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Home My WebLink About01-0227 PETITION FOR PROBATE and GRANT OF LETTERS Estate of Donald S. Bussey also kno wn as No. To: 21-01-227 Register of Wills for the Deceased. County of Cumberland in the Social Security No. 3 21-14 - 3 14 4 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the executor in the last will of the above decedent, dated November 4 and codicil(s) dated n~ed ,19_ (state relevant circumstances. e.g. renunciation. death of executor. etc.) Decendent was domiciled at death in Cumber land CCoaurnty,1.' Psc=nneS,Ylv.ania'l\1li~ 3 his last family or principal residence at 201 Todd Circle, lle FA ./01. (list street, number and muncipality) Decendent,then 86 years of age, died January 28,,~ 2001, at TripIer Army Med1.cal Center, Honolulu, HI . Except as follows, decedent did. not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $200,000.00 $ $ $ WHEREFORE. petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters Te stamen tary theron. /h//;/I (! h: V;~ M~~urers and Traders Trust Company, Successor to Farmers Trust Company (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) - ~ 'iI CJ I: u ~3 u ~ a:~ 3! .~ ;.~ 3c.. ~~ ~ 04 :ii OATH OF PERSONAL REPRESENTATIVE COMMONWEAL TH OF PE~NSYL VANIA "I ss COU~TY OF Cumber land 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 o[ the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent p::titioner(s) will well anci truly administer the estate according to law. ff' d d b 'b d Manufacturers & Traders Trust Co. Sworn to or a Irrne an Sci scn e { I::.'l before me this 26th. . day Of.. /kd;~ '7 ~. ~y 1'9'< 2001 ( _-------' !/. . " /~ {l~Ll~-;; Jfff..J ~/U' Lf'f .[ , Regrster ,I. .!i:!.. // --:> ~-:::::<? - //" N 21-01-227 o. Estate of Donald S. Bussey , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW FEBRUARY 28 ~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 November 4th, 1974 described therein be admitted to probate and fIled of record as the last will of Donald S. Bussey and Letters Testamentary are hereby granted to Manufacturers and Traders Trust Company Successor to Farmers Trust Company \ ?#y rJ ff,//,,::t'<.i.L m / K?<-w<v let' of W' I FEES Probate, Letters, Etc. ......... Short Certificates( ) . . . . . . . . . . . ~-pag.es. J:<.en1.m~latlon ................ JCP $ 235.00 $ 30.00 ~.uu $ S . 00 $ 5 . 00 TOTAL _ $ 284.00 . . . . . f~.~~llMY: . ?~'" . ?9.0.Q ~ . . . . . . . . ATIORNEY (Sup. Ct. 1.0. No.) ADDRESS Filed PHONE ~~?~ 21-01-227 STATE OF HAWAII DEPARTMENT OF HEALTH OFFICE OF HEALTH STATUS MONITORING CERTIFICATE OF DEATH STATE FILE NO. 151 00256 .-1 l 4a R"'Cf GECE.A.SEO FIAST NAME MIDDLE NAME "3 DATE OF DEA.TH (MONTH. OA'( "EAR\ Donald 2001 7a. COUNTY OF DEATH Caucasian Honolulu -<i' SLAND OF DEATH Oahu Minnesota 9. ClTllEN OF WHAT COUNTRY U.S.A. ~ 11. SURVIVING SPOUSE .F WIFE '-JI....E MAIOE'" "'AMEI Anne Carter Lauman t3 3OC:A.L SECURITY NUMBER 321-14-3144 i 14a. USUAL OCCUPAf,ON..iiVf <INOf)F oW:/fIf( ~E DVl'l''''O MaSi .:;F I ~VOA")NGUeOronei t Retired qO~ 140 14C EDUCATION sW"e'o11=li"" 15b':OUNf\( 1.5(. ,':ITY roWN OR LOCATION 15e. NUMBER STREET AND LIP Cumberland Carlisle 201 Todd Circle, 17013 Lewis 1''' D~::';~ ~:ssey Jr. lJ& 2-UQIAl, CREMATION !=lEMOVAL i ,SPEC", Crema t i on ~ '9d DATE 'MONtH OAY'EA", January 30, 2001 MIDDLE NAME Mortimer ~ST NAME Bussey MIDDLE "'AM~ Maude ~AIDEN NAME Bevens 180. MAiliNG A.DDRESS ,';TRl:ET OR 1>0 BOX City OR TOWN STATE, llPI S Miller Rd., Darien, Connecticut i9tl CEME7ERY OR CAEMATOAV--NAME 06820 Services CI Ty OR TOWN STATE Kaneohe Hawa i i 27~urAl ol.AE;roR-,sIGNATURE <( <. CLle~ . 21.. To Ute bHt or my knowhtdge, death occurred at the time. date and ~ Md due to the ~uM4s1 anQ' circumstances l atmec2 HId dncribltd bekwr litems f21b through f27g where appficab4e) i (Sjgn.""......_,~ ' CrT v'SA. f..I.<. 22a. On the lMlSis of examin..ion and/or inv..tigation. in my opinion de..h occurrec1 at the ffI'M, date and pIafc. and due to cauu(S) and Cll'Cumata~ stMed and described bek)w (items f22b through f27g where applieabltl (Signor",""" TltIoJ ~ 4: 2S P M .z .::5 il! iU.. r.:!'~ u~KO J3i ,!!~ a" 22b. DATE SIGNEO (MO, DAY, VR! 22c TIME OF DEATH M 22d. PRONOUNCED DEAD ,MO DAY YAI 22e, PRONOUNCED DEAD IT1ME) M 23 NAME AND ADDAESS OF CERTIFIER (PHYSICIAN, MEDICAL EXAMINER OR CORONER) ,iYPE OR PRINT) DANIEL KINZIE, M.D., CPT, MC, TRIPLER ARMY MEDICAL CENTER, TRIPLER, HAWAII 96859-5000 246. REGISTRAR. SIGNATURE ~.~ 24b DATE RECEIVED BY lOCAL REGISTRAR JAN 3 0 2001 24c DATE FILED BY STATE REGISTRAR JAN 3 0 2001 PART! DEATH WAS CAuseD BY. ENTER ONLY ONE CAUSE PEA LINE FOR (a), (b). AND (e) Af'llJftOJUltATt I'fT!Jf';'AL IE'l'WEEN ()NSET AHO OUnt iMMEDIATE CAUSE " ACUTE CARDIOVASCULAR COLLAPSE 1 DAY 25. CONDITIONS, IF ANY WHICH GAVe RISE TO !MMEDIATE CAliSE 131. STATING THE UNOER- LYING CAUSE LAST { QUE m OR AS A CONSEQuENCE OF I ! J J I I I i ! "- " DISSEMINATED INTRAVASCULAR COAGULOPATHY 1 DAY ClUE TO. Ol=l AS A CONseQUENCE OF co, ACUTE MYOCARDIAL INFARCTION 4 DAYS PAFlT ,'I OTHER SIGNIFICANT CONDITIONS, CONDITIONS CONTRIBUTING iO DEATH BUT NOT :::jELATED TO CAUSE GIVEN iN PART I(al 26a, AUTOPSY (YES OR NO; STEATOHEPATIC WITH CIRRHOSIS YES 27a, AC::-;OENT SUICIDE ,YOMIC;OE OR UNDETERMINED (5PEl:IFY\ 26b, IF YES. WERE FINDINGS CONSIDERED IN DETERMINING CAUSE OF DEATH? NO MYELODYSPLASTIC SYNDROME 27b. DATE OF lNJURY JMONTH. i),h' YEAR) 27c. TIME OF iNJURY 27d DESCRIBE HOW INJURY OCCURRED 27'e ,NJ<jRY AT WORK" SP€'CIF'V YES OR NOl J7g. L.OCATION (STREET OR R F D NO CITY OR TOWN, STATE) FE8 - 9 210101 I CERnFY THIS IS A mUE COPY OR j\.BSTRACTOFThE RECORD ON Fi;,,L 11-1 "'n-~- HftWtt.n STft'l'F' r)e-PAp-n...1~.,.rf' r-)~:;" ...".