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HomeMy WebLinkAbout01-0244 Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Ruth F. Gamble also known as No. 21-00-244 , Deceased Social Security No. 193 -36-2993 Janet S. Gore and Jan M. Wiley Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) [K] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut ors nat'ned in th~ iast Will of the Decedent, dated 05/06/99 and codicil{s) dated None State relevant circumstances, e.g., renunciation, death of executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: D B. Grant of Letters of Administration (c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: I Name Relationship Residence I (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her last family or principal residence at 700 Walnut Bottom Rd., Carlisle Borough (list street, number, and municipality) Decedent, then ~years of age, died 0~/28 ,W..Q,l, at Forest Park Health Center, PA (Location) Decedent 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 560,000.00 $ $ $ $ situated as follows: Janet S. Gore 7 Breton Lane, Dillsbur , PA 7019 Jan M. Wiley One S. Baltimore St., Dillsbur , PA 17019 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems. Inc. /16 -c::2Y/- /~ Form RW-l (1991) Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of P .. r(s) and that, as personal repr entative(s) of the Oecedent, Petitioner(s) will well and truly admin' er the estate according to I Sworn to or affirmed and subscribed ~ Ja et S. before me this~~day;)f / ~- -lfAL '^^ . J) J-..... MARCH we 2001 '~M. Wiley , ~//y() ~//P~:h!&u~.cv For the R glster / No. 21-01-244 Estate of Ruth F. Gamble Deceased Social Security No: 193 - 36 - 2993 Date of Death: 02/28/01 AND NOW, MARCH 6 ,x~200i{l consideration of the Petition on the reverse side hereon. satisfactory proof having been presented before me, IT IS DECREED that Letters IT] Testamentary D Of Administration (c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate) are hereby granted to Janet S. Gore and Jan M. Wiley in the above estate and that the instrument(s) dated 05/06/99 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Shon Cenificate(s). $ 60.00 I (J ,!Ji { /7?OL~/. ~L~/~p?///// /lJ1'//~..w/;(y Regis er of Wills Letters. . . . . $ 375.00 Renunciation. $ Attorney: Jan M. Wiley, Esquire Affidavits ( $ 1.0. No: 06298 The Wiley Group One S. Baltimore St. Extra Pages ( ). . $ 6.00 Address: Codicil. $ Dillsburg, PA 17019 JCP Fee. $ 5.00 Telephone: 717/432-0426 Inventory. $ Other . . $ TOTAL. $ 446.00 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991 WARNING: IT IS ILLEGAL TO ALTER THIS COpy OR TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. '::or,HVIONWEAL TH OF PENI%\ LV ANli, DEPA.Rri\\ENT or HEAL Tii ViTi\L HEconDS OC.r~L REGISTRAR'S CERTIFICATION OF DEAT}'j 4791398 \.;;\.~(;:~~5\;' Ct';~f1~:\ '\'~' ""j.~ i'~ 'fl\ .';;-~\\ {%:~;~:\~f;l' March 1, 2001 21-01-244 Ruth F. . Gamble Se~ Female 193 - 36 - 2993 Date February. ,28,_ 2001 Den! December 1Q, 1912 8iI1(-;018C(:: Sb.~.mQ~,:kn.L~*=~ n n syl'!fJ !It.~. PI-::1C" Forest Park N1.lI:S:kl}g, Q~nt_~!" . Gl,lDlQ~rli!,l'l.c:l .c;()\.111:t:y Carlisle Borough Rae: White EJeIIlen..t:(i~Y Teacher Ar med Forcp~, 'y No Mal Widowed .f_9.:r:~,?t: Park ,Nyts.t!!g Center Carlisle PA Mrs. Janet Gore Funeral Director Scott D. Brenneman, FD CocklinFup,gJ'alJ:J.Q:m~L._!.I1,~.~, 39,~ ~ .C'h~.~!.I!~.~_.~t!~E:!t" Dillslltirg, PA 17019-0424 ~-, Inanition End Stage Alzheimer's Disease Pal: ,! Sev~re CHF Descr:bE: flOVV injury ~~atLrcl' XXX )etuTl1lnerj ,.lay ~.,~Q~~!!c!~_.~.,. 100. S.lIig'h Street, NE!liY!-}l~,. '!~I!!l!J!lvania 17241 d t ! Ci ! j 11 e ;' e q I V en! s C 0 rr c (; t! y cop i e (1 L (j a: Reg i s t r arT h t~ CH I 9 I a Ice rt ; f : c 'J ! rnanerlt t!! ng 6 7608 March 1. 2001 153 Logan Road, Dillsburg, PA 17019 .... .. . fl., ;0'" ..... 21-01-244 iliasl mill nnn QIl'smmtut OF RUTH F. GAMBLE BE IT REMEMBERED, that I, RUTH F. GAMBLE, of 18 Frost Lane, Dillsburg, York County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this as and for my Last will and Testament, hereby revoking and making null and void any and all Wills and Testaments and writings in the nature thereof by me at any time heretofore made. ITEM 1: I direct that all my just debts and funeral expenses be paid as soon after my demise as may be convenient. ITEM 2: I give the sum of Five Thousand ($5,000.00) Dollars to SANDRA WISE, of Dillsburg, Pennsylvania. ITEM 3: All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, whether it be real, personal or mixed, including property over which I have a power of appointment, I give, devise and bequeath as follows: (a) Thirty-Three and one-third (33 1/3) percent thereof to WILLIAM S. GORE. (b) Thirty-three and one-third (33 1/3) percent thereof to JANET S. GORE. (C) Thirty-three and one-third (33 1/3) percent thereof to my sister, MARGARET E. SHINER. ITEM 4: I direct my hereinafter named Co-Executors to w: ~/ -t: ~.4.tA& (-SEAL) RUTH F. GAMBLE \Ovv~. uCvr,hvL -1- ..,. - .~ . fII.' .- , ' .". I' . pay all inheritance, estate, succession and legacy taxes of whatsoever nature and kind, to which my estate or the transfer of any property passing hereunder or otherwise passing by reason of my demise, may be subject and to charge such taxes against my residuary estate, it being my intention that none of the aforesaid taxes, either federal or state, on any property required to be included in my gross estate, under the provisions of any state or federal law now in force or hereafter enacted, shall be prorated among the persons interested in my estate to whom such property is or may be transferred or to whom any benefit accrues. ITEM 5: I appoint JANET S. GORE and JAN M. WILEY, ESQUIRE, as Co-Executors of this my Last will and Testament. ITEM 6 : I direct that my Co-Executors shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this to -th day of -rr7~ ' 1999. \1?':k tr. .4~~/(SEAL) RUTH F. GAMBLE ~(V~~ -2- ~l' . ~" - -" COMMONWEALTH OF PENNSYLVANIA . . : SS COUNTY OF YORK We, RUTH F. GAMBLE, ::r 0 F. 4f+rr>an :7 all fl1. W / I-e-'-I and g~-I htJ.fI 'f L ~ ~ a n1 b~Y'" , the Testatrix and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last will and Testament and that she had signed willingly (or willingly directed another to sign for her), and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed this Last will and Testament as wi tness and that to the best of their knowledge the Testatrix was at the time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. w~ ~ WI E Sworn to and subscribed before me this tp-dJ day of , 1999. TARY PUBLIC CERTIFICATION OF NOTICE UNDER n.ULE 5.6 (a) Name of Decedent: Ruth F. Gamble Date of Death: February 28,2001 Estate Number: 21-01-0244 To the Register: I certify that notice of beneficial interest required by Rule 5.6 (a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on March 19, 2001: Name William S. Gore Janet S. Gore Margaret E. Shiner Sandra Wise Address 7 Breton Lane, Dillsburg, P A 17019 7 Breton Lane, Dillsburg, P A 17019 303 Court St., Doylestown, PA 18901 108 Lucust Way, Dillsburg, PA 17019 Notice has now been given to all persons entitle eto under Rule 5.6 (a) except N/A. Date: March 19, 2001 M. L-J Name: Jan M. Wiley, Esquire Address: One S. Baltimore St. Dillsburg, P A 17019 Telephone: (717) 432-9666 Capacity: Counsel for personal Rep. ~nventory of the real and personal estate of Ruth F. Gamble deceased "SEE ATTACHED" .. TOTAL: $536,02 .96 I REV-1502 EX + (1-97) .. COMMONWEALTH OF PENNSYLVANiA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ruth F. Gamble SCHEDULE A REAL ESTATE FILE NUMBER 21-01-0244 All real property owned solely or as a tenant -In common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a wUllng buyer and a willing seller, neither being compelled to buy or sell, both having reasqnable know\edge of the relevant facts. Real property which Is Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 Sale of home & property situate at 18 Frost lane, Dillsl:urg, PA: 2 sale of Lot, situate in carroll Twp., York COUnty, PA: 90,000.00 100.