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HomeMy WebLinkAbout01-0281 Eswreof Arthur C. Phillips, Jr. also known as PETITION FOR PROBATE and GRANT OF LETTERS ;>1 - Q\ - ";)g , No. To: Register of Wills for the I Deceased. County of Cumberland in the Social Security No. .2 II -' 30 - l.s> , 38 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(~, who is~18 years of age or older andhe execut or in the last will of the above decedent, dated September 25 and codicil(s) dated named , 1921-- (state relevant circumstances. e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in h is last family or principal residence at Cumberland County Pennsylvania, with 29 Harmony Hall Drive, Carlisle, PA 17013 Middlesex Township (list street, number and muncipality) Decendent, then 61 at home 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: N'::"..;.JL 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: 29 Harmony Hall Drive, Carlisle years of age, died March 7 ,~ 2001 I i l "'2- t C:::>C':C~ $ $ $ $ I 7 5"', DU> ~ 7. ~', C>o('~ WHEREFORE, petitioner'" respectfully request(s) the probate of the last will anQ ~~) presented herewith and the grant of letters testamentary theron. (testamentary; administration c.La.; administration d.b.n.c.La.) ~ '" ~ .. t.> C .. ~3 '" .. 0::'" c -cO c''::: co''::: ~'" ~o.. .. '- ;;0 .. c 0/) Vi ~#,~ A1 red H. Phillips 1 ~outh Stoner Avenue Sh;rpm~n~townJ PA 17011 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I S8 COUNTY OF CUMBERLAND J The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate-according to law. Swom to "' affi,med aod ,ub,cdbed ~~~ ~ before me this 12TH day of OQ X~2 ~ l::: ~ :s: No. 21 - 01 - ?81 Estate of ARTHUR C PHILLIPS JR , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW MARCH 14 )19 ?001, 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 SEPT 25, 1997 described therein be admitted to probate and filed of record as the last will of ARTHUR C PHILLIPS JR and Letters TESTAMENTARY are hereby granted to ALFRED H PHILLIPS Mm~~ MARY CLEWIS FEES Filed $ 270.00 $ 10.00 $ $ 3.00 5.00 TOTAL _ $ 1nR nn . . . . . . . MA.RC~. .1.4,. .2.QQJ. . . . . . . . . . . 717-243-4574 PHONE John H. Brou;os, Esquire #6268 ATTORNEY (Sup. Ct. I.D. No.) Probate, Letters, Etc. ......... Short Certificates(lc) . . . . . . . . . . Renunciation ................ X-page- llCP 4 North Hanover Street. Carlisle, PA ADDRESS 17013 Called attorney on 3-14-01 l u'r,:;.~n~ '~.cy 0/'~(, This is to certify that the information here given is correctly copied fto~ an original certificate of death dul~ filed with Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filmg. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 p 7247658 No. 1!:t" c ...,/ H105.144 Rev. 1191 me as 2L.. ~J~::,~~ MAR 9 2001 Date COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH (Coroner) :IPRINT IN !ANENT :KINK NAME Of DECEDENT (First, Middle. last) SEX 2. Male C Jr. UNDER' DAY Hour' Minutes DATE OF BIRTH (Month. Day. 'feet) BIRTHPlACE (City and Slate or Foreign Country) .... fl"EOF DEIJH Aprx. ODEAO(..ontn.D.y.....,) .. 1:00 A.... 2.. 27, "'AT I: EM., the dIMUn,ln;ul'iel or complicationa which ctIuSlld the death. 00 not ant... the mode 01 dying, IUCh a. ctIrdlac or respiratory arr8ll, Ihock or haal1lailure. Lilt onty one cause on nch line. b. Disease DUE 10 (OR /\5 A CONSEOUENCE OF): DUE 10 (OR AS A CONSEOUENCE OF): .. WERE AUTOPSY FINDINGS """LABLE PRIOR lO COMPLE'TlON OF CAUSE OFOE1J'H? MANNER OF DEATH DATE OF INJURY (Month, DaV, Veer) ~ o o ST,qe FILE NUMBER SOCIAL SECURITY NUMBER .. DATE OF DEATH (Month. Day. 't'Mr) .. March 7, 2001 ~)o RACE - Amarican Indiln. Black, White, ate IS_ ...White SURVIVING SPOUSE (II wife. give maiden name) twp. citylboro. 23b. 23c. WAS CASE REFERRED TO :~L EXAMINER/CORONER? No 0 2. ,Approximate PART II: Other significanl conditions contributing to death. but : intarval between nol resuhing in Ihe underlying cause given In PART I. !onaaUnd ..... TIME OF INJURY INJURY AT 'NOAK? H""",,Ido Pending InvestlgaliOn o o ~ o =~~~~~~Al home, farm, street, factory, office .... wn,State) Natural v.sD Accklant No 0 ....... ... Could not be ct.tennil18d 1Ia, lib. CERTIFIER (Check only one) -CEJllTlfYtNO PHYSICIAN (Physician certilying C8U98 01 dea1h when anolher physician has pronounced dealh and compIe!ed Item 23) To the best of my knowhldgit,deathoccurr.d due totha CIIu8le(a) end mannafU atatad. ......................................,............. -PRONOUNCING AND ceRTIFYING PHYSICIAN (Physician both pt'onouncing death and certifying 10 cauta of dealh) Ta the best of my knawt4Ictga, CIHth accvnwd at the u.n., date. and place, and due to the cauae(S) and fMMer U alated.. . . . . . . .. . . . . . . . . . . . . . . . . -MEDICAL EXAMINER/CORONER On the bula of examtMtlon and/ar Inve"lgatlon. In my opinion, death occurred It the time. date, and plac., and due ta the c.uH{a) and manner.. atated., . . . , . . . .. . . , , . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . .. . . . . . . . 31.. REGISTRAR'S SIGNATURE AND NU ~. ~~&.~~ l4.Jlbl-J\1OI Yo. o Coroner DATE SlGNED(Monlt1. Day. 'I'Hr) o .... ....March 8, 2001 NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OF DEATH (Ilem 27) fype or Prinl Michael L. Norris, Coroner ~ 6375 Basehore Road, Suite HI P' '2. Mechanicsburg, Pa. 17050 DATE FILED (Month, Day, Year) ... .ill 1J Arthur C. Phillips, Jr. of 29 Harmony Hall Drive, Carlisle, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. 