~, ~ t~- O~~ "Ph.D.. sn~ ~:'''":~;''''R 21-01-227 11L&llt Dill &ub mtllt&ttttut OF DONALD S. BUS SE Y I, DONALD S. BUSSEY, of Carlisle, Cumberland County, Pennsylvania, make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former wills by me at any time heretofore made. I. I direct the payment of my just debts and funeral expenses as soon after my death as will be convenient to my Co-Executors hereinafter named. II. I glve and bequeath all my personal effects to my wife, Anne Lauman Bussey. III. The Co-Executors hereinafter named shall pay from the assets in my probate estate all inheritance, estate, succession or other taxes. IV. Provided my wife, Anne Lauman Bussey, survives me, I give all the rest, residue and remainder of my estate of whatever nature or kind and wheresoever situate at the time of my death unto the Farmers Trust Company, of Carlisle, Pennsylvania, IN TRUST, NEVERTHELESS, upun the following terms and conditions: A. Trustee shall invest and reinvest the assets of the Trust and pay the income to my wife, Anne Lauman Bussey, for and during her lifetime or until she shall remarry. B. Should my wife be incapacitated for any reason, Trustee is hereby authorized to use and apply the income on her account and for her benefit tl) such others as may appear proper to Trustee in its sole discretion. c. Should the income be not sufficient to maintain my wife in her present standard of living when taken together with her other sources of income, Trustee in its sole and separate discretion shall make distribution of principal to my wife in such amounts and at such times as to it may appear to be desirable and appropriate. D. Upon the death or remarriage of my wife the Trust shall terminate and Trustee shall distribute the principal of the Trust 3 s follows: - 1 - 1. One-half to Farmers Trust Company, Trustee under an Agreement of Trust dated November d 1974, in which I am the Settlor and my daughter, Elizabeth Carter Bussey, is the Beneficiary. 2. One-half to my son, Donald Sedgwick Bussey, Jr. Should my son fail to survive my wife, and have one or more children surviving these assets shall be held in Trust by the Trustee for the care, support, education and welfare of such children until each attains the age of twenty-one, at which time that share of principal allocable to each child shall be paid to such child. Upon the youngest child becoming twenty- one the Trust shall terminate. But should my son fail to survlve my wife and die without issue, then this portion of the principal shall be distributed in accordance with the I I I I I I I 1 i I I I I I I I I I I I I , I I I I I Trust Agreement identified in Paragraph D. 1. However, regardless of the foregoing provisions for equal treatment of the children of Settlor's son and of any laws providing for equal treatment, should the needs of said children be unequal, in the opinion of Trustee, Trustee is authorized and directed to exercise its discretion to make such unequal distributions of income and principal as appears to be appropriate under the circumstances. Upon each child attaining the age of twenty-one, the Trust shall terminate as to such child provided that Trustee determines the distribution should be made equally. Should Trustee in its sole discretion deter- mine that the needs of the children differ substantially in considering their mental and physical attributes, the Trust shall continue until the youngest child attains the age of twenty-one at which time it shall terminate and distribution shall be made in such unequal principal shares, even to the exclusion of one or more children, as the Trustee deems appropriate, in its sole and absolute discretion. Should any of Settlor's son's children require a guardian of his or her estate, Trustee is hereby appointed to act as such Guardian. - 2 - E. No part of the income or principal of the property held under any Trust herein created, shall be subject to attachment, levy or seizure by any creditors, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary prior to his or her actual receipt thereof. The Trustee shall pay over the net income and the principal to the parties herein designated, as their interest may appear, without regard to any attempted anticipation, pledging or assignment by any beneficiary under a Trust, and without regard to any claim thereto or attempted levy, attachment, seizure or other process against said bene- ficiary. F. The Trustee shall possess, among other things, the following powers: 1. To vary or to retain investments, when deemed desirable by the Trustee, and to invest in such bonds, stocks, notes, real estate mortgages or securities, or in such other property, real or personal, as the Trustee shall deem wise, without being restricted to so-called "legal investments", and without being limited by any statute or rule of law regarding investments by fiduciaries. 2. In order to effect a division of the principal of a Trust or for any other purpose, including any final distribution of a Trust, the Trustee is authorized to make said divisions or distributions partly or wholly in kind. 3. To pay all costs, taxes, expenses and charges in connection with the administration of a Trust, including a reasonable compensation to agents. 4. In the discretion of the Trustee, to unite with other owners of similar property in carrying out any plans for the reorganization of any corporation or company whose securities form a part of a Trust. 5. To vote any shares of stock which form a part of a Trust. 