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional shee1s of the same size) 90,100.00 7 CPA21 NTF 10904 Copyright Forms Software Only, 1997 Neice, Inc. REV-1503 EX + (1-97) 'COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ruth F. Gamble SCHEDULE B STOCKS & BONDS FILE NUMBER 21-01-0244 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 Smith Barney Account No. 740-1012342902: 39,291.57 7 CPA31 NTF 10905 Copyright Forms Software Only, 1997 Nelco, In=. TOTAL (Also enter on line 2, Recapitulatlon) $ (If more space is needed, Insert additional sheets of the sama size) 39,291.57 REV;1508 EX + (1-97) SCHEDULE E CASH, BANK DEPOSITS, &: MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ruth F. Gamble FILE NUMBER Include "foc_ads of litigation &. date proceeds were received by the estate. All r ITEM NO. DESCRIPTION 1 Mellon Bank Account Nt.nnber: 00310-409832: 2 Mellon Bank Account Nt.nnber 00135969: 3 -Fulton Bank Savings Account #339-33110: 4 Fulton Bank Chedking Acct. #3619-68660: 5 Fulton Bank CD#643-0056383: 6 Fulton Bank CO#643-0056384: 7 Fulton Bank 0)#643-0056385: 8 Fulton Bank CO#643-0056386: 9 Fulton Bank CQ#643-0056387: 10 Fulton Bank CO#643-0056388: 11 Fulton Bank CD#643-0056390: 12 Waypoint Bank Savings Account #1000002643: 13 waypoint Bank CD #1066225798: 14 Waypoint Batik CD #1066234211: 15 Waypoint Bank CO#1066234274: 16 Waypoint Bank CD#1066234316: 17 Waypoint Bank CD#1066240578: 18 .Waypoint.Bank:CD#1066240586: 19 Waypoint Bank CD#1066240623: 20 Waypoint Bank CO#l066240683: 21 Waypoint Bank CD#1066245741: 22 Waypoint Bank CO#1066245767: Total from continuation TOTAL Also enter on line 5, Reca ltulation) $ (If more space is .needed, Insert additional sheets of the same size) 7 CPA81 NTF 10906 Copyright Forms Software Only, 1997 Neltoo, Inc. 21-01-0244 must be disclosed on Sch. F. VALUE AT DATE OF DEATH 2,952.01 25,050.67 2,859.83 3,870.93 5,013.21 15,037.37 10,034.78 26,045.37 6,020.33 8,010.02 9,010.47 2 (091.62 5,021.53 5,021.53 10,038.84 10,224.75 10,040.54 5,019.71 5,019.34 15,059.14 5,018.09 20,042.38 200 130.93 406 633.39 Fstate of: Ruth F. Gamble . SCHEDlJIE E - cash, Bank Deposits and Miscellaneous personal Property Page 2 21-01-0244 Item No. Description Value at Date of Death 23 ' Waypoint'Barik CD#1066245800: 24 Commerce Bank Savings #410116054: 25 Commerce Bank TiJne Deposit Acct. #1849: 26 COImnerce Bank Tllne Deposit Account #8942: 27 COImnerce Bank TiIne Deposit Account #8932: 28 CcsmJno.xce Bank Time Deposit Account #9848: 29 Commerce Bank TiJne Deposit Account #21615: 30 Commerce Bank T:llne Deposit Account #24228: 31 Commerce Bank Time Deposit Account #100426: 32 COImnerce Bank Time Deposit Account #300927: 33 ENe Bank CQ#21001060343: 34 PNC Bank CO#21001060377: 11,038.98 1,383.96 25,290.75 6,009.34 7,027.76 10,022.62 31,014.37 7,007.49 18,117.87 3, 007 .48 12,015.41 10,041.58 35 me Bank 0)#3J.200074417: 5, 059 .12 36 PNe Checking Account #5001000769: 37 PNe Bank Checking Account #5140022343: 38 mc Bank Savings Account #5130385845: 39 M&T Bank Savings ~t #15004200835097: 40 M&T Bank CD#31003911377058: 41 M&T Bank C)#31003911377074: 42 PNC Bank CQ#21001060355: 43 PA Blue Shield (refund): 44, American General Life Insurance Co. (annuity payment): 45 York Hospital (refund): 4,002.01 9, 336.69 864 .10 2,271.26 10, 032 . 09 10,029.62 10, 000 . 00 251.50 980.00 21.11 ~. (Carry f~rward ,to ~~ sched~e) 194,825.11 page ;;J 21_01-0244, ~'tB of: }\Uth!'. Q81lib1.e . ~ E _ cash. ~ peposits a:rd ~~ ~ ~ value at oate of neath ------------= 980.00 ~ipt.ion 1.,200.00 1.,094.99 202 .00 so ~ c;e:oera~ 'Lite ~ CD. (annuity payroent) : ~ ?a~ ~ved :fratl ~Y'S: ~ poin'tB (refurii): pA pept. of ~ ('I;a)t refurii) : ~ r..~~'$ ~ ~ CD. (refurii): pub~iC ~~ ..,t0yee5 ~~ syst.ent\ 226.00 It.eJ1\ No. -- 46 41 1.,602.8'3 48 49 5'1 ~.(~f~to~~e) . . . . . . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: I :,J It.. C Y ,j A 1\] ;-,.1 ~ BALTIMORE STREET [~I~__1_58lJF~(~~ PA 1?()1(~ PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT No.AA 496639 REV-1162 EX (11-96) ACN ASSESSMENT CONTROL NUMBER 1 (; 1 AMOUNT ~bL4 . L,OO. (d) ESTATE INFORMATION: FOLD HERE FOLD HERE FILE NUMBER 2 1 -, E:OO 1 '.Or~;{iJ~ ~::;~~;N 193-- :36-,,299:::3 (FIRST) (MI) NAME OF DECEDENT (LAST) Cl;\!1F1:~f: t.{Lf }~'l i DATE OF ;AI24N~ ':>.=1'.=.. : .' POSTMARK DATE :.:'~ / (_: .~'~/ c~' () ,C) :L COUNTY C ur"IBE.::f;;:L{.\!\i rJ DATE OF DEATH 2./ Z:lt3 / ..?()() i - '.' ~~ C'; Jt :1 c'~:. 'J SEAL , -, TOTAL AMOUNT PAID ~.~ ,..~ " /'" RECEIVED BY i/"'" ,~"(. ,: {' (f Iv1 A F, V' c: _ L r::,k:-JI 5 i.{[ G I T E:' F! /6r :'J} REGISTER OF WILLS . '. ''II' lI'~t " \~ ~f.. i:,J ~:+ '" '~~) () t); (J () . ..... :-: j.} Ei ~~~,~-",",.....,.,.-I' .' ./~. ".<<~._ f 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 JAN M WILEY ONE S BALTIMORE ST DILLSBURG, PA 17019 _u___u fold ESTATE INFORMATION: SSN: 193-36-2993 FILE NUMBER: 21-2001- 0244 DECEDENT NAME: GAMBLE RUTH F DATE OF PAYMENT: 08/02/2001 POSTMARK DATE: 08/01/2001 COUNTY: CUMBERLAND DATE OF DEATH: 02/28/2001 NO. CD 000112 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $2,711.43 I I I I I I I I TOTAL AMOUNT PAID: $2,711.43 REMARKS: JAN M WILEY ESQUIRE CHECK# 4773 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS / ~~/t/-, /q 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 09-24-2001 GAMBLE 02-28-2001 21 01-0244 CUMBERLAND 101 JAN M WILEY ESQ THE WILEY GROUP 1 S BALTIMORE ST DILLSBURG PA 17019-1102 s~* REV-1547 EX AFP (12-00> RUTH F Amount Remitted CHANGED (1) (2) (;3) (4) (5) (6) (7) 90.100.00 39.291.57 .00 .00 406.633.39 .00 63.498.88 (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=is4-j-E3f-AFP--fi2":O()f-NO,.-icE--Oj:-'rNHEifiTANCE-TAX-APPRAisEHENT~--Aii-oWAN-CE-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GAMBLE RUTH F FILE NO. 21 01-0244 ACN 101 DATE 09-24-2001 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) s. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 94,781.51 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 599,523.84 94.799 3~ 504,724.52 .00 504,724.52 NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: IS. Amount of Line 14 at Spousal rate (IS) 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 = .00 166,574.84 X 12 = 19,988.98 338,149.68 X 15 = 50,722.45 (19)= 70,711.43 17.81 (11) (12) (13) (14) PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 05-23-2001 AA496639 3.400.00 64,600.00 08-01-2001 CDOOO112 .00 2.711.43 TOTAL TAX CREDIT 70,711.43 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * 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.) c STATUS REPORT UNDER RULE 6.12 Name of Decedent: I<LLfh F t;t1JYlble Date of Death: ~Ja?JD I , Will No. ~/-OI-tJ;),yLj Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: J. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: C. ,Did the personal representative state an account informally to the parties in interest? Yes X 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 ma be attached to this report. Date: 7-3i -D I ~ t+ 1\) f\A., I .t )::r- L F-Y f- S (J 1 ).J:Q F- Name (Please type or pr1nt) i s. ;~(d +1 Morp Sf-. Addres s 'J:Yi! \..sb Url), Pt+' ,cd q ( 11'7) L{3;J - q& iI {JJ Tel. No. Capacity: Personal Representative ~counsel for,personal representat1ve (MAH: rmf / AM3 ) , REV-1!jPO EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECE- DENT CHECK APPRO- PRIATE BLOCKS COR- RE- SPON DENT RECA- PITULA- TION TAX COMPU- TATION REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENrs NAME (LAST, FIRST, AND MIDDLE INITIAL) Gamble Ruth F. DATE OF DEATH (MM-DD-YEAR) 02 28 01 12 10 1912 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~ 1. Original Return 4. Um~ed Estate 8. OIlClldentDllldTllstatll (Attach copy of Will) 9. UtlgaUon Proceeds Received ~ 2. Supplemental Return 4a. Futurelnterllst Compromise (datil of death aftar 12-12-62) 7. Ollcechtnt Maintained a Living Trust Attach a copy of TrLlst) 10. ~Pousa.1 Poverty Credit (date of duth between n-31-91and 1-1-95) C- OFFICIAL USE QNL Y /C:r02/<1- );2. ""'''',.... :~":~:~i: NAME Jan M. wil FIRM NAME (It Applicable) '!heWil TELEPHONE NUMBER 717-432-9666 e FII-E NUMBER 21 01 0244 NUMBER COUNTY CODe YEAR 1. Real Estate (Schedule A) 2. SIooks and Bends (Schedule B) (1) (2) SOCIAL SECURITY NUMBER 193-36-2993 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 3; Remainder Return B (date of death prier to 12-13-82) 5. Federal Estate Tax Return ReC1uired 1 8. Total Number of Sate Deposn BOX88 011. ElllctiontotaxundllrSllc,9113(A) (Attach Sch 0) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. Jolnuy Owned Property (Schedule F) o Separate Billing Requested (6) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) (7) 8. Total Groaa _ (total Unes1-7) 9. Funeral Expenses & Administrative CostS (Scheclule H)(9) 10. Oebb of Decedent, Mortgage Liabilities, & Uens (Scheclulel) (10) 11. Total Deductions (total Unes 9 & 10) 12. Net Value of Estate (Una 8 minus Una 11) 13. Chsrltable and Governmental Bequests/See 9113 Trusts tor which an aleetion to tax has not been made (Schadule J) 14. Net Value Sub ect to Tax Una 12 minus Une 13) 90,100.00 39,291.57 None None OFFICiAL USE ONLY 406,633.39 None 63,498.88 (8) 94 ,781. 51 17.81 (11) (12) (13) 599,523.84 94,799.32 504,724.52 None (14) 504 724.52 SEE INSTRUCTIONS ON PAGE 2 FOR APPUCABLE RATES 15, Amount of LIne 14 taxable atthe spousal tax rate, ortransfers under Sec. 9118 (a)(1.2) )( .0 (15) 16. Amount of Line 14 taxable at lineal rate 0.00 X.O 45 (16) 17. AmOUfltof Lll'\e 14ttl.xabltl&taib"l'l\}rate 166,574.84 X .12 (17) 18. Amount of Line 14taxabJe at collateral rate 338,149.68 x.15 (18) 19. Till( Due (19) 20. 0 1000!~cKl!mw;wmiMij;j~~QI~;:i!R~mji(ijt\i"'l:Mli!iiAmefjt1 NTF 211755 Copyright 2000 Qreatland/NlIlco LP- Forms Software Only 0.00 19,988.98 50,722.45 70,711.43 }XfmgtM1N#MhtHMN@UMtm]~~~:Wtd~fr.(tM~~AW1~!rj~$U6N$f~.I~I_~j~.:Wijj;ft(~.Q~~mBMI#1Jil%itrtMtH/M\gHg@ffimn!W o PA15001 Estate of: Ruth F. Gamble 21-01-0244 SUMM1\RY OF AllDCATIONS 'ro BENEFICIARIES Taxable at sibling rate Margaret E. Shiner 166,574.84 Taxable at oollateral rate Samra Wise Janet S. Gore william S. Gore 5,000.00 166,574.84 166,574.84 338,149.68 c PA RE\i-l500 EX (e-oo) Com Page 2 Decedent's ~plete Address: STREET ADDRESS Forest ParX Nursirrr center CITY I STATE IZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Pagel Une 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 70,711.43 64,600.00 3,400.00 Total Credits (A + B + C) (2) 68,000.00 3. Interest/Penalty n applicable D. Interest E. PenaJlty 0.00 0.00 Total InteresVPenally (0 + E) 4. If Une 2 is greater than Une 1 + Une 3, enter the difference. This is the OVERPAVMENT. Check box on Page 1 Un. 20 10 request a refund 5. If Una 1 + Una 3 is greater than Una 2, enter the difference. This Is the TAX DUE. A. Enter the Interest on the tax due. B. Enter the total 01 Una 5 + SA. this is the IlAlANCE DUE. Make Check Payable to: REGISTER OF WILLS. AGENT [ji1@It.flMThl]tflJ~Jllli1ii~~WJrflfl~I~~~*i~r~'1~ff.kttflfM*[1~gMf{{tHMI~r*lftliNIr.@1~1~1~mg*~IJ@~~mf~ff1~~MMtf~j1~~t.Ji[WfM~:U~:f:j::: '}^~;'~~V)~:i;f~~2~); PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS (3) 0.00 (4) (5) (SA) (5B) 2,711.43 0.00 2,711.43 1. Did decedent make a transfer and: .. retain the use or Income 01 the properly translened; ....................................... b. retain the right to designate who shall use the property transferred or its income; ................" c. retain a reversionary interest; or. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . d. receive the promise for life of either payments, benefits or care? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. If death occurred after 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 banaficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ~ 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 perjulY, 1 declare that I have examined this returnj including accompanying schedules and statements, and to the best ot my knowled and benet, it is true, co and complete. Declaration 0 preparer other tlian the personal representative is based on information of whic e arer has an kn ed . S NAT 0 PE SO ES LE FOR F ING ETURN DATE 1'3/ Yes No ~ ! 8 ~ o DATE 01 . Balti.m:>re st. PA 17019 jmW:~:;':'.A:@itWtMm&@W%mt?:KHmMW~j.%%~lWttK~WtMmnromtnmm.%tmmM~W\tM%iMMNtm\t:::;.,~..:.>j ,y'~'::, ~;' ~>)'~~ . ;" .:~::<:a\It..?:t::.-::::::::::~:':~: imMWl ~:mM es of death on or after July 1,1994 and before January 1, 1995, the tax rate impo5ild 01'1 the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S.' 9118 (a)(1.1)(i)). For dates of death on or after January 1, 1995, Ute tax rate Is im;lO$ed on the ne\ value of transfers to orforthe use of the surviving spouse is 0% [72 P.S. . 9116 (a) (1.1) (ii)), The statute Itn.... "nt "1f..mDt a transfer to a surviving SpoUSll from tax, and the statutory requirements for disclosure of A.$sets and filing" tax return are still applicable even if the surviving spouse Is the only beneficiary. For dates of death on or after JLlly 1, 2000: The taxratlll impaled on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. '9116{a)(1.2l]. The taxra" imposed on the net value of transfers to orfor the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72.P.S.. 9118(1.2) [72 P.S. Ii 9116{a)(1)). The tax rate Imposed on the net value of transfers to or forthe use of the decedent's siblings is 12"10 [72 P.S.' 9118{a}{1.31~ AslbUng is de~ined, under SectIon 9102, as an Irrdivldual who huat leaatone parent In common with the decedent, whether by blood or adoption. o PAl5002 NTF 29758 Copyright 2000 GreatlandfNelco LP - Forms Software Only Estate of: Ruth F. Gamble 21-01-0244 'nle followirq person{s) are signirq the retuJ:n as representative(s) of the estate: Janet S. Gore 7 Breton Iane Dillsl::l.1l:g, PA 17019 COMMONWEAlTH 0' f!NNS'ttV..N'A DEPARTMENT OF REVENUe INKEIlnAHCI TAX DIVISION DEPT. 210601 I:'I..RRISIURG. PA 1712B.0601 Please Print or Type" MUST BE COMPI.ETED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAFE DEPOSIT BOX IS LOCATED AND RETURNED TO ABOVE AOORU.S COUNTY CODE FILE NUMBER SOCIAL SECURITY OR DEATH CERTIFICATE NUMBER 19-3- 36- 2993 DTOFDTH 2/28/01 REU/5EX+il.92) . (Q) [t2> Y fi:. SAFE DEPOSIT BOX INVENTORY DECE ENT'S NAME (LAST, FIRST, MIDDLEJ GAMBLE RUTH F. ADDRESS OF DECEDENT (STReeT) FOREST .PARK NURSING HOME, 700 WALNUT BOTI'OM RD NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX (NAM!j ATIDRNEY JAN M. WILEY (CITY! CARLISLE (STAT!) PA {STReET ADDRESS} 1 SOUTH BALTIMORE STREEI' (CITY) DIUSBURG (STAT!I PA NAME. ADDRESS AND RELATIONSHIP IIF ANY) TO DECEDENT. OF PERSON(S) PRESENT AT THE BOX OPENING a. (NAM!) _ 'IRELATIONSHlp). --JA"'~+ S. C;orc ~. ISTRm ADDRESS) ICITY) 7 B.r~76p LN. )")-/J_-.6/J",,<;f>,.. b. INAMEI .::r: (RELATIONSHIP) '" I'Y ....-I _ "^'; Ie '1 E\4 . J,. 11 #.If (STREET ADDRESSI (CITY) I...s; ~.4-t..-f. s-l: ,t\;:}:.;;::.. t.<.' (ZIP CODE) 17013 (ll'CODI! . 