1Jttm~: I direct that all my debts and funeral expenses shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. 1Jttm llrb:Jo: I direct that my remains be cremated and my remains given to my twin brother Alfred H. Phillips of Shiremanstown, Cumberland County, Pennsylvania. 1Jttm llrbrtt: I give, devise, and bequeath my entire estate to my twin brother Alfred H. Phillips. In the event that he predeceases me, then I give, devise and bequeath my entire estate to my younger brother Larry R. Phillips of Elwood City, Pennsylvania. 1Jttm jfour: I appoint my twin brother Alfred H. Phillips Executor of this my last will. Should he fail to qualify or cease to act as Executor, I appoint my younger brother Larry R. Phillips to act as Executor with the same rights, powers, and duties. 1Jttm jfibt: All estate, inheritance, succession, and other taxes, imposed or payable by reason of my death, and interest and penalties thereon, with respect to all property comprising my gross estate for tax purposes, whether or not such property passes under this will, shall be paid out of the principal of my residuary estate, without apportionment or right of reimbursement. 1Jttm ,j,ix: I direct that my personal representative or guardian shall not be required to give bond for the faithful performance of their duties in any jurisdiction. 1Jttm ,j,tbtn: In addition to the rights and powers given to the fiduciaries by law or elsewhere in this will, I give to my Executor during the full time necessary and for the administration of my estate the following rights and powers to be exercised in his or her sole discretion. A. To retain any real or personal property which may at any time form a part of my estate so long as he or she deems it advisable. B. To invest in any real or personal property without restrictions to legal investments. C. To repair, alter, improve or lease for any period of time any real or personal property and to give options for leases. D. To sell at public or private sale, for cash or credit, with or without security, to exchange or to partition, to mortgage or pledge real or personal property, and to give options for leases. E. To make distribution in kind. F. To compromise claims. IN WITNESS WHEREOF, I have hereunto set my hand this 25th day of September, 1997. ffotlJlttb _ t2L? C d4~* . Arthur c. Phillips, Jf. c. The preceding instrument, consisting of this and one other typewritten page each identified by the signature of the Testator was on the day and date thereof signed, published and declared by the Testator therein named as and for his last will, in the presence of us, who at his request, in his presence and in the presence of each other have subscribed 0 a- (~ a....v- COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND WeJohnH. Broujos and J.LID C,e T /ftJ J ~,L b ILIf-.tJ , witnesses whose names are signed to the attached or foregoing instrument being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the instrument as his last will; that he signed willingly and executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the will as witnesses; and that to the best of our knowledge, the estator was at the time 18 or more years of age, of sound mind and under no constraint or undu in. ceo Go; ~ . Sworn and subscribed to before me t day of September, 1997. ) L! Notarial Seal Sherr! L. Murphy, Notary Puolic Carlis;e Bora, Cumberlanci COI 'nty My Commission Expires Jan. 4, 199' COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND I Arthur C.Phillips, Jr. whose name is signed to the attached document, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last will; that I signed it as my free and voluntary act for the purposes therein expressed. /d~,,, ~ dAC~ ~ . Arthur C. Phillips, Jr. / ~ Sworn and affirmed to and acknowledged before me this 25th day of September, 1997. ~~ olltk-'~ ~ -OTARY PUBLI ,. Notarial Seal Sh.e~r' L. Murphy, Notary PUiJlic CarliSle Bora, Cumberlam; en, 'nty My Commission Expire" ,Jan. 4, 198~ r II .... G) co to (7) ..... ~ ci z '~>, ~... wA. cS iii - UJ (,) ~w w ~i a: >-c -' Iw c I~ ~ cll. G:u. !o z - <( ~ ::i . > UI i;~ ! ~~5 r:: :X:u..> :c !:iOiS Q. inn o~i~~ I L _" 8 . l- S Z ::l ~ 0 .. ~ .... <( . iaa: z2a:W oCl)1-1XI <(CI)z~ Wo::l (1)OZ ~ :il ~ Q 1&1 ~ u.t (,) I!L .... o .... I iii'" .. I~ ..,~ ~I az 14' (') .... o I' .... ,.i'" , << 0.. .. l:Ih iI .... -' I u .' I -... I I w a: w :c ~ , , " .... -....... - : r', ".. ' " ;. .J '. .cr .- 1--. ".. . ~ ~ LtJ : .: ,," _~, '," It : Zi ' ")0' - "!11.1ii.. I ",~lt ~ ......H. . <t hi ~ @t: 0: ...J 2: ~ ~ ~ ~ . ' : c ~ CD t') I' ..0 I g I ~ .... ... a: :n AI ~ IN) ~ z U3 u ~ 0) ~ ~ ...-- J:: ... ,... Z II ~i :r: Q QI .... 8 Q .... 0 0 z 8 !;( I !Zt 0 <l ::::t ... QI O. ....I tU a: a:2 w.... ...'- ....." I: ..... 0 0....1 ZI' wg J: :x; I' u. w-, ~o ~ ~o ~ wi &I.... ~..... 0..... ~ w..... W 1XI... OJ:: Q...o ~o 0(1) ~ ~O.t ~o.. u. <( ~u u. 0 ::lii 0 z w w !ii z w w ::lii ~ => ~ ...J <( 0 0 W u: z 0 Q. 0 0 '., w a: w :c ~ CI) lo::: II: <( ~ W II: I I - -0. I I 1 1 I ~1 1 I 1 \ - I 1 1 1 1 1 1 1 1 1 ~] :::!) 