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Home My WebLink About01-0305 Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Jean A. Richards also known as No. ~/-OI- 3a.s- , Deceased Social Security No. 201,-16 - 6978 Judy C. Moul Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) [!] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut or the Decedent, dated 07/09/199 and codicil(s) dated None named in the last Will of 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: o 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: Name Relationshi Residence (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumber land County, Pennsylvania with his/her last family or principal residence at 1931 Kent Drive, Lower Allen Township (list street, number, and municipality) Decedent, then ~years of age, died 03/12/2001 at Fairview Township, PA (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PAl All personal property (If not domiciled in PAl Personal property in Pennsylvania (If not domiciled in PAl Personal property in County Value of real estate in Pennsylvania $ $ $ $ 55,000.00 situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the a riate form to the undersi ned: Si nature Judy C. Moul 1922 Chatham Drive, Cam Hill, PA 17011 J 10 - ~ I ~-I/ Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991) . . Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland Sworn to or affirmed and subscribed ~~ C nilAn/I., ~udy . Moul C" before me this Jo day of Wp./r 1'..l ) r.o, , I",.: , 4'dl 172t~~ ~ flM,I!t2.~~~ For the Register No. 21-01-305 Estate of Jean A. Richards Deceased Social Security No: 201-16 - 6978 Date of Death: 03/12/2001 AND NOW, MARCH 20, 2001 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary D Of Administration (c.I.a.; d.b.n.c.l.a.; pendente lite; durante absentia; durante minoritate) are hereby granted to Judy C. Mou1 in the above estate and that the instrument(s) dated 07/09/1997 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES '11J/7~ t!, /4UJUJ ~,t1. 4. .:;e;:;~u1 ~4 . Register of Wills Letters. . . . . . . $ 115.00 Short Certificate(s). .5. $ 15.00 Renunciation. $ Affidavits ( $ Extra Pages ( 4 ). $ 12.00 Codicil. . $ JCP Fee. $ 5.00 Inventory. $ Other . . $ TOTAL. $ 147. 00 MAILED LETTERS TO ATTORNEY MARCH 21, 2001 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991) :-'1 ~};.?n<; l~.;;V This I_ocal is to certify that the information here given is correctly copied from an original certificate of death dul~ filed with 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. me as No. ~/?(~ Local Re~ Fee for this certificate, $2.00 p 7178600 ~ 2001.. .143 ROY. 2/e7 COMMONWEALTH OF PENNSYlVolNIA' DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH 74 Yro. COUNlY OF DE.Cnt UNDER 1 YEAfI _! 0."" 1 Jean A. Richards UNDER 1 DIll' Houno ! M_ SEX a. Fanale STATE FILE NUMBER SOCIAL seCURITY NUMeER NAME OF DECEDENT (FIrst Middle, Las) 1. AGE (L...1liI1IIdoy) ..201 - 16 - 6978 DATE OF DEATH iMond'I. Day. ...} ..March 12, 2001 York DECEDENT'S USUAl 0CCIJf\IllI0N <<:-...=::~ ~::~:'l' L Claims Rep. l?J. Blue ~1'!'1s MAILING ADORE.\SW... CilyITown. _. Z",CodoI .' lYJl Kent Dn.ve Ie. ::.,) 0 1711. Did - ...... -..hip? 17d.0 :;"'~=ol MOTHER'S NAME IF.... ModdIo. _ Surname) II. Frances K. an INfORMANT'S MAlUNG AIlIlRESS \SWoa CiIy/bon. SlaIa. ZIp~) .1922 Chatham Drive, Hill, PA 17011 PlACE OF DISPOSITION. N.... 01 c-ry, c,_ lOCATlON. CIIy~, S_. Z1p~ 0< 0Ih0<_ MARITAl. S1JII'US._ --.- 1..Wid~ 17<<X ....__.. Tower, 11.11 ~n RACE.___,_...... ~ 1.. White SURYMHG SPOu8E 1"-._-- SHield Camp Hill, PA 17011 II. MrHER'S NAME (F.... MoOdIa.laII) DECEDENT'S ACTUAL RESIDENCE (Sea ......",. on OIher Side) ...... ~. Charles E. Walt Sr. Jud C. Maul _.