17019. . (STATE} (ZIP COD!) /7019 . (STATE) p,.. .. (NAME} (STREET ADDRESS) (CITYj ~SiATEl NAME AND ADDRESS OF ANANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED (NAME) PNG BANK lSTReeT ADDRtSS~ (CITY) 403 NORTH BALTIMORE STREEI' DIU.SBURG (STATE) PA a. b. (NAM!) ~ rL. .::::]A.,.; M. W: Je'1 ISTREET ADDRESS) L/J. I. ..s. ljAU. S+ ISTATE) IZlP CODE) (CITY! n p"" I 7 0 J <:t ])i It b \J I" r.+. NAME AND TITLE OF EMPLOYE AKING THE INVENTORY r.-- I <lA.-( '>" J 1'0.. '1~ y" e;~t ISTATE) WAS A WILL IN THE BOX? DYES 0 II Y'" .. Dat..1 will. b. Nom. and addr... of personal '.presentative, if named In the will (NAME) {STREET ADDRESSJ (CITY) (STATEI c. Nam. and ocld,... of crttonwy, if ony (NAME} {STREET ADDRESS} (CITY! (STATE) (ZIPCOJ;>E1 . J7t!i I' . IZIPCODE) IZJPCQpEl 17019 ~ ' ..... .,~ ,"! (ZIPCQDEJ {ZIP,CODEI (ZIP CODf) ",' Page of '-~, -. SAFE DEPOSIT INSTRUCTIONS (1) Cash: Report total only. (2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stockis registered, and number of shares and class of stock. (3) Obligations of U. S. Government: Number of items, date of issue, face value, names in whiJ:h registered and type of ownership, i.e., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or ather designation. (Bearer Bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, lost date appearing in book, name of bank and branch, and balance. (6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible.. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: list and describe as fully as possible. (8) All other contents. TORY ; _r ITEM NO. ITEM DESCRIPTION I .Dc /'{. C CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS RRECT AND COMPLETETO THE BEST OF MY KNOWLEDGE AND BE A UFtE , ~. PRI ME AN J~41 ~5P' APP OPRIATE B X: C.o e?"-i... a'" d ~Executorftrix} o Administrator{tril() o Estate Representative 0 Joint owner o~ safe deposit box NOrE: Attad, addltlonaIS'h" X II" sheet (s)lf necessary or use duplicates ofthls page of form. REY-1502 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ruth F. Gamble SCHEDULE A REAL ESTATE FILE NUMBER 21-01-0244 All real property owned solely or 88 . tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, nelther being compelled to buy or sell, both having reasonaQle knowledge of the relevant faClB. Real property which Ie JolnUy-owned with right oIeurvlvorehlp must be dleclosad on Schedula F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 sale of hane & property situate at 18 Frost Lane, DillsbJrg, PA: 2 sale of Lot, situate in Can'oll 'lWp., York County, PA: 90,000.00 100.00 TOTAL (Also enter on line 1, Recaohulation) $ (If more space is needed, Insert additional sheets of the same size) 90 100.00 7 CPA21 NTF 10904 CopyrIght Forms Software Only, 1997 Nelco, Inc. u.s. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT A. HI}fl-l UNIFORM SETTLEMENT STATEMENT ,.. B. T of loan 1.[ J FHA 2.ll FmHA 3.1 ] Conv. Unins. 6. File Number. 7. Loan Number. 8. Mortgage lneurence Case Number. 4.[]VA 5.fIConv.lns. 10751 5700121721 C. NOTE: This fann furnishes a statef1lent of settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p 0 c.)" were paid outside the closing' they are shown for Informational purposes andere not Included In the tolals. . . 0: Name & Address of Borrower. E. Name, Address & TIN of Seller. F. Name & Address of Lender: Eric N. Trembly & Leann M. Trembly Janet S. Gore & Jan M. Wiley Fulton Mortgage Company 1 B Frost Lane 7 Breton .Lane 1 Penn Square. Suite 304 DlIIsbum PA 17019 Di\lsbum PA 17019 Lancaster PA 17802 G. Property Location: TIN of Seller: I H, SetlleJ)1enl Agent: 18 Frost.Lane Place of Settlement Jan M. Wiley. Eequire Dfllsburg, PA 17019 Wiley, Lenox, Colgan & Marzzacco, P.C. 1 S. Bell/more Street, DlIIsburg, PA 17019 Parcel No. 20-000~PC-0023.AO 1 S. Baltimore Streel DlIlsbum. PA 17019 I. Settiement Date: MaY 29 2001 J. Summary of Borrower's Transaction . 1 DO Gross Amount Due from Borrower' K. Summary of Seller's Transaction 400 Gran Amount Due to Seller: - 101. Contract sales nrice 90 000.00 401. Contract sales Dnce 90 000.00 102.Pe~onaIPronP.rtv -402. P'6fSOOa\ ,PrnnArN 103. Borrower's setuement chames (line 1400 3 712.88 403. 104. 404. 105. 405. Adjustments for Items paid by seller In advance Adlustments for lIems osld b'I seller In advance 106. City/town taxes 5124101 to 12/31/01 29.68 406. Cltvllown laxes 5124101 to 12/3111)1 29.68 107. Countv taxes 5/24101 to 12/31101 217.41 407. Countv taxes 5124101 to 12/311ll1 217.41 108. School taxes 5/24101 to 6130101 127.52 408. School taxes 5124101 to 6130101 127.52 109. to 0.00 409. to 0.00 110. 410. 111. 411. 112. 412. 113. 413. 120. Gross Amount Pue from Borrower 94087.47 420. Grou Amount Due to Sener 90374.61 200. Amounts Paid hv or In Behalf of Borrower: 500. Reductions In Amount Due to Seller: 201. Oen<\!,its Of earnest monev 7 000.00 501. Excess deooslt (see lnstruc:;llons\ 7 000.00 202. Princioal amount of new loan(s 79610.00 502. Settlement chames to' seller line 1400\ 905.00 203. Existino toan(s taken sumec\ to 503. Exislinn loan/ll.) taken sub eel to 204. 504. Pmtoff of first mortl1al1e 205. 505. Pavnff of second morfasl1e 206. 606. 207. 507. 208. 508. 209. 509. Adiusbnents for Items unpaid by seller' Adiusbnents for Items unDlld by seller 210. Citv/town taxes to 0.00 510. Cltvnown taxes 10 0.00 211, County taxes to 0.00 511. Countv taxes to 0.00 212. Assessments to 0.00 512. Assessments to 0.00 213. to 0.00 613.. to 0.00 214. 514. 2.15. 515. 216. 516. 217. 517. 218. 518. 219. 519. , 220. Total Paid Bv/for Borrower 88,610.00 520. Total Reduction Amount Due Seller 7,905.00 300. Cash at Settlement Fromlto BotTower 600. Cash ai Settlement ToIfrom Seller 301. Gross amount due from borrower line 1201 94.087.47 601. Gross amount due 10 seller line 420) 90 374.81 302. Less amounts Daid bvlfor borrower ([Ine 220 86 810.00 602. Less reducl:ions in amount due seller lIine 620) 7 905.00 303. Cash IHI from IflI to Borrower 7.477.47 603. Cash 1181110 nI from Seller 82 489.81 Substitute Form 1099 Seller Statement The infonnation in Blocks E, G, H, i & line 401 (or. If line 401 is asterisked. line 403 and 404) Is ImPortant tax Infonnatlon and Is being furnished to the I~temal Revenue Service. If you are required to file a return, 8 SElncljon will be Imposed on you If this item Is required to be reported and the IRS determines that it has not been reported. If this real estate Is your principal residence, file Fonn2119. Stile or ExchatJge of Principal Residence, for any gain, with your income tax return; for other transactions. complete the applicable parts. of Form 4797, Fonn 6252 and/or Schedule 0 (Form 1040). You are required to provide the Settlement Agent (named above) with your correct taxpayer ldentmcatlon humber. If you do not provide the Settlement Agent with your taxpayer Identification number, you mey be subject to cIvlJ or criminal penafUes Imposed by law. Under pene of perjury, I rtl that the number shown on this statement y correct taxpayer idenUflcatlon number. - (Seller) (Sells., 700. 1;otal SaleolBroker'o Commlnlon: bond on 0 90 000.00 % Division f Commis '00 ine 700 as follows' 701. 702. 703. Commission id at Settlement 704. 800. (tems Pa abteln Connection with loan 801. Losn Ort ;""lIon Fee 802. Loan Discoun 803. raissl Fee 225.00 - Central Pen raisers 804. Credll Re rt 18.00 - B 80 . lender's Ins action Fee BOO. Mort e Insurance lication Fee 807. lication Fee 95. 80B. 00 ment P tion 809. Insurance Servi Fee - eritrac 810. Tax Service Fee - Fif81 American Real state eM S 811. Flood Certification Fee - Fl tAmerican Rood. 812. Automated UndelWl'1tin F e - Fannie Mae 813. 814. 900. ltemo Ro ul...d Lsndor to Be Paid In Ad....""" 901.lnlo...o from M 9 2001 to Jun 1 2001 1 .6100 rdo 902. Mo a e nsurance Premium for 903. Hazard Insurance Premium for 904. 905. 