3:} ~I 0:1 WI ~1 (!). w1 0:1 I I 1 1 I I I I I I I 1 I I- I 1 I I I - ;-- _:::- CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Arthur C. Phillips, Jr. Date of Death: March 7,2001 Will No.: Admin. No.: 21-01-00281 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiary of the above-captioned estate on June 7,2001 : Name Address Alfred H. Phillips 3 South Stoner Avenue, Shiremanstown, PA 17011 Date: June 7, 2001 Notice has now been given to all persons entitled thereto under Rul John H. Broujos, Esquire #06268 4 North Hanover Street Carlisle, P A 17013 (717) 243-4574 Capacity: Personal Representative X Counsel for Personal Representative / t IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ARTHUR C PHILLIPS , Deceased No. 21-01-281 of 2001 To the Clerk of the Orphans' Court: Enter the claim of CAPITAL ONE Acct. 5291071437472507 In the amount of $1,283.77 , against the above entitled estate. The decedent, who resided at 29 HARMONY HALL DR, , CARLISLE PA 17013 died on 03/07/2001 . Written notice of said claim was given to ALFORD PHILLIPS ,if known to claimant, at (Personal Representative or counsel) 3 SOUTH STONER AVE, SHIREMANSTOWN, PA 17011 on July 8, 2001 (Date) (Claimant) ~~r Address: 5330 East Main Street, Suite 200 Columbus, Ohio 43213 Claimant's Counsel Address () r ~ ~ -0 ~ ~ m I Cl )> U> 0 0 Z -I Z ;;0 -:! ~ 0 m m U> 0 U> m ........ ~ Z 0 ;;0 =+; ~ -0 Q) ........ CJ1 ~ 'T\ ::J: "0 (Xl (".) m ~ ~ "0 -....I -....I (".) ;;0 Z ~r '-" 0 () -I U> -....I m ~ I () 0- ...... C (I) ~ ~ -0 0 '-" ~ ~ 0 ;;0 C (".) r- () ;;0 Z Z ~ -....I r -0 -I 0 (".) U> 0 3!: I Z -I CD -I ~ Z r 0 U> m r -0 -I N -0 m -0 ...... r U> I N 0 () 0 ...... 0 I ~ 0 m N OJ () (Xl r () m ...... m 0 ~ r U> c m ~ 0 OJ C U> 0 I ~ (".) N ...... (".) PROBATE COURT CUm1:::erland County, State of Pennsylvania Arthur C. Phillips Jr., Deceased Case #21-01-281 Proof of Mailinq I mailed the creditors claim to the fiduciary (and attorney, if applicable) as follows: I deposited a copy/copies of the claim with th~ L~2ted States Postal Service in a sealed envelope with the postage fully pre-paid. I used first-class mail. I am employed in the county where the mailing occurred. The envelope (s) was/were addressed and mailed as follows: Mr. Alfred Phillips c/o JOM Broujos, Esq. 4 N. Hanover Carlisle, PA 17013 Date of Mailing: County of Mailing: lo.!t~;:/ Dallas, Texas the foregoing is true and correct. for The Bon Ton P.O. Box 741026 Dallas, TX 75374 PACKEl .IE: BTS-C0240S1F-001 48 RUN ON: 8/10/2001 00:54:38 THE BUN-TON REPORT # 979 ACCT# 097-931-224 F C 717/737-3227 LIMIT 01/99 ADu CODE ADu AMT 00000000 IN/COLL STATUS 805 CYCLE o MPI o HIMPITY o HIMPILY HIMPIMO 8 NAME + ADDRESS ADDRESS CITY STATE SPOUSE EMPLOYER ADDRESS CITY STATE PHONE: *********************** ****************** EXT: ARTHUR C PHILLIPS uR HOME PHONE DATE OPEN 3 S STONER AVE OTHER ACCT CAMP HILL PA17011 REQ PAYMENT AIR BAL CURR PAY MEMO PUR MEMO CR HOL-BON TOTAL 805 COMMENTS: PREV-BAL 791. 18 911 . 38 PURCHASE .00 .00 PAY/RET .00 135.00 FIN-CHRG 13.97 14.80 NEW BAL 805. 15 791.18 PAST/DUE .00 .00 CUR PRV :& PROBATE CDURT Cumber land County, State of Pennsylvania Arthur c. Phillips Jr., Deceased Case #21-01-281 Proof of Mailinq I rrailed the creditors claim to the fiduciary (and attomey, if applicable) as follows: I deposited a copy/copies of the claim with the United States Postal Ser:vice in a sealed envelope with the postage fully pre-paid. I used first-class rrail. I am employed in the county where the rrailing occurred. The envelope (s) was/were addressed and rrailed as follows: Mr. Alfred Phillips c/o John Broujos, Esq. 4 N. Hanover St. Carlisle, PA 17013 Date of Mailing: County of Mailing: I <!) /; ~/o / Dallas, Texas I declare under penalty of perjury that the foregoing is true and correct. Date: /oj~/ 4~=, Agent for Boscov's P.O. Box 741026 Dallas, TX 75374 BE;Cq,y's . Inc. Page: 1 Docume~ R-:..,a'rr'te]: BAEBARA / ~_y-41 - 0, !Wailing, PA -19606-4116, Ph:61 0.779.2000/ Fx:61 0.370.3495/ ;'yI'l<\IV.bu$cuv$.<,ulII mIQ ( BOSCOV'S CREDIT DIVISION ACCOUNT INQUIRY ORGANIZATION 100 LOGO 110 ACCT 0000000000108830905 REL SHORT NAME PHILLIPS ESTATE STATE PA HOME PHONE BLOCK CODES H TOT CR LMT 0 EMPL CD 99 STATUS Z ~R PLAN '(ff-' CA CR LMT 0 CSH AUTH . CASH BAL .00 TOT DISP 0 .0 CASH AVAL .00 CASH DSP 0 . O-T-B **********0 CYCLE DB 0 . ~TE <:qpgitwisio~6/10/1998 PCT LEVEL / ID S PA CYCLE CR 0 .00 CARD FEE DATE CURR BAL 215.37 CYCLE PMTS .00 DTE LST BILL 08/0h/?OOl PAGE 01 08/29/2001 16:03:29 D 2 4 6 CLAIM fORM ESTATE OF /lIPTH<<-iC ~,r///LL/?~ 'f~. Notice of c~ai.m by THe BeN rtJ IV in the amount of S '7t7/ /5/ fUed pursuant to ORPP..ANS' COURT DIVISION O~ COURT OF COMMON p~~ OF t!a/J?1JE~LAIJ DCOlJNTY FA _ _NO. ~/-CJ/-..:zf/ sac:ion JJS4, Probata, Estates and Fiduciaries Code Laws of 1972. Act No. 104 effec:ive Ju~y 1, 1972 as amended. Date /cJ//// ~ I . 944.1 LBJ FREEWAY Lock.Box 30 Dallas~ TX 75243 TO THE~RX OF THE ORPHANS' COURT DIVISION: in the amount of S r/Y LE (C~a.imant 7'rI /3' c:!4l? L~ 5 L E. Aadress) 8CJ# rLJ!\/ and Address) Enter the c~ai.m of against the above entit~ed Estate. The decedent who resided at ?4 died on - cJ.J #7/((:J / , (Iy.lte) Written notice of said claim was mailed to . see attached (Personal Represencative or Counsel) at on (Address) The basis of aforesaid claim is as follows: (Date) (Itemi:e fully to enable personal representative to make proper investigation). (Name) 44TLBJ FREEWAY Lock Box 30 Dallas. TX 75243 (Address) 972-644-6360 Claimant's Counsel (Address) .. CLAIM FORM ESTATE OF /ler/luft!.. 0, /?/-I/LL/P:S J e. .,- BttJ5 {'fl VI S cR.../.5: .3 ? fUad pursuant: to section 3384, Prabata, Estatas and ORPP..ANS' COURT DIVISION O~ COURT OF COMMON P!.E.AS OF CU t7?l3'ftfLIt/f lYOUNTY /"::>4 u_ _NO. c:?/ -c:; /.. ;:; S / Notice of c.laim by in the amount of S Fiduciaries Code Laws of 1972, Act No. 104 effective Ju.ly 1, 1972 as amended. Date /~////8/ . / 9441 LBJ FREEWAY Lock Box 30 Dallas~ TX 75243 TO THE~RK OF THE ORPHANS' COURT DIVISION: in the amount of S !3@5eCJL//5 (C.laimane and Address) ~/.