSHIP TO DECD & DATE OF TRANSFER. NO. ATTACH COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST APPliCABLE) None TOTAL fAlso enter on line 7, Recanitulation) $ 0.00 7 CPA01 NTF 10910 (If more space is needed, insert additional sheets of the same size) Copyright Forms Software Only, 1997 Nelco, Inc. REV-1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ROSE E MEKEEL SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NO. DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 VALLEY ROCK OF AGES MEMJRIAL - lli3RAVING 154.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 0.00 Name of Personal Representative(s) Social Security Number(s)/EIN No. of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid; 2. Attorney Fees 0.00 3. Famlly Exemption: (If decedent's address is not the same as claimant's, attach explanation) 0.00 Claimant Street Address City Stale Zip Relationship of Claimant to Decedent 4. Probate Fees 0.00 5. Accou ntant's Fees 950.00 6. Tax Return Preparer's Fees 0.00 7 SPINT - 'TELEPHONE EXPENSES 125.00 8 CUMBERLAND CDUNTY RmISTffi OF WILL - PROBATE FEES 109.00 9 MARY THEOFANIDIS - EXECUIDR'S EXPENSE OF AIMINISTERING ESTI\.TE 921. 00 10 SMI1H ELLIOT & KEARNS - PREPARATICN OF FINAL 1040 175.00 TOTAL (Also enter on line 9, RecsDitulation) $ 2,434.00 7 CPA11 NTF 10911 Cor-yri\dl'.t Forms $c1tware Only, ~21217 Nelco, Inc. (If more space is needed, insert additional sheets of the same size) . " REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ROSE E MEKEEL SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS FILE NUMBER Include unreimbursed medical exnenses. ITEM NO. DESCRIPTION AMOUNT 1 PA DEPARTMENT OF REVENUE - 2001 TAX LIABILITY 30.00 2 SPRINT - TELEPHONE BILL 6.00 3 PHARMERICA - MEDICATION 667.00 4 PAUL D. DALBEY DEM - MEDICAL SERVICFS 41. 00 5 BELVEDERE MEDICAL mRroRATION - MEDICAL BILL 32.00 6 STATE EMPWYEFS RETIREMENT SYSTEM - REPAYMENT OF PENSION 187.00 7 CPA12 NTF 10912 TOTAL (Also enter on line 10, Rae.ellul.tien) $ (If more space is needed, insert additional sheets of the same size) 963.00 Copyright Forms Software Only, 1997 Nelco, Inc. . REV-1513 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES ROSE E MEKEEL No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 MARY THEDFANIDIS 1116 BERING DRIVE N) 15 HOUS'IDN, TX 77057 2 RICHARD RCMIG 1298 KINGSLEY ROAD CAMP HILL, PA 17011 FILE NUMBER RELATIONSHIP TO DECEDENT Do Not List Trustee(s) NIECE NEPHEW AMOUNT OR SHARE OF ESTATE 11,015.00 11,014.00 ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 17 AS APPROPRIATE ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE None B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS None 7 CPA13 NTF 10913 TOTAL OF PART II -- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 Copyright Forms Software Only, 1997 Nelco, Inc, (If more space is needed, insert additional sheets of the same size) . . REV-1649 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ROSE E ME.KEEL Do not complete this schedule unless estate Is making election to tax assets under Section 9113(A) of Inheritance & Estate Tax Act. If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the Trust(marital, residual A, B, By-pass, Unified Credit, etc.). If a trust or similar arrangement meets the requirements of Section 9113(A), and: a. The trust or similar arrangement is listed on Schedule 0, and b. The value of the trust or similar arrangement Is entered in whole or in part as an asset on Schedule 0, then the transferor's personal representative may specificallv identify the trust (al\ or a fractional portion or percentage) to be included in the election to have such trust or similar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule 0, the personal representative shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule O. The denominator is equal to the total value of the trust or similar arrangement. SCHEDULE 0 ELECTION UNDER SEC. 9113(A) (SPOUSAL DISTRIBUTIONS) FILE NUMBER PART A: Enter the description and value of aU interests, both taxable and non-taxable, regardless of location, which pass to the. decedent's survivin spouse under a Section 9113 (A) trust or similar arran ement. DESCRIPTION VALUE None Part A Total $ 0 .00 PART B: Enter the description and value of all interests included in Part A for which the Section 9113 (A election to tax is bein made. DESCRIPTION VALUE None 7 PA16491 NTF 10882 Part B Total $ (If more space is needed, insert additional sheets of the same size) 0.00 Copyright Forms Software Only, 1997 Nelco, Inc.