1000. Reservet De osited with Lender 1001. Hazard Insurance monU\s rmonth 1002. Mo a nsurance nths r th 1003. C ro ta as m nths ST th '\004. Coun e taxes 4 months 34.63 er Ul 1005, School ro rt taxes 12 months 111.54 ermonth 1006. P Ilnsurance s 44.45 r rnonlh 1007. 100B. 1009 A ate Accountin Ad'u tment 1100. Title Ch r 8S 1101. Settl ntfclosln fe 1102. A stract!tlUe sea 1103. ntle minati n 1104. TlfIe os rance binder 1105. Document re aralian 1106. Nota fees 1107.A orne 'stees includes above item numbers 1108. TiUe insurance Poli No. 920322 Indudes above Item numbers 1109, L ndel' covers 9610. 1110. Owner's coverage $90,000.00 111 . Endorsements 100 300 900 1112. CJosin Protection Letter 1113. 1200. Govl!mment ReeD In and Transfer Cha es 1201. Re rdin 0 ed 31.0 Mo a e 55.00 R lease 1202. Ci lcoon taxlstam s: Deed 900.00 Mo a e 1203. Slate taxi s: De d 00 art a e 1204. 120 . 12 1300. Additional Settlement Cha es 1301. SuM> 302. Pes t ctio 1303.0ve i ht Fee elas' Documents 1304. Madeli e Ha old Tax Collector- T C flCBtIon 1305. 1306. 307. 130B. 1400. Total Settlemen Char es his Number Paid from Borrowe(o Funds BI: SellIement Peld From Seller's Funda at Sa men 0.00 P.OC. P.O. . P.O.C. 175.00 54.00 75.00 7.00 P .C. 33. 0.00 0.00 O. 138.52 1410.48 0.00 138. 788.75 150.00 3500 6600 .00 000 .00 8.00 5.00 3712.86 905.00 Seiler B_ Seller Jan M. Wiley Leann M. bly st of my knowledge the HUO-1 Semement Statement which I have prepared 18 true ,and accurate account of nd have been or will be disbursed by the undersigned as part of the seltlement oJ \hIs transaction. ...... . Settlement Agent s::- !,?Jj J t!!J I Dole Jan M. Wiley, EsqUire -I " WARNI . 11$8 ctllflll to knowingly make faJaealtltement5tolt1e UnIted Slates on IhlsoranvolheretmUacfotm. P'lmBIUea\lPOl'o1Xlrl'lldlon1llln1l'Jctude.fIna and ~ Far detBlIs fo'&e: TYtIe 1& U.S. Code S$CIIon 1001 and Seclkm 1010. Borrower j: II il THE WlLEY i i GROUP' ATfORNEYSATLAW [I ONE SOlTIH BAI.:l1MOREST. II DIUSBURG,PAI7019 I II II II II II Ii i Ii II I, il il I i' )1 II II 2001, BY AND BETWEEN, II II II ,I 1\ ,j II II II II II Ii Ii il II I II I, Ii 'I I ,) 1\ II I: Ii /a..I'c.e"j '/fJ"jo-CO')-;t! - tJ0#13,itO r N DEN T U R E THIS INDENTURE, made the ,3(st of /Ju j if' day , JANET S. GORE AND JAN M. WILEY, CO-EXECUTORS, under the Last will and Testament of RUTH F. GAMBLE, late of Carlisle Borough, CUmberland County, herein referred to as Grantors of the One Part, AND WILLIAM S. GORE and JANET S. GORE, husband and wife, of 7 Breton Lane, Dillsburg, Pennsylvania, herein referred to as Grantees, of the Second Part. WHEREAS, Ruth F. Gamble, departed this life on February 28, 2001, having first made her Last Will and Testament in writing; and WHEREAS, Janet S. Gore and Jan M. Wiley were appointed and constituted as Co-Executors of the Estate of said Ruth F. Gamble by Item # 5 of said will; and WHEREAS, Janet S. Gore and Jan M. Wiley, pursuant to the power granted to them, are desirous of conveying said piece or II i: parcel of real estate described herein, owned by the Estate of ,I Ruth F. Gamble. w r T N E SSE T H That the said Grantors for and in consideration of the sum 11 'i II II II II II ~R~ II ATl'ORNEl'SATLAW i' ONESOUIHBALTIMOREsr. ! I DnLSBURG, PA 17019 II II I !I II II i,l I II " II Ii ,I II II II 1\ " I :1 II " II ALL THAT CERTAIN tract County, Pennsylvania, II described as follows: 'I I, " of ONE HUNDRED DOLLARS ($100.00) lawful money of the united States of America, unto them well and truly paid by the Grantees at before the sealing and delivery hereof, the receipt or whereof is hereby acknowledged, has granted, bargained, sold, aliened, released and confirmed, and by these presents do grant, bargain, alien, sell, enfeoff, release and confirm unto the Grantees, their heirs, successors and assigns: of land situate in Carroll Township, York being more fully bounded, limited and BEGINNING at a point on the eastern side of private, unnamed forty (40) foot wide street, designated as "A" street on the 1,'1' hereinafter mentioned plan, said point marking the common point of adjoinder of the within described tract with other lands now I' or formerly of Ethel Bunner, said point also being located, for II' reference purposes, a distance of one hundred five (105) feet, as extending along the easternmost edge of af,orementioned "A" iil Street, from the northern edge of Carroll Drive (T~886); thence 1 departing from lands now or formerly of Ethel Bunner, and II extending along the eastern edge of aforementioned "A" Street, III North zero (00) degrees fifteen (15) minutes west, for a , distance of one hundred five and no hundredths (105.00) feet to , a point on the edge of said roadway at lands now or formerly of II Eugene C. Toomey; thence departing from aforementioned "A" II street, and extending along lands now or formerly of Eugene C. " Toomey North eighty-nine (89) degrees forty-five (45) minutes '1,1' East, for a distance of one hundred forty-three and zero hundredths (143.00) feet to a point at lands now or formerly of il the A.A. McWilliams Estate; thence extending along lands now or ,I formerly of the A.A. McWilliams Estate, South zero (00) degrees fifteen (15) minutes East for a distance of one hundred five and zero hundredths (105.00) feet to a point at lands now or formerly of Ethel Bunner; thence extending along lands now or formerly of Ethel Bunner, South eighty-nine (89) degrees forty- five (45) minutes West, for a distance of one hundred forty- three and zero hundredths (143.00) feet to a point on the easternmost edge of aforementioned "A" street, said point marking the place of BEGINNING. THE WILEY GROUP A.TIORNEYSA.TLAW (i, ONESOlJ'IHBALTIMQREsr. ! I " DlLLSBURG,PAl7D19 II II " " II 11 II ,;1 I )1 [' I II " JI II il I: Ii CONTAINING 15,015 square feet, and being an unnumbered lot on a final plan of resubdivision of Clarence and Ruth Gamble, dated september 28, 1976, revised November 19, 1976, and recorded in the Office of the ReCorder of Deeds in and for York County, pennsylvania, in Plan Book Z, at page 175. I] I I ,I I'i[ IT BEING a part of the same premises which Ruth F. Gamble, by her deed dated February 6, 1986 and recorded in the Office of 'II[ the Recorder of Deeds in and for York county Pennsylvania on , June 3, 1986 in Deed Book 92-I, Page 183, granted and conveyed Ii unto Ruth F. Gamble. The said Ruth F. Gamble died on February I 28, 2001, and by her Last will & Testament duly probated in the i Office of the Register of Wills in and for Cumberland County, I pennsylvania on March 6, 2001, nominated and appointed Janet S. ,] Gore and Jan M. Wiley as Co-Executors. The said Janet S. gore 11 and Jan M. Wiley, Co-Executors of the Estate of Ruth F. Gamble, " are the GRANTORS HEREIN. Ii II II II II II [' II " TO HAVE AND TO HOLD the said piece or parcel of land above described with improvements erected, buildings, thereon hereditaments and premises hereby granted and released, or mentioned and intended so to be, with the appurtenances, unto the said Grantees, their heirs, successors and assigns, to and for the only proper use and behoof of the said Grantees, their \1 heirs, successors and assigns forever. II AND the said Janet S. Gore and Jan M. Wiley, Co-Executors, IJ of the Estate of Ruth F. Gamble, for themselves and their I' II !i I] II successors, do hereby by these presents covenant, promise and agree to, and with the said Grantees, their heirs, successors " II i' I! II and assigns, that they the said Grantors have not done, committed, or knowingly or willingly suffered to be done, or committed any act, matter or thing whatsoever whereby the THE WILEY GROUP : A'ITORNEVSATLAW I ONE SOUl'H BALTIMORE sr. DILLSBURG,PAI7019 ' II II II II I II \1 II premises hereby granted, or