~, g 7 l~/l-R~/5Le) f//1- (Address) / against the above entit.led Estate. The decedent Enter the c.laim of who resided at died on . (g -7- c:lCC/ (". (Date) Written notice of said claim was mailed to . see attached (Persona.l Representative or Counse.l) at on (Address) The basis of aforesaid c.laim is as follows: (Date) (Itemize fully to enable personal representative to make proper investigation). (Name) Agent Claimant's Counsel (Agdress) Name L 441 BJ FREEVVAY Lock Box 30 Dallas. TX 75243 (Address) 972-644-6360 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX( 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 000616 BROUJOS JOHN ESQ 4 N HANOVER ST CARLISLE, PA 17013 ACN ASSESSMENT CONTROL NUMBER AMOUNT ____nn fold 101 $4,073.71 ESTATE INFORMATION: SSN: 211-30-6738 FILE NUMBER: 21-2001- 0281 DECEDENT NAME: PHILLIPS ARTHUR C JR DATE OF PAYMENT: 12/07/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/07/2001 TOTAL AMOUNT PAID: $4,073.71 REMARKS: ALFRED H PHILLIPS C/O JOHN H BROUJOS CHECK#109 SEAL INITIALS: SK RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS INVENTORY OF THE REAL AND PERSONAL EST ATE OF Arthur C. Phillips, Jr., deceased Date of Death: March 7, 2001 1. Residence, split level at 29 Harmony Hall Drive, Carlisle $ 80,000.00 2. M & T Bank checking acct #1057391 1,272.49 3. Members 1 st FCU savings acct #121358 555.22 4. Mellon Bank checking acct #182-204-1040 for Shamrock Cleaning Service 330.61 5. Household items. 2,650.00 6. 1997 Chevrolet Lumina VIN: 2G 1 WL52MXV9263164 8,500.00 TOTAL $ 93,308.32 COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND Alfred H. Phillips, being duly sworn according to law, deposes and says that he, the Executor of the Estate of Arthur C. Phillips, Jr., late of Carlisle, Cumberland County, Pennsylvania, deceased, and that the within is an inventory made by Alfred H. Phillips, the Executor of the entire estate of decedent, consisting of all the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent its fair value as ofthe date of decedent's death. , Sworn and subscribed before me, this _ day of December, 2001. NOTARY PUBLIC \- /6~C2//-;Y . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* BUREAU OF INDIVIDUAL TAXES .INHERITANCE TAX DIVISION DEPT. 280601 HARRIS8URG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REY-1541 EX AFP liZ-III JOHN H BROUJOS E~g2 FEB-1 BROUJOS 8 GILROY 4 N HANOVER ST CI&rh CARLISLE Cl"...bUQl;'-.. P 1 :43 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-29-2002 PHILLIPS 03-07-2001 21 01-0281 CUMBERLAND 101 ARTHUR C ReCOrCd( RefJ:'~-:;tr, Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=is4i-EY-AFP--n'2-:00Y-NOTicE--OF-YNHE"Rii;.irCE-TAx-A"PPRA"isEMENT~--AiDjw;'NCE-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF PHILLIPS ARTHUR C FILE NO. 21 01-0281 ACN 101 DATE 01-29-2002 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (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 U) (2) (3) (4) (5) (6) (7) 80,000.00 .00 .00 .00 13.308.32 .00 .00 NOTE: To insure proper credit to your account. subllit the upper portion of this forll with your tax paYllent. (8) 93.308.32 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 (9) UO) 5.925.00 43,310.75 Ul) (12) (3) (4) 49.:731; 75 44.072.57 .00 44.072.57 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 REDITS: P MENT DATE 06-07-2001 12-07-2001 .00 X .00 X 44.072.57 X .00 X 00 = 045 = 12 = 15 = NOTE: (9)= .00 .00 5.288.71 .00 5.288.71 REC PT NUMBER AA496691 CD000616 DISCOUNT (+) INTEREST/PEN PAID (-) 73.68 .00 AMOUNT PAID 1.400.00 4.073.71 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 5.547.39 258.68CR .00 258.68CR . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ....... .. REV-1470 EX (6-66) * INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128~01 DECEDENTS NAME FILE NUMBER 2101-0281 101 Arthur C. Phillips, Jr. REVIEWED BY ACN ANITA MCCULLY ITEM SCHEDULE NO. EXPLANATION OF CHANGES Total on line 14 was not correctly carried forward to line 17 on recapitulation page. ROW Page 1 16 ..c:1 /7- Y' 'v BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REV-1U7 EX AFP (01-021 F(C'c( : c DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-19-2002 PHILLIPS 03-07-2001 21 01-0281 CUMBERLAND 101 ARTHUR C .02 MAR 1 8 P 2 : 1 6 JOHN H BROUJOS ESQ BROUJOS 8 GILROY 4 N HANOVER ST CARLISLE Allount Rellitted I..>i:;ir PA rHliP3" MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forI! with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ rfiv=i6'ifj-E,3f-AFP-foY:02y------...--iNHERITANCE-TAX-STAfEMENT-OF-ACCouiif--...--------------------- ESTATE OF PHILLIPS ARTHUR C FILE NO. 21 01-0281 ACN 101 DATE 02-19-2002 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-29-2002 5,288.71 P R I NCI PAL TAX DUE: .......................