6. To hold the assets of the Trust in the name of a nominee. IV. Should my wife fail to survive me then I give, devise and bequeath all of my property, of whatsoever nature or kind, and wheresoever situate at the time of my death in equal shares as hereinbefore set forth in D 1 and 2. V. Trustee shall pay from the assets of the Trust any and all inheritance, State, succession or other taxes, which may be assessed or - 3 - levied upon the assets distributed from said Trust upon the termination thereof. VI. I nominate, constitute and appoint my wife, Anne L. Bussey, and Farmers Trust Company to be Co-Executors of this, my Last Will and Testa- men t . IN WITNESS WHEREOF, I have hereunto set my hand and seal this 4th day of November , A.D. 1974. Y/lA4d~3&7 ( SEAL ) Signed, sealed, published and declared by DONALD S. BUSSEY, the above named Testator, as and for his Last Will and Testament, in the presence of us, who, in his presence, at his request and in the presence of each other have hereunto subscr i,~ our names as witnesses. ~T~~/~W~/ -L_'y// lid']) rvuJ:a::-U-?L_/ b~ ,~.yt...;yu;/vra.....(.....// - 4 - 21-01-227 RENUNCIATION In Re Estate of Donald S. Bussey deceased. To the Register of Wills of Cumberland County, Pennsylvania. Manufacturers and Traders Trust Company, Successor to The undersigned Farmers Trust Company as Guardian for Anne L. BusseYof CoExecutor the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters Testamentary be issued to Manufacturers and Traders Trust Company, Successor to Farmers Trust Company WITNESS Our hand this 26th day of February ,~J~;L Manufacturers and TRaders Tr. Co. Successor to Farmers Trust Co. Guardian of the Estate of Anne L. Bussey, an incapacitated lD lVl ual Orphans Court # 629 for 1987 ne West High Carlisle, PA (Address) (Signature) (Address) (Signature) (Address) \ \MAINSER VER\PUBLIC\roger\estate admin\Bussey Estate\Nonsubscribing witness oath.doc 21-02-227 OATH OF NON-SUBSCRIBING WITNESS Roger M. Morgenthal and Tricia L. Bailey, (each) a subscriber thereto, (each) being duly qualified according to law, depose(s) and say(s) that he/she is familiar with the signature of DONALD S. BUSSEY, Testator of the Will presented herewith, and that he/she believes the signature on the Will is in the handwriting of DONALD S. BUSSEY, to the best of his /her knowledge and belief. Sworn to or affirmed and subscribed ~jtt~ (name) 95 Alexander Spring Road, Suite 3, Carlisle, P A Before me this 26 day of (address) ~Y~Lj_lLr (name) 95 Alexander Spring Road, Suite 3, Carlisle, PA February, 2001. ~ua~//~~.7~hL ,-eglste~~--L/ ~<"'~ (address) .-1 "" / i. '~ :,-:! 1-';;'-' .....,... I 1 J J J 1 [ I I I I r j r I 1 f I I I f { 1 I r [ { f [ { [ ( [ I f I I [ I [ I I I [ f [ f I I f 5 z ~ ~ fB ~w)( z=>;! wz-, Q.w. u.>::l O~Q :r S; ~~e <C.....z wz~_ ~wO~ ~~::l~ " ~C" ~Q.a::t OW::lw 00100 I i ~.....~._~~ r ,) i I! ..... N I.t) CD en ..... ~ o z St- wCL. 1-- ~t! w zen 0 c(w W >0 a: -'z > c( -I ~w c( Z(,) - ZO ~c( _ I-LL. a:LL. ~O ~ <C Z <C ::; (/) > w ~w~ Q z=>..... ~ wz-, .0 Q.w. C\I ~Gi5 ;::: a:_ _ j!:u.> <c .,Joe Q. ...... liE - ~~~c;~ z~::l~~ .i~~~~ olb~lb~ 00100:r I- Z :::> e ~ <( I- Z-'a: we z~a:w ()CI)l-lD <(CI)z~ we:::> ~()Z <( w a: w :r ~ .. n . .. n . J . t ~ 8 . 8 8 :& · U o 8 ... o ... o ~ I- Z :::> ~ <( ~ g N a: alii , .... \ CO ... >-1:: m lDet w fa!: Q: > [j () w a: I ~l -I ~' LLI 01 '1]1 1-. !af (!}l ~ r I I r r . ~ } ~~J ~ I ~Y'28j8 : I. ~-..... lli 8..J D.I tJ r ~J & ~ ~ i ~~ ~~ r ~~;~p~ ~ IJ ,t f ~ I ~it!l_llr ~I ~ . ~ ,,,,-,' - ~ :~.",><!:,I\'l1'I-. ~,. I 1 - ! 4' 4' ... (I) J 4' .... I ~ - := a: ~ Z ,. ~ r:! M&r Investment Group Register of Wills Cumberland County Court House One Courthouse Square Carlisle, PA 17013 u CERTIFICATION OF NOTICE UNDER RULE 5:~-(a) Name of Decedent: DONALD S. BUSSEY Date of Death: January 28, 2001 Will No. 2101-0227 Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) ofthe Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on May 1,2001. Manufacturers and Traders Trust Company as Guardian for Anne L. Bussey One West High Street Carlisle, PA 17013 Manufacturers and Traders Trust Company, Trustee One West High Street Carlisle, PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a). Date: May 1,2001 Signature Name David C. Gority Address Manufacturers and Traders T ust Company One West High Street Carlisle, PA 17013 717-240-4504 Capacity: Personal Representative cc: Roger Morgenthal, Esq. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MANUFACTURES & TRADERS TRST CO 1415 RITNER HIGHWAY CARLISLE, PA 17013 -------- fold ESTATE INFORMATION: SSN: 321-14-3144 FILE NUMBER: 21-2001- 0227 DECEDENT NAME: BUSSEY DONALD S DATE OF PAYMENT: 08/24/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/28/2001 NO. CD 000198 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $396.70 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: M & T INVESTMENT GROUP CHECK# 1016415 SEAL INITIALS: DO RECEIVED BY: REGISTER OF WILLS $396.70 MARY C. LEWIS REGISTER OF WILLS ~15OllEXI8-OOI w '" "'.... "ii!'" w"" :>:00 "II:'" .... == ,-_..."".,':'-i','-' .,,,.~ COMMONWEALTH OF PENNSYlVANIA DEPARTMENT OF REVENUE DEPT. 280001 HARRISBURG, PA 17128-0601 /b-0)~EV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT ... z W Q W U W Q DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) Bussey, Donald S. DATE OF DEATH (MM-OD-YEAR) DATE OF BIRTH (MM-DD-YEARI 01-28-01 09-09-14 (IF APPUCABLE) SURVIVING SPOUSES NAME (lAST, FIRST, AND MIDDLE INITIAL) Anne L. Busse 00 1. OniF1al Return o 4. limited Eslale o 6. OecedentDiedTestate(Atlach~ofWil) o 9. Utigation Proceeds Received o 2. Supplemental Re\tJm o 48. Future Interest Compromise (dale of deal/'l after 12-12-82) o 7. Decedent Ma/nlained a living Trust ,....."""