any part thereof, is, are, shall or I' j] II II II ji II " may be impeached, encumbered, in title, charge, charged or estate or otherwise howsoever. IT WITNESS WHEREOF, the said Janet S. Gore and Jan M. wiley, in their fiduciary capacity as aforesaid, anafin their own right have caused this Indenture to be executed, attested to and I ! : I, dated the day and year first above written. WITNESS: I ~~J/cUJt~ I ~f. VdlLrtLl- I (SEAL) CO-EXECUTOR (SEAL) CO-E~ECUTOR ~p. II II Ii 'II :1 I, II Ii i II COMMONWEALTH OF PENNSYLVANIA " I I II I I II 11 I " I . . . . SS COUNTY OF YORK : On this the 31st day of 'ftoU .L~ ' 2001, before me, the undersigned officer, per onall appeared Janet S. Gore and Jan M. Wiley, Co-Executors of the Estate of Ruth F. Gamble, known to me (or satisfactorily proven), acknowledged that they executed the foregoing Indenture for the purposes therein contained. hand and IN WITNESS notarial seal the WHEREOF, I have hereunto set my day and year first above written: ~ ""j)"JJJ~ ;iff J hA) NOTARY P LIC I Nolarial Seal E .i Dawn Gladfelter, Notary Public DiUsbUrg Bore, York County My ~ommiSslor' Expires May 11, :!005 Memljer,pennsylvanlaAssOCIllIiOnOfNotaries MY COMMISSION EXPIRES: II I hereby certify that the precise address 'i of the Grantee (s) herein is: I 7 &.Llbn Wfl- ~i J/sblJt9 fA- no /9 II " il II I' ,I II TIlE WILEY '1',1' GROUP , ATfORNEVSATLAW '1'1 ONE SOUlll BAlJ'IMORE ST. "-."- I~ il ii ATTORNEY FOR GRANTEE (8) I! COMMONWEALTH OF PENNSYLVANIA . . . . I II ii ,I " I, COUNTY OF CUMBERLAND : RECORDED in the Office of the Recorder of Deeds in and for Cumberland county, Pennsylvania, in Deed Book ___, Page WITNESS my hand and seal of Office this , 2001. day of RECORDER REV-1503 EX + (1-97) COMMONWEALTH OF PENNSY~VANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ruth F. Gamble SCHEDULE B STOCKS & BONDS FI~E NUMBER 21-01-0244 All property Jointly-owned wI1h right of survivorship musl be disclosed on Scheduls F. ITEM NO. DESCRIPTION VA~UE AT DATE OF DEATH 1 smith Barney Account No. 740-1012342902: 39,291. 57 TOT~ (Also enter on line 2, Recaoltulation\ '$ (11 more space is needed, Insert additional sheets of the same size) 39.291. 57 7 CPA31 NTF 10905 Copyright Form. Software Only, 1997 Nelco, Inc. PFS ~ SMITH BARNEY MONEY FUNDS CASH - CLASS A 3887015 DATE 04/24/01 PAYEE RUTH GAMBLE 7 BRETON LN DILLSBURG PA 17019-9361 CHECK NO. 3401965 TRANSACTION INFORMATION -------------------------------------------------------------------------------- ACCOUNT NO: 740-1012342902 TAX ID NO: 193-36-2993 DESCRIPTION: REDEMPTION ACCOUNT TYPE: VOLUNTARY REDEMPTION DATE: REDEMPTION PRICE: SHARES SOLD: 04i24/01 01. 00 39,2 1.570 REDEMPTION AMOUNT: TAXES WITHHELD: FEE(S) : DEFE~ED SALES CHARGE: CHECK. AMOUNT: $39,291.57 ,00.00 00.00 00.00 $39, 91.57 FOR TRANSFER AGENCY USE -------------------------------------------------------------------------------- REMAINING SHARES: .000 ESCROWED SHARES: .000 PAC CASH: $00.00 SOURCE ID: RDEA-030538 TRANSACTION NO: 99964 ACCOUNT STATUS: 9 PAC INDICATOR: N LOI INDICATOR: N LIQ INDICATOR: R ADDR CHG DAYS: 00 AGE: 88 PAYEE ACCOUNT NO: 740-101234290A CHECK FRAUD IS A FEDERAL OFFENSE THIS CHECK IS PHOTOGRAPHICALLY PROTECTED AND HAS A COLORED BACKGROUND - NOT A WHITE BACKGROUND . . ~,'__' ,. ':,.~"""" _", " "'~"""._' :..,~":,, _", ',"<_ .,..-1'_'::r;;,:"."._,.1..~.' SMITH BARNEYMQNEX: FUNIlS'eASH - CLASS A 3120BRECKINRIDGEBLVO DlitlTIH; G.A\30099-OOO1' "',' 74P-IOd342902 '~~~ 04/24/01 zii,~"i" 3401965 ."" THIs ~~itVIJ\riFORTY FIVE DAYS FROM ISSUE DATE ~~.~ .. .'tf\' "':~':"'::' ". ..; ,~. . ". ~. ... 60-160 433 .lit....it :4,llQUtT ...... """"""""$39,29]57 " , .*............*.W~...~ ." J;'.X: T~TY-lfUm THOUSAlW, TWO HUNVtmD"tffimTy-ONE AND 57/100 ---.,----------- .~ I I I I I , I I I " .'.'\j ,,~ :,',- ) . Pay To l'lOl"VALt!Jo,Jjm~JIOO't!Nt ii-"'G9!!lU.-sIGNED JANET S GORE & JAN M WILEY ADMINISTRATORS ESTATE OF RUm GAMBLE C/O: .IAN M WILEXi.,.''\ TIORNEY AT ONE SOUTH BAL l11VlORE ST I Dll..LSBURGPAI7019 I ~N ~K;~'^' ~.!TfSBURG~, PA (17~-7B26) l~." <:~t:~,~." ' 'J:; . :, 8,,< -- "., The Order of: . . 11- . .. 1), ~ UN ~~': . ",'-'_"i' ';;Ir 11':11.01.111;511' 1:01.:1301.1;01.1: I.? 2.1178 21;11' REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ruth F. Gamble SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-01-0244 Include proceeds oi "t\glltion & dateprocellds were recetv.d by the estate. All prOD. Jolntlv-owned with right of survlvorshlD must be disclosed on Sch. F. VALUE AT DATE OF DEATH ITEM NO. DESCRIPTION 1 Mellon Bank Account NI.nnber: 00310-409832: 2 Mellon Bank Account NI.nnber 00135969: 3 F\11ton Bank Savings Account #339-33110: 4 F\11ton Bank Checking Acct. #3619-68660: 5 F\11ton Bank 00#643-0056383: 6 F\11ton Bank 00#643-0056384: 7 F\11ton Bank 00#643-0056385: 8 F\11ton Bank 00#643-0056386: 9 F\11ton Bank 00#643-0056387: 10 F\11ton Bank 00#643-0056388: 11 F\11ton Bank 00#643-0056390: 12 Waypoint Bank Savings Account #1000002643: 13 Waypoint Bank CD #1066225798: 14 Waypoint Bank CD #1066234211: 15 waypoint Bank 00#1066234274: 16 waypoint Bank 00#1066234316: 17 waypoint Bank 00#1066240578: 18 waypoint Bank 00#1066240586: 19 Waypoint Bank 00#1066240623: 20 Waypoint Bank 00#1066240683: 21 Waypoint Bank 00#1066245741: 22 Waypoint Bank 00#1066245767: Total fran =ntinuation oaoe(s) TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, Insert additional sheets of the same size) 7 CPA81 NTF 10908 Copyright Forms Software Only, 1997 Nelco, Inc. 2,952.01 25,050.67 2,859.83 3,870.93 5,013.21 15,037.37 10,034.78 26,045.37 6,020.33 8,010.02 9,010.47 2,091.62 5,021.53 5,021.53 10,038.84 10,224.75 10,040.54 5,019.71 5,019.34 15,059.14 5,018.09 20,042.38 200,130.93 406,633.39 Fstate of: Ruth F. Gamble SCHEOOLE E - Cash, Bank Deposits and Miscellaneous Personal Property Item No. Description Page 2 21-01-0244 Value at Date of Death 23 waypoint Bank 00#1066245800: 24 Cuuu,en:e Bank savings #410116054: 25 canmerce Bank TiJne Deposit Acct. #1849: 26 canmerce Bank TiJne Deposit Account #8942: 27 canmerce Bank TiJne Deposit Account #8932: 28 CCmrerce Bank TiJne Deposit Account #9848: 29 cammerce Bank TiJne Deposit Account #21615: 30 canmerce Bank TiJne Deposit Account #24228: 31 I"'rln1n1Prce Bank TiJne Deposit Account #100426: 32 canmerce Bank TiJne Deposit Account #300927: 33 PNC Bank 00#21001060343: 34 PNC Bank 00#21001060377: 35 PNC Bank 00#31200074417: 36 PNC Check.in:J Account #5001000769: 37 PNC Bank Checki.n;J Account #5140022343: 38 PNC Bank savings Account #5130385845: 39 M&T Bank savings Account #15004200835097: 40 M&T Bank 00#31003911377058: 41 M&T Bank 00#31003911377074: 42 PNC Bank 00#21001060355: 43 PA Blue Shield (refun;i): 44 AIrerican General Life Insurance Co. (annuity payrrent): 45 York Hospital (refun:i): 'lOI'AL. (Carry forward to main schedule) 11,038.98 1,383.96 25,290.75 6,009.34 7,027.76 10,022.62 31,014.37 7,007.49 18,117.87 3,007.48 12,015.41 10,041.58 5,059.12 4,002.01 9,336.69 864.10 2,271.26 10,032.09 10,029.62 10,000.00 251. 50 980.00 21.11 194,825.11 Page 3 Estate of: Ruth F. Gamble SCHEDULE E - Cash, Bank Deposits and Miscellaneous Personal Property 21-01-0244 Item No. Description Value at Date of Death 46 American General Life Insurance Co. (annuity payment) : 47 Rent Payments Received from Trembly'S: 48 outlook Pointe (refurrl): 49 PA Dept. of Revenue (tax refurrl) : 50 Merd1ants & Businessmen's Mutual Insurance Co. (refurrl): 51 Public Shcool E)[ployees Retirement system: 980.00 1,200.00 1,094.99 202.00 226.00 1,602.83 TCYI7'.L. (carry forward to main schedule) . . . . . . 