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-07-2001 AA496691 73.68 1, 400.00 12-07-2001 CDOO0616 .00 4,073.71 01-30-2002 REFUND .00 258.68- TOTAL TAX CREDIT 5,288.71 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 lIE IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) Final Settlement Statement THIS is a statement made this 1./a.C day of ~, 2002, by Alfred H. Phillips, 29 Harmony Hall Drive, Carlisle, P A 17013, sol~and Executor ofthe Estate of Arthur C. Phillips, Jr., Decedent, and whose name is set forth as signatory at the end ofthis Statement. WITNESSETH: A. Arthur C. Phillips, Jr. of 29 Harmony Hall Drive, Carlisle, Cumberland County, Pennsylvania, died on March 7, 2001. B. On March 14,2001, Letters Testamentary were granted to Alfred H. Phillips at File No. 21-01-0281 in the Register of Wills Office for Cumberland County, Pennsylvania. C. Executor has administered the estate until the present time and has paid all debts of the estate, including inheritance tax owed. D. Decedent died testate, copy of will being attached hereto, providing for the residue of decedent's estate to pass to his twin brother, whose name is subscribed hereunder. K The assets of the estate are set forth in Exhibit A attached hereto and made a part hereof. F. Executor has paid the debts of the estate as set forth in Exhibit B attached hereto and made a part hereof. G. There remains to be distributed to the beneficiary the assets set forth in the Schedule of Distribution in Exhibit C attached hereto and made a part hereof. H. The party desires to forego a formal account and schedule of distribution and desires to conclude the estate by virtue of filing of this Statement. NOW, THEREFORE, the said party intending to be legally bound sets forth the following: 1. Executor of the estate of deceased will not file a formal accounting or sch~ule of distribution. ,~ , 2. Inheritance Tax was paid. 3. The party will distribute the assets in accordance with Exhibit C. ., _.:~ 4. The beneficiary designates this statement as a "satisfaction of award" and hereby authorizes and directs the Clerk of Orphans' Court to mark satisfied of record any award which may subsequently be made by the Court with respect to the distribution made to the distributee in this Statement. 5. The said beneficiary acknowledges that this Final Settlement Statement shall be filed with the Clerk of Orphans' Court in final settlement of the estate of decedent Arthur C. Phillips, Jr. IN WITNESS WHEREOF, the Executor/Beneficiary, intending to be legally bound hereby, sets his hand and seal the day and year first above written. Alfr H. Phillips, Execut 29 armony Hall Drive Carlisle, P A 17013 COMMONWEAL TH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND On this, the / Sf" day of :r ~ ' 2002, before me the undersigned officer personally appeared Alfred H. Phillips kno to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he executed the same for the purpose therein contained. m WITNESS WHEREOF, I have hereunto set my hanz~~;~ Notary Pu lie ~/Uj~ v Notarial Seal Bridget Ann Corcoran. NotarY Public Carlisle BOlO. Cumberland CountY My Commi.sion BxpiJes JU\1C 10. 2006 Member. PeMiytvanlaAjiociatlOnclNolart8l EXHIBIT A - ASSETS ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Residence, split level, .35 acres $ 80,000.00 29 Harmony Hall Drive, Carlisle, PA 2. Checking Account # 1057391, M&T Bank 1,272.49 3. Savings Account # 121358, Members 1st FCU 555.22 4. Checking Account # 182-204-1040, Mellon Bank 330.61 for Shamrock Cleaning Service 5. Household Furnishings 2,650.00 6. 1997 Chevrolet Lumina VIN: 2G1WL52MXV9263164 8.500.00 TOTAL ASSETS $ 93,308.32 EXHIBIT B - DEBTS AND DEDUCTIONS ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES 1. Hoffman-Roth Funeral Home $ 1,775.00 B. ADMINISTRATIVE COSTS 1. Personal Representative Commissions - Alfred H. Phillips 2. Attorney Fees - Broujos & Gilroy, P.C.; EIN 23-2267691 3. Family Exemption 4. Register of Wills - Probate Fees -0- 3,800.00 - 0 - 308.00 C. MISCELLANEOUS EXPENSES 1. Register of Wills - Inventory 2. Register of Wills - Inheritance Tax Return 3. Register of Wills - Final Settlement Statement 10.00 15.00 17.00 D. MISCELLANEOUS DEBTS 1 . M & T Bank mortgage # 978708-6 2. Boscov's acct # 108830905 3. The Bon Ton acct # 097-931-224 4. Capital One Mastercard acct # 5291 071437472507 ($1,283.77 less 10% discount) 5. Sprint 6. Darlene Moyer - personal tax 7. York Waste - trash removal 8. Middlesex Township - water 9. P P & L - electric 10. Comcast Cable - cable TV 11. J C Penney 12. The Bon Ton -final payment 13. Wolfe & Shearer - appraisal of house 14. Margie Bushey - jewelry appraisal TOTAL 40,349.88 215.37 791.18 1,155.39 96.72 10.00 30.75 86.63 109.85 36.34 43.64 135.00 225.00 25.00 49,235.75 5,288.71 Inheritance Tax TOTAL DEBTS AND DEDUCTIONS $54,524.46 ***** EXHIBIT C - DISTRIBUTION Assets $ 93,308.32 Balance for Distribution $ 54,524.46 $ 38,783.86 Debts and Deductions .-' ", '-', ,.._.....~ ~ (QJ ~:)'u Mill J Arthur C. Phillips, Jr. of 29 Harmony Hall Drive, Carlisle, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. Jttm em: I direct that all my debts and funeral expenses shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ]lttm ll!ttlo: I direct that my remains be cremated and my remains given to my twin brother Alfred H. Phillips of Shiremanstown, Cumberland County, Pennsylvania. Jttm ll!bm: I give, devise, and bequeath my entire estate to my twin brother Alfred H. Phillips. In the event that he predeceases me, then I give, devise and bequeath my entire estate to my younger brother Larry R. Phillips of Elwood City, Pennsylvania. Jttm .four: I appoint my twin brother Alfred H. Phillips Executor of this my last will. Should he fail to qualify or cease to act as Executor, I appoint my younger brother Larry R. Phillips to act as Executor with the same rights, powers, and duties. Jttm .fibt: All estate, inheritance, succession, and other taxes, imposed or payable by reason of my death, and interest and penalties thereon, with respect to all property comprising my gross estate for tax purposes, whether or not such