..,Ml) o 10. Spousal Poverty Credit (d8l8ofd8alh b<<weert 12031-91 and 1-l..f15) O"F'C,Al. USE ONLY ~ FILE NUMBER 21-01 00227 CCUNTYCOOE YEM - NliiiER - - - SOCIAL SECURITY NUMBER 321 - 14 3144 THIS RE11lRN MUST BE ALED IN DUPlICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder ReMn ldatBofdeSlhpriorv1HJ.82) o 5. Federal Eslale Tax Relum Required 8. ToIaI Number of Sefe Deposit Boxes o 11. EIeclion 10 lax under Sec. 9113(A} '''''''' ,",0) ... z w Q Z o .. .. ~ o " NAMf)avid C. God ty RRM NAME (I!_"'j Manufacturers & Traders Trust C TELEPHONE NUMBER 717 240-4505 COMPlETE MAILING ADDRESS 1415 Ritner Highway Carlisle, PA 17013 z o ~ :J ... a: c( u W D:: 1. Real Eslale (SchoOOle A) 2. SfocI<s and Bonds (_Ie B) 3. Closely Heij CoIporation, _ip or SoIe-PropOeiorship 4. Mortgages & Notes Receivable (Schedule D) 5. C8sI1, Bank Oeposits & Miscellaneous P_ Property (Schedule E) 6. Joinlly Owned Property (Schedule F) o Sepamte Billing Requeslad 7. InIef-VIVOS Transfers & Miscellaneous Noo-P_te Property (Schedule G Of l) 8. TofalGrossAasets (totat lines l-n 9. Funeral Expenses & Adm/nislralive Cosls (Schedule H 0. Debts of Deceden~ Mor1gage liabilities, & liens (Schedule I) 11. ToIaIlleduc1lons (Iolal Unes 9 & 10) 12. NoIVal.. of Estate (line 8 minus Line 11) 13. Cha"lable and GovemmentaI Bequests/See 9113 Trusls for which an election 10 lax has not been made (Schedule J) (I) (2) (3) (4) (5) (6) In (9) (10) 19,762.30 9,806.31 z o !ci: I-' :J a.. :E o u ~ 14. Not Value Subject to Tax (Line 12 minus Una 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR API'LICABlE RATES 15. Amot.<llotUne 14tlxable al!he SjlO\lSllIIaX <ate, Of transfers \JI\der See. 9118 (a)(I.2) 16. Amot.<ll otUne 14 taxable at lineal rale 125,774.51 17. Amount of Une 14 taxable at sibling rate 18. Amounl ofUne 14 taxable at coUateral rate 19. Tax Out 200 0.00 8,870.68 0.00 0.00 146,472.44 0.00 x.o_ (15) 45 (16) x.O_ x J2 (17) x .15 (16) (19) '" ",'c;'.'.\ '2"'~,.BE~ ,:~~' CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT OFFICIAL USE ONLY 0.00 (6) 155,343.12 (11) 29,568.61 (12) 125,774.51 (13) 0.00 (14) 125,774.51 5,659.85 5,659.85 Decedent's Complete Address: STREET ADDRESS 201 Todd Circle CITY Carlisle I STATE PA I ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 5,659.85 5,000.00 263.15 TotalCredIls(A+B+C) (2) 5,263.15 3. InleresUPenally ff applICable D. Interest E. Penalty TotallnterestlPenaIly ( 0 + E ) (3) 4. If Une 2 is greater than line 1 + line 3, enter the difference. This is the OVERPAYMENT. Chock box on Page 1 Une 20 to request a refund (4) 0.00 5. K lino1 + line 3 is groater than Line 2, enter the difference. This is the TAX DUE. (5) 396.70 A. Enter the interest on the tax due. (SA) B. Entor the total of line 5 + SA. This is the BALANCE DUE. 396.70 (58) Make Check Payable to: REGISTER OF WILLS, AGENT f,\'f''iI''''"~'l'i.lllill]rtl'~-Tl' ~~rn mr-ilmr n 1~$!l'"-l~..t"l1~:!r![1'!I1'~ f~~~ilI.A 'l!~ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN OX" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transfetTed;.......................................................................................... 0 b. retain the righllo designate who shall use the property transferred or its income; ............................................ 0 c. retain a reversionary inleres~ or.......................................................................................................................... 0 d. receive the promise for life of either pa)Tl1llllls, benefits or care? ...................................................................... 0 2. K death occurred after December 12, 19B2, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 3. Did decedent own an "in trust lor" or payable upon death bank account or security at his or her death? .............. 0 4. Did decedent own an Individual Retirell1enl Account, annuity, or other nOtl1lrobate property which contains a beneficiary designation? ........................................................................................................................ 0 No gj I EJ t;!I ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. !\UG Z 0 2O'IT1 f 7111.5 DATE ADDRESS .., --lilt'lriil"'!];tii1j~i!!1~J7 m:"W~..-;>'i.~ Ji' . . "',,,, _ n 1 j For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on tho net value of llansters to or for the use of the surviving spouse is 3% [72 P.S. S9116 (a)(1.1) (ij]. For dates of death on or after January 1, 1995, the tax rale imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) Oil]. The statute does not exemDt a llanster to a suNivlng spouse from tax, and the .statutory requirements for disclosure of assets and fi6ng a tax return are still applicable even if the surviving spouse is the only beneficiary. For dales of death on or after July 1, 2000: The tax rale imposed on the net value of llansfers from a deoeased child 1Wenly-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. ~9116(aX1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedenfs 6neal beneficiaries is 4.5%, except as noted in 72 PS. ~9116(1.2) [72 P.S. ~9116(a)(1)]. The tax rale imposed on the net value of llan8feIs 10 or for the use of the decedenfs slbllnga is 12% [72 P.S. S9116(a)(1.3)]. A sibling is defined, under Section 9102, as en ind'lVidual who has at least one parent in common with the decedent, whether by blood or adoption. _'~M~n '* COMMONWEAl!H OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDEN1 ECEDEN1 SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER 21-01-00227 Ixma1d S. Bussey AU real property owned Jokily or a. a tenant In common must be reported at fair marieet value. Fair mari<.et value is defined as the price at which property would be exchanged between a wiUlng buyer and a willing seIIef, neilher being compelled to buy or sell, bolh having reasonable knowledge of lhe relevant fads. Real property which is jolntly-owned With right at survivorshiD must be dlsckJsed on Schedule f. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH NONE / TOT A~ (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same sIZe) 0.00 """"'''.{l.", ~ ..~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RE I NT OECED NT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER 21-01-00227 Ixmald S. Bussey All propelty jolntly-owned wtth right of surviYolShIp l11US\ be discloSed on Schedule F. ITEM NUMBER 1. DESCRIPTION 20 shares Marriott International VALUE AT DATE OF DEATH 922.70 1,499.03 57.56 6,391. 39 2. 110 shares Host Marriott Corp. 3. 4. 2 shares Sodexho Marriott Services, Inc. 182 shares John Hancock Financial Services TOTAl (Also enter on line 2, Recapitulation) $ 8,870.68 (If more space Is needed, insert additional sheets of the same size) -,.."'.,,"'. COMMONWEALTH OF PENNSYLVANIA INliERfTANCe rAX RETURN R IlEKr oeCEcem SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF 21-0HXJ227 Donald S. Bussey FILE NUMBER Inc;ludelhe procoedS of r~n and the dais the proceeds '""'" _ by Ihe eotale. An proporty ~ wftllUIt right of s.lYivonlri!l_1le dIIcIoud on ScIIodulo F ITEM . NUMBER DESCRIPTION VALUE AT DATE OF DEATH 128.00 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. Cash Proceeds American Express Travelers Cheques M&T Bank checking account # 15004200598124 Interest accrued to date of death on item /13 Waypoint Bank account tI 1700036609 MBNA CD /I 403719531 @ DOD value MBNA CD tI 403166618 @ DOD value MBNA CD tI 408221434 @DOD'value MBNA CD II 409187063 @ DOD value MBNA CD /I 403921459 @ DOD value MBNA CD tI 402762136 @ DOD value 1999 Buick Park Avenue Marriott Vacation Club time share~Beach Place Towers Carlisle Barracks Thrift Shop-proceeds sale Finders Keepers-proceeds sale consignment items Island Publishing Co.-subscription refund AARP-membership refund Penn Mutual Life Insurance Co.-2oo0 Annual Dividend 750.00 52,983.16 97.63 35.36 10,552.99 10,578.75 10,599.48 10,258.53 10,574.56 10,628.77 18,000.00 10,761.00 32.12 288.00 12.00 13.59 178.50 TOTAL {Also ent8r on line 5, Recapitulation) $ 146,472.44 IIf ___ _____._ ___..._... .___.... ~-'...,~,__~, .... _ .", '" RE\lotDEX.i''''''' '* COIAMONWEAJ.lIi OF PENNSYLVANIA INHERITANCE TAX RETURN RE DE ESTATE OF SCHEDULE F JOINTL Y.OWNED PROPERTY IXmald S. Bussey ~an _ __ made joint_In one yar otllle _. _ 01_, ft must" /lllCllIiodOtl SdIoduItG. FILE NUMBER 21-01-00227 SURVMNGJOlNT TENANT(S) NAME RElA11OHSl<IP TO OECEDENT AIlllRESS A. Arme L. Bussey Wife B. c. c/o M&T Bank, Guardian 1415 Ritner Highway Carlisle, PA 17013 JOINTLY-OWNED PROPERTY; i.ElTER DATE OESCRPTlOH OF I'llCP6m "OF OATEOF~TH ITEIl FOR JOiNT MADE Indudo".noot__lIld___",'-Idrll1iIjing""'*"'.'_ O/lTE OF OEAtH DECO'S V....UE OF - TENANT JOItT deedtlrjOillly4lold.......... VAlUE OF ASSET INTEREST OECEDENT'S I~EREST 1. A. 1974 M&T Bank checking account II 481378 7,852.14 0 0 2. A Interest Accrued to OOD on item II 1 5.56 TOTAL (Also enter on line 6, Recapitulation) $ 0.00 (It more soace is needed. Insert additional s/1eels of the same sizel AEV-1511 EX+ (12-99) -!ti COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRA11VE COSTS ESTATE OF Donald S. Bussey FILE NUMBER 21-01-00227 Ilebls of decedent must be repotWd on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Hoffman Roth Funeral Home 1,199.92 2. Williams Funeral Home - Death Certificates 40.00 3. Donald S. Bussey - Reimbursement for travel to Hawaii 1,146.81 4. T. A. Sullivan & Son - grave marker 2,468.78 B. ADMINISTRATIVE COSTS: 1. Personal Represe1'tatlve's Commissions Name of Pemona! Representative{s) Manufacturers & Traders Trust Company 7,427.00 Social Security Number(s)/EIN Number of Personal Representative{s) Street Address 1415 Ritner Highway City Carlisle State ~Zip 17013 Year(s) Commission Paid: 2001 2. Attorney Fees Roger Morgenthal 3,500.00 3. Family Exemption: (If decaden!"s address is not the same as clalman!"s. attach explanation) Claimant Elizabeth Carter Bussey 3,500.00 Street Address 201 Todd Circle City Carlisle Slat.~Zip 17013 Relationship ot Claimant to Decedent Daughter 4. Probate Fees 284.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. USAA - Insurance Premium 109.41 8. Cumberland Law Journal 60.00 9. The Sentinel - advertising le.tters 93.83 10. Register of Wills - short certificate 30.00 11. Rose Detailing - preparation of car for sale 116.55 . - TOTAL (Also enter on line 9. Recapitulation) $ 19,762.30 (ff more space IS needed, insert additional sheets of the same size} ""'0"""''''. COr.IMQNWEAlTH OF P.NNSYlVANIA INH8lITAHCE TAX RfTURN RE511lONT IlOCEIlONT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF Donald S. Bussey FILE NUMBER 21-01-00227 Include unreimbursed medical expen.... ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. DESCRIPTION United Church of Christ Homes - monthly maintenance Castles Lumber Co. - balance due on account # 6000 Marriott Vacation Club - maintenance fee AMOUNT 747.o~ 227.61 808.49 32.00 3.00 493.97 62.91 100.00 16.83 2,079.00 5,234.85 DFAS - balance due The Queen's Medical Center Eunice Trowbridge - reimbursement for costs International Life Support - balance due Central PA BEMA & Medical - balance due Jams Hopkins Medical Center - balance due The GM Card - balance due First USA Bank - balance due TOTAl (Also enter on line 1Q, Recapittllation) $ 9,806.31 (If more space IS needed. insert additional sheets of the same size) "".""""1'''''. CCMllONWEALTH OF PENNSYLVANIA IllHEMAIICE TAX AE11JRN RESIO OECE NT SCHEDULE J BENEFICIARIES ESTATE OF , Donald S. Bussey FILE NUMBER 21-01-00227 RE!J\ nONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Ust Trustee{s) OF ESTATE 1. T AXA8LE DISTRIBUTIONS (include outright spousal distributions) 1. Anne L. Bussey, deceased 7-11-01 wife 1,933.77 2. Manufacturers and Traders Trust Company Trustee for Elizabeth Carter Bussey daughter 1/2 residue 3. Donald S. Bussey, Jr. son 1/2 residue - ENTER DOLlAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON UNES 15 THROUGH 17, AS AFPROPRIA TE. ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTiONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRI8UTIONS 1. TOTAL OF PART IT. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON UNE 13 OF REV 1500 COVER SHEET $ (ff more space is needed. Insert additional; sheets of the same SIZll) ~M&TBank March 6, 2001 RE: Estate Search The Estate of: Date of Death (D.O.D.) DONALD S BUSSEY SR 112812001 To Whom It May Concern; Identified below is the account information requested. l. M&T Bank accounts in which the decedent's name appears; Account Type Account Number Account Title Opening Branch D.O.D. Accrued Interest Balances (Includes Accr. Int.) $7857.70 $5.56 15004200598124 DONALD S BUSSEY ANNE L BUSSEY DONALD S BUSSEY 4319 CHK 481378 SAY 4319 $53,080.79 $97.63 2. Loans, Mortgages, or other obligations titled in the decedent's name Account Number Amount Owed Account Description A Safe Deposit Box titled in the Decedent's name existed at our HIGH STREET CARLISLE OFFICE. The Safe Deposit Box Number is 0003869. If you have any questions about the information provided, please contact our Records Department at (716) 635-4010 or 1-800-724- 2440 outside of the Buffalo, NY calling area. Thank you. Sincerely, M&T BANK CORPORATION BY; ~ttuL-:...e S-r-<"l'\.i.O~<- Authorized Signature DATE; ~ - rO~6 I Manufacturers and Traders Trust Company. 1100 Wehrle Drive. PO. Box 7fiT. Buffalo. NY 14240-0767 /&-;))3 -/6 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 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN DAVID C GORITY MFGRS & TRADERS 1415 RITNER HWV CARLISLE TR CO PA 17013 10-22-2001 BUSSEY 01-28-2001 21 01-0227 CUMBERLAND 101 ~~* REY-1547 EX AFP (12-DDI DONALD S Allount Rellitted ) CHANGED U) (2) (3) (4) (5) (6) (7) .00 8,870.68 .00 .00 146,472.44 .00 .00 (8) MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=i5irj-E>f-AFP--ci2-=OOY-No'ficE--OF-YNHEifiTANCE-'fAX-jrpPRAIsEMiNT~--AL1-owANcE-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BUSSEY DONALD S FILE NO. 21 01-0227 ACN 101 DATE 10-22-2001 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax TAX RETURN WAS: (X) ACCEPTED AS FILED 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 (9) UO) 19,762.30 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 155,343.12 t'Q.568 6] 125,774.51 .00 125,774.51 NOTE: I~ an assessment was issued previOUSly, lines 14, 15 and/or 16, 17, 18 and 19 will r~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due .00 X 00 = .00 125,774.51 X 045 = 5,659.85 .00 X 12 = .00 .00 X 15 = .00 (9)= 5,659.85 9.806.31 (11) (12) (3) (14) TAX CRJ;'DITS' PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 04-26-2001 AA496521 263.16 5,000.00 08-24-2001 CDOOO198 .00 396.70 TOTAL TAX CREDIT 5.659.86 BALANCE OF TAX DUE .0ICR INTEREST AND PEN. .00 TOTAL DUE I .0ICR . 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.) fl, ,,/ V () J'~. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Donald S. Bussey Date of Death: 1/28/01 Will No. 2001-00227 Admin. No. 2001-00227 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes x No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes x 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 this report. Date: /- b.'. d.J ~(2~ Siinature I David C. Gority Name (Please type or print) c/o M&T Investment Group 1415 Ritner Highway, Carlisle, PA 17013 Address ( 717) 240-4505 Tel. No. Capacity: x Personal Representative Counsel for personal representative (MAH:rmf/AM3) Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 12/06/2002 MANUFACTURES & TRADERS TRST CO ONE WEST HIGH STREET CARLISLE, PA 17013 RE: Estate of BUSSEY DONALD S File Number: 2001-00227 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS. COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 1/28/2003 Your prompt attention to this matter will be appreciated. Thank You. cc: ~ile Counsel Judge COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-01-00227 ESTATE OF DONALD S. BUSSEY, DECEASED FIRST AND FINAL ACCOUNT OF Manufacturers and Traders Trust Co., Executor ================================================================================ Date of Death: January 28, 2001 Date of Executor's Appointment: February 28, 2001 Date of First Advertisement of Letters: March 30, 2001 Accounting for the Period: February 1, 2001 to November 29, 2001 ================================================================================ Purpose of Account: Manufacturers and Traders Trust Co., Executor, offers this account to acquaint interested parties with the transactions that have occurred during this administration. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with: David C. Garity, Trust Officer Manufacturers and Traders Trust Co. 1415 Ritner Highway Carlisle, PA 17013 717/240-4505 GROSS ESTATE (Principal Receipts + Income Receipts) 161,828.22 SUMMARY OF ACCOUNT Estate of Donald S. Bussey, Deceased For Period of 02/01/2001 through 11/29/2001 Page Proposed Distributions to Beneficiaries PRINCIPAL Receipts: Per Inventory Filed 1-4 Subseq Prn Receipts Net Gain (or Loss) on Sales or Other Disposition 5 Less Disbursements: Debts of Decedent 6 Funeral Expenses 7 Administration Expenses 8 Federal and State Taxes 9 Fees and Commissions 9 Family Exemption 9 Balance before Distributions Distributions to Beneficiaries 10 Principal Balance on Hand 11 For Information: Investments Made Changes in Investment Holdings 12 -13 INCOME Receipts: This Account 14-16 Net Gain (or Loss) on Sales or Other Disposition Less Disbursements 17 Balance Before Distribution Distributions to Beneficiaries Income Balance on Hand 18 Investments Made Changes in Investment Holdings COMBINED BALANCE ON HAND Current Value 0.00 10,106.87 4,855.51 2,722.38 5,396.70 10,927.00 3,500.00 Fiduciary Acquisition Value 0.00 158,079.00 404.00 362.06 158,845.06 37,508.46 121,336.60 50,000.00 71,336.60 3,345.22 0.00 3,345.22 2,084.01 1,261. 