5,305.82 ~ Mellon Bank Account Number 00310-409832 00135969 Account Title Ruth F Gamble Ruth F Gamble Thursday, March 29,2001 Dilte Opened: 03/18/1983 Principal BalInt from Last as of DOD Posting to DOD $2,950.88 $1.13 Date Opened: 12/03/2000 Principal BalInt from Last as of DOD Posting to DOD $25,000.00 $50.67 Account Type: SA Account Bal YTD Int to as of 000 DOD $2,952.01 $2.38 Account Type: TD Account Bal YTD Int to as of 000 DOD $25,050.67 $176.35 Page 2 of 2 FUlton Bank P,O, BOX 4887 . LANCASTER, PA 17604 People dedicated to your success, ~ (717)291-2589 WWWFULTONBANK,COM '-BOO-FULTON-4 March 23,2001 Jan M. Wiley 1 South Baltimore St. Dillsburg, PA 17019 Dear Jan M. Wiley: RE: Ruth F. Gamble, deceased February 28,2001 In response to your recent inquiry concerning the accounts maintained in the name of the decedent, please be advised that the following accounts were open at the date of death: Savings #3339-33110, open 118/90, balance $2,852.45 and accrued interest $7.38; paying 1.14%, in her name only. Checking #3619-68660, open 2/25/98, balance $3,870.93, in her name only. ACC CD# BALANCE !NT RATE OPEN ROLL OVER MATURITY 643-0056383 5,01321 -0- 5,16 9/30/98 n/a 9/30/03 .in her name only. Interest paid into savings on 2/28 was 19,88 (included in savings balance) 643-0056384 15,03737 -0- 5.16 9/30/98 n/a 9130/03 .in her name only. Interest paid into savings on 2/28 was $59.64 (included in savings balance) 643-0056385 10,034.78 -0- 5.16 9/30/98 n/a 9/30/03 .in her name only. Interest paid into savings on 2/28 was $39.80 (included in savings balance) 643-0056386 26,04537 -0- 5.16 9/30/98 n/a 9/30/03 .in her name only. Interest paid into savings on 2/28 was $103.29 (included in savings balance) 643-0056387 6,020.33 -0- 5,16 9/30/98 n/a 9/30/03 .in her name only, Interest paid into savings on 2/28 was $23.88 (included in savings balance) 643-0056388 8,01O.Q2 -0- 6,11 9/30/98 6/30/00 3/30/02 .in her name only. Interest paid into savings on 2/28 was $38.98 (included in savings balance) 643-0056390 9,010.47 -0- 6.53 9/30/98 3/30/00 9/30/01 1f;::~~amt:~~. Interest paid into savings on 2/28 was $46.87 (included in savings balance) , "17$ ::" C?;9U.hav~ er guestions, please do not hesitate to contact me. r;. 'YetI; ((OIJ' iJ ) ',~ '@.s: Oy, IS Ii '.../1.. ,. Ii' o/)/, ~O/JSlbl/llt II) ~rl!!;."" (,~ I V ~i ' Very truly yours, 'IlIOIJ~ fly; ill., j " "en' S G'-.' " '17 f ( I I! e1Ile-rp;;:;/.!(u;. ,,' c}lI{.{ft/J (/):&~ oetj!S -- , oSl" ' Christine Putt Smith "0':,,- Ie" 10 o/':,credit Confirmation Processor 1;'11.,.. _' Q..!/lJ"c 'i /.,... . Q'\o"'~...." -,) p~. Ifll/"--:- "'~)., fOil/. ' '1:" ~", -.1I',,? ~IWayRqi!'Kt LOOK FOR US. WE'LL GET YOU THERE. MARCH 27,2001 THE WILEY GROUP 1 SOUTH BALTIMORE ST DlLLSBURG P A 17019 The information which you requested on the RUTH GAMBLE ESTATE (Social Security Number 193-36-2993) is as follows. Account Number(s) 1000002643 1066225798 1066234211 Class of Account SAVINGS CERTIFICATE CERTIFICTE Date Opened 122981 121892 010493 Principal Balance 2088.56 5000.00 5000.00 Accrued Interest 3.06 21.53 21.53 Balance at Date of Death 2091.62 5021.53 5021.53 Account Ownership SOLE SOLE SOLE Name of Joint Owner, if any Date Ownership Was Established 122981 121892 010493 Additional Information Requested PLEASE COMPL TE W-9 P.O. Box 1711. HARRISBURG. PeNNSYLVANIA 17105-1711 Toll Free I-B66-WAYPOINT (1-866-929-7646) . www.waypointbank.com "'WayRqiPKt LOOK FOR US, WE'LL GET YOU THERE. Account Number(s) 1066234274 1066234316 1066240578 Class of Account CERTIFICATE CERTIFICATE CERTIFICATE Date Opened 020493 030193 070193 Principal Balance 10000.00 10183.84 10000.00 Accrued Interest 38.84 40,91 40.54 Balance at Date of Death 10038.84 10224.75 10040.54 Account Ownership SOLE SOLE SOLE Name of Joint Owner, if any Date Ownership Was Established 020493 030193 070193 Additional Information Requested PLEASE COMPL TE W-9 P.O. Box 1711. HARRISBURG, PENNSYLVANIA 17105-1711 Toll Free 1-866-WAYPOINT (1-866-929-7646) . www.waypointbank.com .-, Wayt:tqi!lKt LOOK FOR US. WE'LL GET YOU THERE, ACCOlUlt Number(s) 1066240586 1066240623 1066240683 Class of Account CERTIFICATE CERTIFICATE CERTIFICATE Date Opened 070693 OB0393 100193 Principal Balance 5000.00 5000.00 15000.00 Accrued Interest 19.71 19.34 59.14 Balance at Date of Death 5019.71 5019.34 15059.14 Account Ownership SOLE SOLE SOLE Name of Joint Owner, if any Date Ownership Was Established 070693 080393 100193 Additional Information Requested P.O, Box 1711, HARRISBURG, PENNSYllIANIA 17105-1711 Toll Free I-B66-WAVPOINT (1-866-929-7646) , www.waypointbank.com Y'IWay~qi!lt LOOK FOR US. WE'LL GET YOU THERE. AccotU1t Number(s) 1066245741 1066245767 1066245800 Class of Account CERTIFICATE CERTIFICATE CERTIFICATE Date Opened 120693 011094 020394 Principal Balance 5000.00 20000.00 11000.00 Accrued Interest 18.09 42.38 38.98 5018.09 20042.38 Bal<mce at Date of DeaUJ 11038.98 Account Ownership SOLE SOLE sole Name of Joint Owner, if any Date Ownership Was Estahlished 120693 011094 OJ.I1Y.'t AddJlionaI Information Reqnested Sincerely, K~~h Senior Services Rep. RO. Box 1711. HARRISBURG. PeNNSYLVANIA 17105-1711 Toll Free '-866-WAVPOINT (1-866-929-7646) . www.waypointbank.com Commerce "Bank". March 28, 2001 The Wiley Group Attorneys at Law 1 South Baltimore Street Dillsburg, PA 17019 RE: Estate of: Ruth F Gamble Social Security #: 193-36-2993 Date of Death: February 28, 2001 Dear Sir/Madam: In reference to the, letter regarding the above mentioned Estate, we would like to inform you of the information that we have researched and found. Type: Savings Account #: 410116054 Date Opened: 02/03/89 Primary Owner: Ruth F Gamble Power of Attorney: Janet S Gore Date of Death Balance: $1,383.96 Accrued Interest: $0 Type: Time Deposit Account #: 1849 Date Opened: 03/03/89 Primary Owner: Ruth F Gamble Power of Attorney: Janet S Gore Date of Death Balance: $25,290.75 Accrued Interest: $92.78 Commerce Bank, N.A. P.O. Box B599 100 Senate Avenue Camp Hill. Pennsylvania 17001 -B599 Commerce "Bank.. Type: Time Deposit Account #: 8942 Date Opened: 05/18/94 Primary Owner: Ruth F Gamble Power of Attorney: Jane S Gore Date of Death Balance: $6,009.34 Accrued Interest: $9.34 Type: Time Deposit Account #: 8973 Date Opened: 08/01/94 Primary Owner: Ruth F Gamble Power of Attorney: Janet S Gore Date of Death Balance: $7,027.76 Accrued Interest: $27.76 Type: Time Deposit Account #: 9848 Date Opened: 12/13/94 Primary Owner: Ruth F Gamble Power of Attorney: Jane S Gore Date of Death Balance: $10,022.62 Accrued Interest: $22.62 Type: Time Deposit Account #: 21615 Date Opened: 01/26/00 Primary Owner: Ruth F Gamble Date of Death Balance: $31,014.37 Accrued Interest: $14.37 Type: Time Deposit Account #: 24228 Date Opened: 10/21/99 Primary Owner: Ruth F Gamble Power of Attorney: Janet S Gore Date of Death Balance: $7,007.49 Accrued Interest: $7.49 Type: Time Deposit Account #: 100426 Date Opened: 12/02/96 Primary Owner: Ruth F Gamble Date of Death Balance: $18,117.87 Accrued Interest: $254.15 Commerce Bank, N.A. P.O. Box B599 100 Senate Avenue Camp Hill, Pennsylvania 17001-B599 Commerce flBankNA Type: Time Deposit Account #: 300927 Date Opened: 01/11/99 Primary Owner: Ruth F Gamble Date of Death Balance: $3,007.48 Accrued Interest: $7.48 If there are any questions or additional information that is needed, please feel free to contact me at (717) 795-7118 ext. 3151. Sincerely, L0~ g- TY7~ Wanda J. Morris elF Associate Commerce Bank, N.A. P.O. Box 8599 100 Senate Avenue Camp Hill. Pennsylvania 17001.8599 APR-20-2001 12:28 PNCBANK CIF DEPARTMENT 412 705 0057 P.01/02 a PNCBAN< Decedent R.eportiDg Firstside Center 500 First Avenue, 41h Floor Pittsburgh, PA 15219-3128 sa April 20, 2001 The Wiley Group Attn: Jan M. Wiley. Esq1dre 1 South Balfunore Street Dillsburg, P A 17019 RE: Estate of Ruth F. Gamble, Deceased SSN: 193-36-2993 DOD: 02128/2001 