property passes under this will, shall be paid out of the principal of my residuary estate, without apportionment or right of reimbursement. Jttm ~ix: I direct that my personal representative or guardian shall not be required to give bond for the faithful performance of their duties in any jurisdiction. Jttm s;tbtn: In addition to the rights and powers given to the fiduciaries by law or elsewhere in this will, I give to my Executor during the full time necessary and for the administration of my estate the following rights and powers to be exercised in his or her sole discretion. A. To retain any real or personal property which may at any time form a part of my estate so long as he or she deems it advisable. B. To invest in any real or personal property without restrictions to legal investments. C. To repair, alter, improve or lease for any period of time any real or personal property and to give options for leases. D. To sell at public or private sale, for cash or credit, with or without security, to exchange or to partition, to mortgage or pledge real or personal property, and to give options for leases. E. To make distribution in kind. F. To compromise claims. IN WITNESS WHEREOF, I have hereunto set my hand this 25th day of September, 1997. ~inntb. r;~;i#? c' /djt-# Arthur C. Phillips, Jr. L The preceding instrument, consisting of this and one other typewritten page each identified by the signature of the Testator was on the day and date thereof signed, published and declared by the Testator therein named as and for his last will, in the presence of us, who at his request, in hi, _en" ",d in the _enee of eneh othee have ,""eribed 0(/ ..~~~ a- (~ CLA..J--' COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND WeJohnH.Broujosand t-LIDC,e T /kJJ ~.LblL~ ,witnesseswhosenames are signed to the attached or foregoing instrument being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the instrument as his last will; that he signed willingly and executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the will as witnesses; and that to the best of our knowledge, the estator was at the time 18 or more years of age, of sound mind and under no constraint or undu in e. (;(y ~ . Sworn and subscribed to before me thO " day of September, 1997. \ ') '-I Notarial Seal Sherr; L. Murphy, Notary PUJlic Carlis;e Boro. Cumberlanc. CCI'nty My Commission Expires Jan. 4, 199' COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND I Arthur C.Phillips, Jr. whose name is signed to the attached document, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last will; that I signed it as my free and voluntary act for the purposes therein expressed, k~N~ C. d~:L~ CU . Arthur C. Phillips, Jr. /' Sworn and affirmed to and acknowledged before me this 25th day of September, 1997. "'~J"C cJ />.1~,J~'1 . . . OTARY PUBLI~ I I Notarial 80<11 Shere' L. Murehy, NQlil,.y ou,)lic Carhs,(l Bora, CumbfHlcm;: My Commission F=n~\:~'(' '; ,Jn~.: j CJvV STATUS REPORT UNDER RULE 6.12 Name of Decedent: Arthur C. Phillips. Jr. Date of Death: March 7. 2001 Will No. Admin. No. 21-01-0281 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. Ifthe answer to No.1 is Yes, state the following: a. Did the personal representative file a final account/statement 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 X No d. Copies of receipts, releases, joinders and approvals accounts may be filed with the Clerk of Orphans' ourt an attached to this report. Date: 7.1.02";::!- ~~\ 2: ~ Capacity: John . Broujos 4 N. Hanover St., Carlisle, PA 17013 717-243-4574 Personal Representative ~ Counsel for Personal Representative ~-l500~+(~)~~WEALTHOF '* PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 .. HARRISBURG, PA 17128.0001 DECEDENTS NAME (LAST, FIRST. AND MIDDLE INIM) Philli S Jr. Arthur C. DATE OF DEATH (MM-OQ.Yea-) I- Z W o w U w o ~ REV -1500 INHERITANCE TAX. RETURN RESIDENT DECEDENT OFFICW..USEQNlY /~-0217-1 FILE NUMBER 2 1 -0 1 0 0 2 8 1 ~-'l'eAA---NiiiiER-- SOCIAL SECURlTY NUMBER DATE OF BIRTH (MM-OQ.Yea-) 211-30-6738 THIS RETURN IIUST BE FLED IN DUPLICATE WITH THE REGISTER OF WIllS 03/07/2001 03/21/1939 (IF APPLICABLE) SURVIVING SPDUSE'S NAME (lAST, FIRST, AND MIDDLE INITlA4 SOCIAl SECURITY NUMBER uJ .... ",:$., 0"'''' w~() J:cr:9 0..., ~ 00 1. Original Retum o 4. Limited Esla\e 00 6. DecedentDied Teslate (-"","'''"1 o 9. Litigation Proceeds Received o 2. Supplemental Retum o 4a.FuturelnterestCompromiseldalBoftl88lh"12-12~2) o 7. OecedentMalntained a Living Trust (AJ1a:hCO\lY ofTrust\ o 10. Spousal Poverty Credit (dale of death between 12-31-91 and 1.1.95) o 3. Remainder Retum (daEofdeathpriorbI2-13-82) o 5. Federal Estate Tax Retum Required Q... 8. To\alNumberofSafeOepos~8oxes o 11. Election to tax under Sec. 9113(A) (_"'01 .... z uJ o z o .. ~ '" o o z o f= <( ..J ::) t- o: <( () W 0: I. Real Estate (Schedule A) (I) 2. Slocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgage, & Notes Receivable (Schedule 0) (4) 5. Cash, Bank, Deposi~ & Mlscettaneous Perwr.al property {5} (Schedule E) 6. Jointly Owned Property (Schedule F) (6) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G Of L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent Mortgage Liabil~s, & Liens (Schedule I) (10) II. Total Deductions (fotal Lines 9 & 10) 12.. Net Value of Estate {line 6 mInus Line 11) 13. Charttable and Governmental BequestslSec 9113 Trusts for which an election to tax has nol been made (Schedule J) :0 ~ .. f;: I,'" o "" 93,308.32 49,235.75 44,072.57 14. Net Value Subject to Tax (line 12 minus line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 44,072.57 z Q I- <( I- ::) a. :;; o () X <( t- 15. Amount of Line 14 taxable at the spousal tax rate, ortransfelS uMerSec. 