~... SI",O Hill PA 17011 :Jot, .. as. ,~ '-- : onMI and ciNth I I I Po\RTR: OIIlar..-_--.....no.._..... .... -.IlIng..... -.oy;ng _ ghran"lWlT I. [b, c. d. DUE 10 (OR AS A CONSEQUENCE 01'): WERE AU1tlI'SY fINDINGS MANNER OF DEATH _1..A8LE PAlOfIlO Nalural ~ COMP\.ET1ON OF CAUSE 0 OF DE.Cnt? Homiclda -- 0 Ponding lnvoollga_ 0 ...0 NoD - 0 CoukI not be dtll.mined 0 DRE OF INJURY IMonth. Day. _) TIME OF INJURY INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED. ... 0 NeD _. CIIlT_ICh<<O only ""'I .caRTWV" PHYSICIAN (Physcan cet1ItyIng cause 01 deaIh when another phytlCl8n has pronounced death ana CQ'l'Ipieled Item 23) To.......ot..,.knowIedQe.....occunMd.......C8Uee(.)..................tecI,............... ",..,...., _......................... ft. M. PlACE OF JNJURY. At home, finn, strHI, fKtcWy. oIIk:e buOdIng, .... IS...."'l _. ~/<</ .( I :N. .~ NCING AND CERTIFYING ,"YSICIAN (Physician boItI prOOOUOCIf"lQ aeatl and criylng 10 cause 01 dnlhl To'" _ 01 "" .............. _.. occ...... 01'" _. _. ..... pIoca. ond du.lo... cauaa(.)..... _.. .tatad.. . . . . . . . . . . . . . . . . . . . . . . . . 'MEDlCAL EllAIIINERICORONER On........ 01 examination and/or inv..tlptlon. In my opinion, ~.th OCCU"_ a. the tlm.. da.., and plac.. Ind due to the cluae(a. and manner ult8ted........ . . . .... . ... . . . ... ..... . ..... .... ~'. , ... .... .. ..... . .... , .... .. . ...... ......... , .. ,.. , .... , . 31.. R o '" ~ ~ \\ ~ \~ .~ \-..J ,. '-l ~ \J 21-01-305 WILL OF JEAN A. RICHARDS I, JEAN A. RICHARDS, of Lower Allen Township, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, and any and all taxes and assessments imposed by any governmental body as a result of my death, whether on property passing under this will or otherwise, 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. ITEM II. I give and bequeath all of my household goods, automobiles, jewelry, and all other articles of household and personal use, equipment and ornament, together with all insurance thereon and relating thereto, to my children in equal shares, as survive my death by thirty (30) days, and the following specific bequests to my grandchildren: A. Five Hundred ($500.00) Dollars to Zachary Ullrich; and B. Five Hundred ($500.00) Dollars to Casandra Ullrich. ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my possessions and estate of every nature and wherever situate be divided in four 1 ~ ~ ~. ~\ ~.:~ \~ \ ~ ,.r-- .'" ~ J , \-..\ <:: -J '.J", ". equal shares to be distributed as follows: A. One (1) equal share unto my daughter, Vickie J. Barkdoll; B. One (1) equal share to my son, John H. Richards; C. One (1) equal share to Judy C. Moul; D. One (1) equal share to be divided equally among my grandchildren: Michael J. Ullrich, Cindy M. Barkdoll and Jason C. Richards. ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or attachment. ITEM V. I appoint my daughter, Judy C. Moul, executrix of this my last will. Should my said daughter predecease me or otherwise fail to qualify or cease to serve as executrix of this my last will, I appoint my son, John H. Richards to be the executor of this my last will. ITEM VI. In addition to the other powers and authorities granted to my personal representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby give to my personal representatives the following powers and authorities effective without court approval and until actual distribution of all property: to compromise any claim or controversy; to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as my personal representatives