21 0.00 1,261.21 72,597.81 SCHEDULE A RECEIPTS OF PRINCIPAL CASH: 05/30/01 02/28/01 MRP - Refund American Express - Proceeds from travelers cheques 03/02/01 Finders Keepers Antiques - Proceeds for items sold 05/17/01 First USA Bank, NA - Reimbursement for overpayment of credit card acct. 04/02/01 Islands Publishing Co. - Reimbursement from subscription cancellation 03/07/01 M&T Bank - Partial withdrawal from acct. #15004200598124 03/15/01 M&T Bank - Balance at date of death in savings acct. 1/15004200598124 03/15/01 M&T Bank - Interest accrued to date of death on savings acct. #15004200598124 04/11/01 MBNA Cert. of Deposit #403719531 - Proceeds from redemption MBNA Cert. of Deposit 1/403166618 - Proceeds from redemption MBNA Cert. of Deposit 1/408221434 - Proceeds from redemption 04/11/01 04/11/01 -1- 13.59 750.00 288.00 99.16 12.00 20,000.00 32,983.16 97.63 10,552.99 10,578.75 10,599.48 Fiduciary Acquisition Value 04/11/01 MBNA Cert. of Deposit #409187063 - Proceeds from redemption 04/11/01 MBNA Cert. of Deposit #40321459 - Proceeds from redemption 04/11/01 MBNA Cert. of Deposit #402762136 - Proceeds from redemption 02/28/01 Miscellaneous Receipt - Cash from wallet 03/15/01 Miscellaneous Receipt - Social security $560, civil service $539, social security $209.76 04/02/01 Miscellaneous Receipt - Proceeds of Waypoint Bank acct. #1700036609 05/07/01 Miscellaneous Receipt - Refund of MBNA credit balance 03/02/01 Penn Mutual - 2000 dividends on policy #4002719 03/02/01 Trift Shop-Carlisle Barracks - Proceeds for items sold 03/13/01 Trift Shop-Carlisle Barracks - Proceeds for items sold 05/15/01 USAA - Refund from auto insurance policy #7104 0 99 09/28/01 USAA - Auto policy cancellation credit -2- 10,258.53 10,574.56 10,628.77 128.00 1,308.76 35.36 12.00 178.50 19.66 12.46 54.69 1,061.27 120,247.32 04/05/01 04/13/01 04/06/01 04/10/01 04/06/01 04/10/01 08/13/01 08/09/01 08/31/01 PERSONAL PROPERTY: 1999 Buick Park Avenue Sedan Marriott Vacation Club Time Share-Beach Place Towers STOCKS/LISTED: 110.000 shares Host Marriott Corp 182.000 shares John Hancock Financial Services, Inc. - To reflect correct amortized face value 20.000 shares Marriott International, Inc., Cl A 2.000 shares Sodexho Marriott Svcs., Inc. SUBSEQUENT PRINCIPAL RECEIPTS: Carlisle Rent-A-Space - Refund of security deposit Miscellaneous Receipt - Reimbursement for burial expense from VA Miscellaneous Receipt - Proceeds from sale of personal items -3- 18,200.00 10,761. 00 1,499.03 6,391.39 922.70 57.56 20.00 319.00 65.00 28,961. 00 8,870.68 404.00 03/07/01 03/07/01 03/07/01 03/07/01 03/07/01 03/07/01 03/07/01 03/07/01 03/13/01 03/13/01 03/21/01 03/21/01 SCHEDULE C DISBURSEMENTS OF PRINCIPAL SCHEDULE C-1 DEBTS OF DECEDENT Castles Lumber Co. - Work done in mill dept. DFAS Insurance - Acct. /1430037 Marriott Vacation Club Interest - 2001 maintenance The GM Card - Credit card expense The Queen's Medical Center - Medical expense United Church of Christ Homes Nursing home expense USAA - Auto insurance policy /17104 0 99 Zeigler's Storage & Transfer, Inc. - Storage 1/1/01-1/31/01 First USA Bank, NA - Credit card expense First USA Bank, NA - Credit card expense Eunice H. Trowbridge - Reimbursement for air fare & expenses for Carter Bussey in Hawaii International Life Support - Medical expense -6- 227.61 32.00 808.49 2,002.93 3.00 747.65 164.10 25.00 3,737.71 1,576.80 493.97 62.91 03/22/01 The GM Card - Credit card 76.07 expense 04/17/01 Central PA HEMA & Med. - 100.00 Medical expense 04/18/01 First USA Bank, NA - Credit 19.50 card expense 04/18/01 The Johns Hopkins Hospital - 16.83 Medical expense 08/01/01 Marriott Vacation Club Time 12.30 Share-Beach Place Towers - Ownership dues TOTAL DEBTS OF DECEDENT.......... . . . . . . . . . . . . . . . . . . . SCHEDULE C-2 FUNERAL EXPENSES 03/07/01 Donald S. Bussey, Jr. - Reimbursement for air fare to Hawaii 1,146.81 03/07/01 1,199.92 Hoffman-Roth Funeral Home - Funeral services 03/21/01 Williams Funeral Home - Balance due on funeral of Donald S. Bussey-fee for additional death certificates 40.00 06/04/01 2,468.78 T.A. Sullivan & Son - Grave marker stone, lettering, foundation & installation TOTAL FUNERAL EXPENSES.............................. -7- 10,106.87 4,855.51 02/28/01 03/27/01 03/29/01 04/10/01 04/25/01 04/30/01 05/03/01 05/08/01 08/23/01 10/30/01 11/13/01 11/26/01 SCHEDULE C-3 ADMINISTRATION EXPENSES Register of Wills - Letters testamentary 284.00 Cumberland Law Journal - Estate advertising 60.00 M&T Bank - Reimbursement of benefi ts to US Treasury-social security benefits received after date of death 560.00 Register of Wills - 10 short certificates 30.00 The Sentinel - Executor's notice 93.83 M&T Bank - Reimbursement of OPM CSA payment from US Treasury Dept.