9116Ia)(1.2) 19. Tax Due X _(IS) X _(16) 000 46,197.57 X 12 (17) 5,543.71 X .15 (18) (19) 5,543.71 16. Amount of Une 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount ofUne 14 taxable at collateral rate 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT '" ",:BESliRErOANSWERALL QUESTIONS. ON.REVERSESIDE AND RECHECK MATH < < dt'C Add Dece en s omplete ress: STREET ADDRESS 29 Harmonv Hall Drive aTY I STATE I ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 5,543.71 1.400.00 70.00 Total Credits (A +8 +C) (2) 1,470.00 3. InteresUPenalty if applicable D.lnterest E. Penalty TotallnteresUPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) 8. Enter the total of Line 5 + SA. This is the 8ALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 000 4,073.71 4,073.71 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X. IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ........................................................................... 0 [RJ b. retain the right to designate who shall use Ihe property transferred or its income; ........................................ 0 [RJ c. retain a reversionary interest; or ...................................................................................................... 0 00 d. receive the promise for life of either payments, benefits or care? ............................................................. 0 [RJ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?..................................... ......................................................... 0 [RJ 3. Did decedent own an 'in truslfor' or payable upon death bank account or security at his or her death? ................. 0 [RJ 4. Did decedent own an Individual Retirement Acoount, annuity, or other non.probate property which contains a beneficiary designation? ........................................... ........... ................................................. 0 00 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declcn that I have examined this return, includin~ accompanying schedules and statements, and to the best of my knowledge lRl belief, it is true, correct and complete. Declaration of preparer other thi:l'l the personal representative is based on allmformation 01 whICh preparer has any knowledge. SIGNA TUR~~~. SO~ESP~, SIBL 1'1 I G. RETURN DATE {h~ #, 12/7/2001 ADDRESS 29 Harmony Hall Drive Carlisle SIGNATURE OF PREP E ADDRESS 4 No Hanover Street Carlisle PA 17013 DATE 12/7/2001 PA 17013 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 PS. ~9116 (al (1.1 I (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)l. The statute does not exemot a Iransfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The lax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedenl's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(al(ll1. The tax rate imposed on the net value of transfers to orforthe use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Seclion 9102, as an individuai who has at least one parent in common with the decedent, whether by blood or adoption. ""'''''''''''.0. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN I SCHEDULE A REAL ESTATE DESCRIPTION VALUE AT DATE OF DEATH 80,000.00 29 Harmony Hall Drive, Carlisie, PA Residence, split level, .35 acres. See appraisal attached. TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 80000.00 ..~..~ "~.~..~._~--,.<,..<<"'~...""'''''''''''~. '''''_-''i'Mi'''t'~'''.'\~''t~' ..~"'.~ _ "''',W'''!l',,:,..,','l'f~L'l"'\'i:'~E?AFr'_'tci''~<'_~~''';'':'h'>:t:;,''\~W.!'- ,;: ' 1$,., ' ,;,'tll'!"~'l:r;t:I(f_;~'~}:,:;-~(""",::IO~,'.r-,'~~' .t~,... ' ^"'/~';;'\f.)f;. '., M'::~~LFE-,~,_:' "ER__ ;-: 'J,' ",:,,::~~,:\,;{l:/(:i',:{,~,;~':NO~"':;:r-\i~ ,;~:',"' '-c' ',.'- :';i'i',~;;"~ ,,"_.r\:",5;: . .. . , 'I'::;' Ray "Buz" Wolle, CRS Broker/Partner WOLFE & SHEARER REALTORS William L, Shearer, Jr" CRS Broker/Partner - ..... ) 33 SoU!!'l Pitt Street Cerlisle, PA '70~3 117.243.1551 900.377.3027 t<<x 717 .24J.Q472 www.wolfeshsarer.com RESIDENTIAL COMMERCIAL APPRAISAlS INDUSTRIA, CONSULTING INVESTMENTS Oecembcr 5,1001 Mr. John H. Broujos, Esquire Broujo. >nd Gilroy Attorneys At Law 4 North H&nc.v~ Street Carhsle, PA 17013 REF' E.tate of Arthur C. P:l1llips 29 H&t'mOnv Hall Drive Cumbel'hmd COWlt}' Carlisle, PA I i013 Dear Mr Broujos: In complian~ with your rtquest, 1/we nave personally inlipected \he abt">ve caphoned pIOpert)' to estimate- the llWket value as Qfth. dl"'. of death (March 7, 20(1), The '.:alu" s.hownhas been aniyed a.t after careful study of the location and type of improve.ments, l~ir present pbysiCfll ;,ondition and their prei':~l1t Qse. Thc;r-don:, ( believe it ,0 reflect a tNe J'DeaSUr~ of the market value {(AS OF "l\larch 7,2001 V ALUE REPORTED, EIGHTY THOUSAND DOLLARS ($80,000) I hereb)' certify that I have DO tmancial interest, pt<sc:nt or contempl;)ttd~ in th15 P!operty, and. ~t neithel' th~ ~loymeDt to make d1e awral531uQc the c('Impenntioll therefrom is contingent upon the value repomd. Sincerel y yours, ~-\\:~----_.