may determine and at valuations finally to be fixed by them; to 2 invest in all forms of property, including any stock or other securities in any corporate fiduciary or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my personal representatives deem proper, without regard to any principle of risk or diversification; to retain any or all assets of my estate, real or personal, without regard to any principle of risk or diversification; to sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges, or leases, for such prices and upon such terms or conditions as my personal representatives deem proper; and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem proper in their sole discretion. ITEM VII. I direct that my personal representatives and fiduciaries 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 this 9 day of 7~~ , 1997. ,~~~tl- /r?<~~ JEfN A. RICHARDS 3 The preceding instrument, consisting of this and three other typewritten pages, each identified by the signature of the testator was on the date thereof signed, published, and declared by JEAN A. RICHARDS, the testatrix therein named, as and for her last will, in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. ~ '" ~\. \., ~ --;i. ~;... .'\.. q~~ 4 . COMMONWEALTH OF PENNSYLVANIA ) ( SS: COUNTY OF CUMBERLAND ) The undersigned, being the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. J/~ot2. K~~ ,I... . WENDY S. CHe.sf, eb tJ.>7l1tt.V?'ihlic , o.QWelf Allen T\f!p euM~ Co., PA :, My Commissiorl ::.'-,:i.s; ':.\:lY 10, 1999 COMMONWEALTH OF PENNSYL V A ) ( S5: COUNTY OF CUMBERLAND ) WE, ~EL.LY 1-. UL(!.leH and ~-rnIlf.JG ~U{C1L(;L , the 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 testatrix sign and execute the instrument as her last will; that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our knowledge, the testatrix was at that time 18 or more years of age, of sound mind, and under no constraint or undue influence. ~~ ~~ ~ 1-. ';::t. ~ \.. 'r\ " (~, ~ ' ,'-) . AY ';/ . ("-1~~ o 5 'E: -- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Jean A. Richards Date of Death: March 12, 2001 Will No.: 21-01-0305 Admin. No: To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on March 28,2001: NAME ADDRESS Judy C. Moul 1922 Chatham Drive, Camp Hill, Pennsylvania 17011 Vickie J. Barkdoll 1931 Kent Drive, Camp Hill, Pennsylvania 17q 11 John H. Richards 1912 Chatham Drive, Camp Hill, Pennsylvania 17011 Jason C. Richards 2959 Robar Street, Las Vegas, Nevada 89121 Michael J. Ullrich 14 Kensington Drive, Camp Hill, Pennsylvania 17011 Zachary B. Ullrich 14 Kensington Drive, Camp Hill, Pennsylvania 17011 Cassandra N. Ullrich 14 Kensington Drive, Camp Hill, Pennsylvania 17011 Cindy M. Barkdoll 1101 Columbus Avenue, Apt. 4, Lemoyne, PA 17043 Date: Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: none signarure0Jve l4,) Michael L. Bangs, Atto~y-at-Law , \j 302 South 18th Street Camp Hill, P A 17011 (717) 730-7310 ~1~ Capacity: Counsel for Personal Representative 01 - 365 MICHAEL L. BAN6S ATTORNEY AT LAW 302 SOUTH 18TH STREET CAMP HILL, PA 17011 PHONE 717-730-7310 FAX 717-730-7374- E-mail: bangslaw@paonline.com June 14,2001 Mary C. Lewis, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 RE: Estate of Jean A. Richards File No. 21-01-0305 Dear Mrs. Lewis: Enclosed for filing as a part of the above-referenced estate please find the following: 1. The original and one copy of the Pennsylvania Inheritance Tax Return; 2. A check in the amount of$1,427.12 to pay the tax shown to be due; 3. An original Inventory; and 4. A check in the amount of$25.00 to pay the filing fee for these documents. Kindly return a paid receipt to us in the enclosed, stamped, pre-addressed envelope. If you have any questions or require anything further, please contact us. /wsc Enclosures cc: Mrs. Judy C. 