-deposit made after date of death 539.00 Rose Detailing - Complete detail of 1999 Buick Park Ave. 116.55 Darlene L. Moyer - Donald Bussey's 2001 personal taxes 10.00 Register of Wills - Fee to file PA Inheritance Tax 15.00 Cumberland Law Journal - Legal advertising-additional fee due to rate increase 15.00 RESERVE - Additional administrative expenses 500.00 ERA Stroman - Registration fee 499.00 TOTAL ADMINISTRATION EXPENSES....................... -8- 2,722.38 04/27/01 08/23/01 11/13/01 11/13/01 11/13/01 SCHEDULE C-4 FEDERAL AND STATE TAXES Register of Wills - PA Inheritance tax prepayment 5,000.00 Register of Wills - Balance PA Inheritance Tax 396.70 TOTAL FEDERAL AND STATE TAXES....................... SCHEDULE C - 5 FEES AND COMMISSIONS M&T Bank - Executor's fee - TO BE PAID 7,427.00 Roger M. Morgenthal, Esq. - Attorney's fee - TO BE PAID 3,500.00 TOTAL FEES AND COMMISSIONS.......................... SCHEDULE C - 6 FAMILY EXEMPTION RESERVE - Family exemption payment to Elizabeth Carter Bussey 3,500.00 TOTAL FAMILY EXEMPTION.............................. TOTAL DISBURSEMENTS OF PRINCIPAL.................... -9- 5,396.70 10,927.00 3,500.00 37,508.46 Donald S. Bussey, Jr. 11/29/01 SCHEDULE D DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES Donald S. Bussey, Jr. - Advance distribution Manufacturers & Traders Trust Co. Trustee for Elizabeth Bussey 11/29/01 Manufacturers & Traders Trust Co. Trustee for Elizabeth Bussey - Advance distribution TOTAL DISTRIBUTIONS TO BENEFICIARIES...... -10- 25,000.00 25,000.00 50,000.00 PRINCIPAL BALANCE ON HAND # Units Description Vision Instit. Prime Money Market Marriott Vacation Club Time Share-Beach Place Towers -11- Current Value or as Noted 60,575.60 1.00 Fiduciary Acquisition Value 60,575.60 10,761. 00 60,576.60 71,336.60 SCHEDULE F CHANGES IN INVESTMENT HOLDINGS - PRINCIPAL 1999 Buick Park Avenue Sedan 04/05/01 06/22/01 inventoried sold Host Marriott Corp 04/06/01 06/04/01 110.000 shares inventoried (110.000)shares sold 0.000 John Hancock Financial Services, Inc. 04/10/01 06/04/01 182.000 shares inventoried (182.000)shares sold 0.000 ==---==== Marriott International, Inc., CI A 04/06/01 06/04/01 20.000 shares inventoried (20.000)shares sold 0.000 ==--=== Marriott Vacation Club Time Share-Beach Place Towers 04/13/01 inventoried -12- Cost 18,200.00 (18,200.00) 0.00 1,499.03 (1,499.03) 0.00 6,391.39 (6,391.39) 0.00 922.70 (922.70) 0.00 10,761. 00 10,761.00 =--=- Sodexho Marriott Svcs., Inc. 04/10/01 06/04/01 2.000 shares inventoried (2.000)shares sold 57.56 (57.56) 0.000 0.00 -13- SCHEDULE G RECEIPTS OF INCOME SCHEDULE G-l DIVIDENDS Host Marriott Corp 04/18/01 110.000 shares 28.60 Marriot IntI Inc 04/30/01 1.20 TOTAL DIVIDEND INCOME..................... 29.80 SCHEDULE G-2 INTEREST M&T Bank 03/15/01 Interest from date of death on savings acct. #15004200598124 86.01 MBNA Cert. of Deposit #403719531 04/11/01 Interest accrued since date of death 113. 77 MBNA Cert. of Deposit #403166618 04/11/01 Interest accrued since date of death 132.20 MBNA Cert. of Deposit #408221434 04/11/01 Interest accrued since date of death 117.15 -14- MBNA Cert. of Deposit #409187063 04/11/01 Interest accrued since date of death MBNA Cert. of Deposit #40321459 04/11/01 Interest accrued since date of death MBNA Cert. of Deposit #402762136 04/11/01 Interest accrued since date of death Miscellaneous Receipt 04/02/01 Interest on closing of Waypoint Bank acct. /11700036609 Vision Instit. Prime Money Market 04/03/01 04/03/01 05/01/01 05/01/01 06/01/01 06/01/01 07/02/01 07/02/01 08/01/01 08/01/01 09/04/01 09/04/01 10/02/01 10/02/01 11/01/01 11/01/01 0.18 106.41 310.96 2.46 361.47 4.52 5.00 348.43 383.67 5.90 358.19 3.42 317.81 1. 70 291. 32 2.27 TOTAL INTEREST INCOME..................... -15- 129.83 115.13 117.55 0.07 2,503.71 3,315.42 08/13/01 11/26/01 SCHEDULE I DISBURSEMENTS OF INCOME Anne L. Bussey Estate - Income earned to Anne Bussey's date of death Income Commission - Manufacturers & Traders Trust Co. - 5/14/01-11/26/01 1,933.77 150.24 TOTAL DISBURSEMENTS OF INCOME.................. -17- 2,084.01 INCOME BALANCE ON HAND Current Value If Units Description or as Noted Fiduciary Acquisition Value Vision Instit. Prime Money Market 1,261.21 1,261.21 1,261.21 1,261.21 Commonwealth of Pennsylvania: County of Cumberland: David C. Gority, Trust Officer, Manufacturers and Traders Trust Company, being duly sworn, depose and says that the foregoing Account, both as to the items of charge and discharge, is just and true to the best of his knowledge and belief. Manufacturers and Traders Trust Company Officer Sworn t?Jlnd subscribed before me This ~y" day of December, 2001. " ...----'"-..~t~I;-,~.~;:;~~~ir~;~;~-F):::;I:...- '."."11 I C;~lls:e Bo.ro, (~Urnb.drlc1!l(J co.' /lntv . My Commi:,Slnl/ L):,w(,; JUly :o:c, ;?O(!~ ~_'_<~"'~Q.. ~ '~"',," . r, "_'"'~""""_""'_'_'__"_'__~'..:i h/~p,t;:;" ..1~i -18- IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION IN THE ESTATE OF DONALD S. BUSSEY LATE OF THE BOROUGH OF CARLISLE SCHEDULE OF PROPOSED DISTRIBUTION Balance for distribution as per First and Final Account filed December 7,2001 $ 72,597.81 Distribution Donald S. Bussey, Jr. Principal Cash Income Cash 35,668.30 630.60 $ 36,298.90 Manufacturers & Traders Trust Co. Trustee Marriott Vacation Club Time Share Principal Cash Income Cash 10,761.00 24,907.30 630.61 36,298.91 $ 72,597.81 STATEMENT OF THE REASONS FOR THE PROPOSED DISTRIBUTION The above distribution is proposed in accordance with the terms of the Last Will and Testament of Donald S. Bussey, Late of the Borough of Carlisle, Cumberland C unty, Pennsylvania. ,/1 ~ COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND David C. Gority, being duly sworn according to law, deposes and says that she is Trust Officer of Manufacturers and Traders Trust Company, successor to Keystone Financial Bank, N. A., the Account in the Estate above named, and that the facts set forth in the Statement of the Reasons for the Proposed Distribution are true and correct. Da _..~..,.__.----- \ :IV Public .",[\t.i. (;.,,0. ,,",y . ! : \)(,. 2004 .~c._~'..,'_____._. Sworn to and Subscribed before me this /4!!J...... day of ecember, 2001 \ Not; I Kathy J. Le;', I ('Isle Bora, ( i V ..Jmm;ssion! L...---- \v:tlmber, Pennsyl'i :'.'.:;r"J':'~':;