__.. ~~~~ WILLIAM A. BASSETI Cenified =eral R.al E~tate Apprmer GA-001618-L ""''''EX_"." '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE !lUMBER Phillios Jr Arthur C 21 01 00281 Indude the proceeds of litigation and the date the proceeds were reoaNed by the estate. All property jolntly-owned with the right of survlvol$hlp must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. M & T Bank checking acct # 1057391 1,272.49 2. Members 1 st FCU savings acet # 121358 555.22 3. Mellon Bank checking acet # 182-204-1040 330.61 for Shamrock Cleaning Service 4. Household items. list attached. 2,650.00 5. 1997 Chevrolet Lumina VIN: 2G1WL52MXV9263164 8,500.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additIOnal sheets of the same size) 13308.32 Household Items Estate of Arthur C. Phillips, Jr. Living Room Sofa Chairs Lamps 2 end tables Coffee table Fake firep lace Pictures Library table Misc. $ 50 100 50 50 50 50 100 50 --.2Q 550 Dining Room Table and chairs Buffet China cupboard China and silver Grandmother clock $200 100 50 200 300 850 Kitchen Table and 2 chairs Refrigerator Antique cupboard $ 50 200 -12 325 Bedrooms Basement Jewelry Sofa 50 Tools 50 3 rings 350 Chairs 50 TV 25 Table 100 2 beds 200 3 dressers 75 2 shelf units ~ 525 TOTAL $ 2,650 MARGARET B. BUSHEY ANTIQUE AND ESTATE JEWELRY December 7, 2001 The foUowing three rings have been examined and identified for the purpose of estate distribution. No liability is assumed for any action taken with regard to this identification. DESCRIPTION APPROXIMATE VALUE One Gent's 10K White Gold Ring with Synthetic Gemstones $25.00 One Gent's 14K Yellow Gold Ring with Two Diamonds each approximately .20 - .25C each with a clarity grade of II - U $175.00 One Gent's 14K YeUow Gold Ring with One Diamond approximately .20 - .25 C with a clarity grade of II $150.00 ""''''''.'''''* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Phillios Jr Arthur C Debts of decedent must be reported on Schedule I. FILE NUMBER 21 01 00281 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Hoffman-Roth Funeral Home 1,775.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (5) Alfred H. Phillips 0.00 Social Security Number(s) I EIN Number of Personal Representative{s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees Broujos & Gilroy, P.C. EIN: 3,800.00 3. Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation) 0.00 Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees to Register of Wills 308.00 5. Acoountanl's Fees 6. Tax Return Prepare(s Fees 7. Register of Wills - Inventory 10.00 8. Register of Wills - Inheritance Tax Return 15.00 9. Register of Wills - Final Settlement Statement 17.00 TOTAL (Also enter on line 9, Recapitulation) $ 5925.00 (tf more space is needed, insert additionai sheets of the same size) R"''';~.(l97l. COMMONWEALTH OF PENNSYLVANIA !NHERI1I\NCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS FILE NUMBER 21 01 ESTATE OF Phillios Jr. Arthur C. 00281 Include unrelmbursed medical expenses. ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. DESCRIPTION AMOUNT 40,349.88 M & T Bank mortgage # 978708-6 Boscov's acct # 108830905 215.37 The Bon Ton acct #097-931-224 791.18 Capital One Mastercard acct #5291071437472507 $1.283.77 less 10% discount 1,155.39 Sprint 96.72 Darlene Moyer - personal tax 10.00 York Waste - trash removal 30.75 Middlesex Township - water 86.63 P P & L - electric 109.85 Corneas! - eable TV 36.34 J C Penney 43.64 The Bon Ton 135.00 Wolfe & Shearer - appraisal of house 225.00 Margie Bushey. jewelry appraisal 25.00 TOTAL (Also enter on line 10. Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 43310.75 ~ M&f Mortgage Corporation A SUBSIDIARY OF M.!JBANK. O."er 140 Years of Experience Behind Us April 09, 2001-/a~kz{,~ ;{// 30 673J7 ------., Arthur C Phillips 29 Harmony Hall Dr Carlis 7013 840b ~, ~iJJ}m()~ RE: Loan NO'(~ Property Addres~armony Hall Rd Carlisle PA 17013 !it, =t p1tuYv. /I /q'3~f3 J /fl, tJOO ~-d l!!-,<<t. ~::<;7~ II /Jr ~ ~ fb~YC{, of;f ? Dear Mortgage Customer(s): &#. j-J7oo---- 7;?~- ;<e2::<L/. ~ Your mortgage loan is in default, with a total amount and may be subject to an inspection to confirm the above referenced property. You will be responsible reimbursement of this cost. $ 891.68, of the To cure this default, avoid further cOllect~'on 'fforts and prevent additional negative credit reporting, your ac unt must be brought current immediately. Please send the amount aue to the following address: / M&T Mortgage cor~ration Attn: Payment P ocessing P.O. Box 444 Buffalo, NY Please include your your check or money order. If your default was caused by ents beyond your control, you may be eligible for assistance in av iding foreclosure and resuming normal monthly payments thr gh a number of different loss mitigation programs. c/~r - ~d-,- P ;lJv/~ .C ~ m~cc. gf' -1 .' . /' P/; a: ~ c::;r',al/t',':( /./ ? ;/f~:f' if? ./t>",F7' ,/ . /: ~ !/CL906 ~ . ?/ .2,~ (, M&T Mortgage Corporation' P.O. Box 1288 . Buffalo, New York 14240 . (716) 626-7010 . (800) 724.2224 ~/ ~ ;) I f c7 www.mandtbank.com Please call our office i mediately at 1-800-724-1633 to discuss the loss mitigation options available to you. r!/! Sincerely, ...--' Mary Tromanhauser /~,?./- .:.... :v J' hI tL Zc Jo{~l~;d1-~ """;""'."."* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF NUMBER I. r FILE NUMBER 21 01 RELATIONSHIP TO DECEDENT Do Not List Trusteels) OD2R1 AMOUNT OR SHARE OF ESTATE 100% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON.TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1. Alfred H. Phillips 29 Harmony Hall Drive Carlisle, PA 17013 brother 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS ,. TOTAL OF PART 11- ENTER TOTAL NON.TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size)