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I Q - J I REV-15oo EX + (6-00) CAPB HpRL EplO CRAC KOTK ES C P o 0 R N R 0 E E S N T REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 021 C- OFFICIAL USE ONLY IJI 1J305 NUMBER o E C E o E N T COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Richards Jean A. DATE OF DEATH (MM-DD-YEAR) COUNTY CODE YEAR SOCIAL SECURITY NUMBER 201-16-6978 THIS RETURN MUST BE FILED IN DUPUCATE WITH THE DATE OF BIRTH (MM-DD-YEAR) 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy of Will) (Attach copy of Trust) o 9. Litigation Proceeds Received 010. Spousal Poverty Credit 0 11. Election to tax under Sec. 9113(A) (date of death between 12-31-91 and 1-1-95) (Attach Sch 0) !!!:!..'$~~~tJ~"i'~$\l:I!IIQIM~~Ii.j:i1g~~_Q8Ie$lljQeNI.'III~n~eNIJiI..f1.~MI11Ji~~li:I.JI~~p':[I~i....'" NAME COMPLETE MAILING ADDRESS 1. Original Return 4. limited Estate X 6. Decedent Died Testate o 3 date of death . Remainder Return prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total N umber of Safe Deposit Boxes OFFICIAL USE ONLY ....', (8) 44,241. 02 (11) 12.527.32 (12) 31,713.70 (13) (14) 31,713.70 (15) (16) (17) (18) (19) 0.00 1,427.12 0.00 0.00 1,427.12 Michael L. Ban FIRM NAME (If Applicable) 302 South 18th Street Camp Hill, PA 17011 TELEPHONE NUMBER R E C A P I T U L A T I o N 0- 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Sub'ect to Tax (Line 12 minus Line 13) (1 ) (2) (3) None 38 ,4:~Q, 20 None (4) (5) None 896.84 (6) 4,853.98 None 12,084.35 442.97 C o M P T U A T X A T I o N SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(aX1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20, 31,713.70 x X X X .0 0 .0 45 .12 .15 Copyright (c) 2000 form software only The Lackner Group,lnc. Form REV-1500 EX (Rev. 6-00) t l ,. Decedent's Complete Address: STREET ADDRESS 1931 Kent Drive CITY Cam Hill STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 1,427.12 Total Credits ( A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( 0 + 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) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (sa) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSW~~'H~~!~!!i~'~'~~;~~I:~~iii~~~~~~g:~i~i ~~~i~~~iji~i~;'~~ '"'~!;: 1~:::+~:g::'~~~~:~~~11TE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; . ~ ~~x 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 beneficiary 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. 0.00 0.00 1,427.12 0.00 1,427.12 o o o [Xl []] [XJ Under penalties of perjury, I declare thltl have examined this return. Including accompanying schedules and statements. and to the best of my knowledge and belief, It Is true. correct and complete. Declaration of pre parer other than the personal representative Is based on all Information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Judy C. Mou1 1922 Chatham Drive .. -- -...----- ......... ---.......----... --........ ----- --.. ---- -- -....... -...... Cam Hill, PA 17011 Michael L. Bangs, Esq. 302 South 18th Street - - -ccm---Hii-i: -PA - -i-f6ir - - - -- - -- - -- - - - - -- - - - - - - -- DATE 1'-1 Jy...c., ':>..0' v I DATE For dates of death on or r 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% [7 P. S. 9116 (a) (1.1) (il). 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)]. The statute does not exempt a transfer 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 tax 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 decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116( 1.2) [72 PS 9116(aXll] The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(aX1.3)j. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent. whether by blood or adoption. Copyright (c) 2000 form software only The Lackner Group. Inc. Form REV-1500 EX (Rev. 6-00) .. . REV-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERIT ANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS SS# 201-16-6978 03/12/2001 Jean A. Richards All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION 9,000 shares Janney Montgomery Scott - FHLMC 1519-K Fixed Income Security 2 3,000 shares Janney Montgomery Scott - FHLMC #1464-G Fixed Income Security 3 5,298.4 shares Prudential Mutual Fund Services, LLC - MoneyMart Assets Fund #11139426 4 3,619.23 shares Prudential Mutual Fund Services, LLC - MoneyMart Assets Fund #2703512206 5 1,496.82 shares Prudential Mutual Fund Services, LLC - Active Balance Fund Class A #46773 UNIT VALUE .995 1.00 1.00 1. 00 11.77 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. TOTAL (Also enter on line 2, Recapitulation) FILE NUMBER VALUE AT DATE OF DEATH 8,955.00 3,000.00 5,298.40 3,619.23 17,617.57 38,490.20 Form REV-1503 EX (Rev. 1-97) f . , Janney Atnulltl,",'eudlellu""u 1832 Mon!gomery Scott LLC March 30, 2001 Michael L. Bangs Attorney At Law 302 South 18th Street Camp Hill, PA 17011 20 Erford Road Suite 3 I 5 Lemoyne. PA 17043-1109 (717) 731.4400 fax: (717) 731-4411 RE: Jean A. Richards Mr. Bangs, Enclosed please find the new account form, which will be needed to open the Estate Account for Jean A. Richards. We will need for the Executor to sign the form where indicated. We will also need a Short Certificate and an Affidavit of Domicile to establish the Estate Account. The two securities in the account at time of death are valued as follows: 9000 FHLMC 1519-K 7.00% 05/15/08 3000 FHLMC 1464-0 7.25% 12/15/21 99.50 100.00 The Money Market value was $896.84. Once we receive the required paperwork, we can move the assets to the Estate Account at which time they can be liquidated. If you have any further questions, please feel free to contact me at 717-731-4400. Sincerely, Martin M. Chronister Vice President Investments MMC/dle Members: NYSE · NASDAQ · SIPC . . $ Prudential Prudential Mutual Fund Services llC PO, Box 8098, Philadelphia, PA 19101 April 4, 2001 Michael L. Bangs 302 S. 18th St. Camp Hill PA 17011 Re: Jean A. Richards SSN# 201-16-6978 Dear Michael Bangs: Thank you for your recent correspondence regarding the individual referenced above. Our records indicate on March 12,2001 the accounts were valued as follows: FUND SHARES PRICE VALUE 11139426 MoneyMart Assets Fund 5,298.400 $1.00 $5,298.40 2703512206 MoneyMart Assets Fund 3,619.230 $1.00 $3,619.23 46773 Active Balanced Fund Class A 1,496.820 $11. 77 $17,617.57 The account balance is detennined by multiplying the total number of shares in the account by the Net Asset Value (Price per share of the fund). Please keep in mind that the Net Asset Value of the fund fluctuates on a daily basis and therefore, the account value will also fluctuate daily. Please be advised the accounts are registered in the name of Jean A. Richards solely. In addition, the Prudential Global Total Return Fund Class A accounts numbered 11139426 and 2703512206 were closed due to exchanges into the Prudential MoneyMart Assets I . . Fund. The Prudential Balanced Fund Class A account number 46773 was closed due to an exchange into the Active Balanced Fund. We trust this information has been helpful. Should you have any questions, please feel free to write us at the above address or