Dear Ms. Wiley: Please find the date of death balances you have requested listed below. CERTIFICATE OF DEPOSIT ##21001060343 EstablUhed 04120/1992 RUTH F GAMBLE DOD Balance: $12,000.00 + $15.41 accrued interest #Z1001060355 Established 0712811992 Jf RUTH F GAMBLE DOD Balance: $10,000.00 + $0.00 acaued interest #21001060377 Established 10/0111992 RUTH F GAMBLE DOD Balance: $10,000.00 + $41.58 accrued interest #31200074417 Established 01131/1997 RUTH F GAMBLE DOD Balance: $5,000.00 + $59.12 accrued intmest Page 1 of2 A member of The PNC Flftllnelal Sc:rvi<'c$ Group PNC Sank NA Pittsbu'1lh Pennsylvania 15265 213131 12:29 PNCBANK elF DEPARTMENT 412 705 131357 P.132/02 0. PNCBAl\K CHECKING ACCOUNT ##5001000769 Established 11/2011997 RUTH F GAMBLE DaD Balance: $4.001.54 + $0.47 accrued inteIest t#51400n343 Established 08/07/1993 RUTH F GAMBLE DaD Balance: $9,334.16 + $2.53 accrued interest SAVINGS ACCOUNT #5130385845 Established 08/07/1993 RUTH F GAMBLE DaD Balance: $863.49 + $0.61 accrued interest Our omee ouly provides elate of death balaDces for IRA's, CD's, C~ki.g aDd Savings accounts. We do ~ Financial TflUlBaetiODS or Statement Orders. For Further infonnatioD please c:aU 1-800-4-BANKER or your loeal PNC Brauch and . ask to speak with a Financial Services Representative. Sincerely, ~ ....~~ 1-800-762-1775 Page 2 of2 A member of The PNC Finane..! SeMees Group PNC BAnk NA Pittsburgh I'onnsylllllni. 15265 TOTAL P. 132 ~M&fBank June 12,2001 RE: Estate Search The Estate of: Date of Death (O.O.D.) RUTH F GAMBLE 2/28/2001 To Whom It May Concern: Identified below is the account information requested. 1. M&T Bank accounts in which the decedent's name appears: Account Account Number Account Title Opening Branch Type SAY 15004200835097 RUTH F GAMBLE 4350 OPENED 4/91 JANET S GORE POA CD 31003911377058 RUTH F GAMBLE 4350 OPENED 5194 CD 31003911377074 RUTH F GAMBLE 4350 OPENED 6/94 JANET S GORE POA 2. Loans, Mortgages, or other obligations titled in the decedent's name Account Number Amount Owed NO Safe Deposit Box titled in the Decedent's name existed at our office. D.O.D. Accrued Interest Balances (Includes Accr. Int.) $2271.26 $2.66 $10,032.09 $32.09 $10,029.62 $29.62 Account Description 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 CORPORA nON BY: ~~ tu Authorized ignature kA.L~ DATE: <0 ~ \ "2- -OJ Manufacturers and Traders Trust Company' 1100 Wehrle Drive, P.O. Box 701, Buffalo, NY 14240-0767 . .REVc15~O EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF R1Il:h F. Gamble SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21-01-0244 This schedule must be completed end flied" the enswer to any of questions 1 through 4 on the reverse side of tha REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF EXCLUSION ITEM INCLUDE NAME OF THE TRANSFEREE, THEIR DATE OF DEATH DECO'S (IF TAXABLE VALUE RELATIONSHIP TO DECO & DATE OF TRANSFER. NO. ATTACH COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST APPLICABLE) 1 American General Armuity 63,498.88 Al.0088455F: TOTAL (Also enter on line 7, Recapitulation) $ 63 498.88 7 CPA01 NTF 10910 Copyright Forms Softwarll Only, 1!il97 Nelco, Inc. (If more space is needed, Insert additional sheets of the same size) AMERIO\N I GENERAL FINANCIAL GROUP American General Life Insurance Company May 7, 2001 Jan M. Wiley 1 South Baltimore St. Dillsburg PA 17019 Contract Number: A10088455F Contract Owner: Ruth F. Gamble ~ Dear Ms. Wiley: We acknowledge the recent notice of death of Ruth F. Gamble and wish to extend our condolences to the family. The requirements to process this claim are indicated below. Please forward them as soon as possible: 1. Claimant's statement to be completed by the beneficiary. 2. The contract(s). If the policy is not being returned, please indicate on the Claimant's Statement if it was either lost or destroyed. 3. IRS Form W-4P to be completed by the beneficiary. Please be advised, if Federal withholding is elected, the Company will only withhold 10% of the taxable gain. 4. A copy of the Probated Bill. check dated , since It was Please return this information to P. O. Box 1401, Houston, Texas 77210-1401 Annuity Administration. If you have any questions or need additional assistance, please contact the Annuity Administration Department at 1-800-247-6584. ~ W~ 011.) Jeanie Henderson/Ag Claim Analyst American General Life Insurance Company Monber Ameni:-an Genent/ FinandaJ Group Administrative Offices . P.O. Box 1401 . HoustOn, TX 77251-1401 . Fax 713-831-3701 REV-1~11EX + (1-97) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ruth F. Gamble FILE NUMBER 21-01-0244 Debts 01 decedent must be reoorted on Schedule I. ITEM NO. A. FUNERAL EXPENSES: DESCRIPTION AMOUNT 1 Cocklin Funeral Halle: 8,289.05 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Janet S. G=e Social Security Number{s)/EIN No. of Personal Representative{s) Street Address 7 Breton lane City Dil1sb.lrq Slate 36,000.00 PA Zip 17019 Year{s) Commission Paid: 2001 2. 3. Attorney Fees Name: Jan M. Wiley, Esquire Family Exemption: (If decedents address is not the same as claimant's, attach explanation) Claimant Street Address City state Zip Relationship of Claimant to Decedent 36,000.00 0.00 4. Probate Fees 446.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 See Schedule attached Total fran continuation page(s) 14,046.46 TOTAL (Also enter on line 9, Recapitulation) $ (If more space Is needed, Insert additional sheets of the same size) 94.781. 51 7 CPA11 NTF 10911 copyright Forms Software Only, 1997 NelcD,lnc. Estate of: Ruth F. GalIlble salEDULE H, PARI' B - Administrative Costs Item No. Description 7 Jerry Cole, CPA (2000 tax retuzn) : 8 PSERS (rei.Jnrorsement for benefit oveJ:payment): 9 snow Removal (Frost Lane): 10 American General (re:i:mOOrselrent for overpayment) : 11 Rese, Inc. (work done at Frost Lane) : 12 Real Estate settlement dlarges (Frost Lane): 13 Albert's Hauling (lot cleanup): 14 Allfirst Bank (bank dlarges) : 15 Eric N. Trembly (reimb.lrsement for survey expense): 16 'lhe Sentinel (advertise estate) : 17 CUllIberlan:l law Journal (advertise estate): 18 Notary Fee: 19 Register of wills (filing fee) : 20 Reoorder of Deeds (filing & transfer tax) : 'IOI'AL. (carry forward to main schedule) . . . . . . Page 2 21-01-0244 Amount 75.00 2,645.16 101. 50 1,000.00 351. 87 7,905.00 1,000.00 37.51 674.15 113.27 75.00 4.00 31. 00 33.00 14,046.46 . RE)J,15~2 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ruth F. Gamble Include unrelmbursed medical 8xDenses. ITEM NO. SCHEDULE I DEBTS OF DECEDENT. MORTGAGE LIABILITIES & LIENS FILE NUMBER 21-01-0244 DESCRIPTION AMOUNT 1 Graham Medical Clinic (last illness): 17.81 7 CPA12 NTF 10912 TOTAL (Also enter on line 10. RecaDitulationl $ (If more space Is needed, insert additional sheets of the same size) 17.81 Cop.yrlghtFarms So~twa.n~ Only. 1991 Hsleo, Inc. - REV-1513 EX. (1-97) " . I' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Ruth F. Gamble 21-01-0244 RELATIONSHIP TO DECEDENT AMOUNT OR No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Ust Trustee(s) SHARE OF ESTATE I. TAXABLE D1STRIBUTlONS (include outright spousal distributions) 1 samra wise frien:l 5,000.00 108 Locust Way OillshJrg, PA 17019 2 Janet S. Gore niece 166,574.84 7 Breton lane OillsbJrg, PA 17019 J William S. Gore nephew 166,574.84 7 Breton lane oillsbJrg, PA 17019 4 Margaret E. Shiner sister 166,574.84 JOJ COUrt st. Doylestown, PA 18901 ENT~R DOl LAR AMTS. FOR DISTRIBS SHOWN AROVE 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 TOTAL OF PART 11-- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 7 CPA13 NTF 10913 (If more space Is needed, Insert additional sheets of the same size) Copyright Forms Software Only, 1997 Nelco, Inc.