contact our Customer Service Division at 1-800-225-1852. Sincerely, ~~ Rachelle Emmons Customer Service Specialist t" . . REV-150a EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Jean A. Richards SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER SSfI 201-16-6978 03/12/2001 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION Janney Montgomery Scott - Money Market Account VALUE AT DATE OF DEATH 896.84 TOTAL (Also enter on line 5, Recapitulation) S 896.84 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-15G8 EX (Rev. 1-97) Jl , . REV-1509 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Jean A. Richards SCHEDULE F JOINTL V-OWNED PROPERTY FILE NUMBER SSfI 201-16-6978 03/12/2001 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. A. SURVIVING JOINT TENANT(S) NAME Judy C. Maul ADDRESS 1922 Chatham Drive Camp Hill, PA 17011 RELATIONSHIP TO DECEDENT Daughter B. John H. Richards 1912 Chatham Drive Camp Hill, PA 17011 Son c. Josephine L. Swallow 1287 High Street Churchtown, PA Sister JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial Institution and bank DATE OF DEATH DECD'S VALUE OF account number or similar Identifying number. NUMBER TENANT JOINT Attach deed for )olntly- held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1 A 01/28/71 A11first Bank - Checking 3,992.18 50.00% 1,996.09 Account flO071722130 2 B 03/28/84 A11first Bank - Money 5,172.36 50.00% 2,586.18 Market Account #0094210179 3 C 12/28/84 A11first Bank - Checking 815.14 33.33% 271.71 Account #0038307251 TOTAL (Also enter on line 6, Recapitulation) $ 4,853.98 (If more space is needed insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1509 EX (Rev. 1-97) 04/02/01 11:15 ~ ~1 302 934 2955 CIS J i4J 0021003 iii allfirst Allflm F1AlI1c1a1 CtnteI N.A. PO Box 900 Mlllboro, DE 19966 April 2, 2001 Michael L. Banp Attorney At Law 302 South lSd1 Street Camp HW, PA 17011 Rt: Estate of Jecm A. Richards Social Security: 201 ~16-6978 Dare of Death: March 12. 2001 Dear Sir or Madam: Per your inquiry dalcd March 28, 200 I please be advised that at the time of dcaI:h. tht abovc:-named decedcot had on deposit with this bank tile following: 1. Ty~ oj Accollrtt Basic Checking AccOW1I NJU11ber 00383072$/ OwMrJhip (NQmu oj) JeartA. Richards SWY:Il'l KDMjf Josephbtt L Swallow ~ng D<<e /JQ/Q/ICf m Dolls 0/ E<<dh /2/28184 $8H./4 Accrut:d Interest $ 0.00 Total $8]J.U 2. Ty~ of A~oUlll AccounrNUJItNr Direct DepoJit Clttlcldng 007J722JJO Ownenhip (Nturtes of) Opet1ng Data Balanc, OH Dat, 01 Death Jean A. RicNrJ'(b Judy C. MouJ 01/28/7] TOIai $3,992.18 $ 0.00 -S3,992.18---......_- AccfWd InJITtnlt ,aVOl 11: 15 trl 302 934 2955 CIS ~UUJ;U >. / 3. Type of AccOUllJ Mongy Martlt Ch6ckmg / I AccOWl/ Number 00942/0/7() Ownership (Names oj) J,onA. ~ John H. kichmdJ O~Jng Dtw OJI28184 &Jane, on Dale of n.ath $5,/72.36 Acc1Wd JnUlreJt $ J.96 T ola/ ...JJ,mTf---...-..--....-.. Tlwu /lCCCUll/I ....,.. C01lW,Mdft_ Iii, tt&4l'uilion of Q1fot'-!wmcitl/ '''''/milan. un/Omm4~ty, M'Dr' 11Mb. to tJCt!", /111>' /1/!~li<1If JH"IQi"in~ 10 Ill. Mill In. AllIlOUIII IfGr '_joI,,' Thtt .It., dMJ 1161 ~I'" any atrDImll ill whJcIt tlw J~ 1IId1Nzv. bHn Iilu" (/1 Prmc, q AI/t;Ir~', CW1Iodillll ofUI'fiJc- TNIf8/f'J, ~tlliw J>fIYK, ", 7iwIcc "M"" Q W,./I1111 Agt'QIlfllfU, POI' figlh" lICCount informal/Oil, clOlli1'lI a~ n:imbUl'Ir_", a/1/l/f04 ff[u 10 below brallcll: WEST SROJU: PLAZA OFFICE UOO MARKET STRUT UMOVNIi:, PA 110.43 117-2SS-2211 .; Sue Klmblo Assistant III Cis Services. (302) 934-2909 &., REV-1S11 EX +(1-97) If. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Jean A. Richards Debts of decedent must be reported on Schedule I. ITEM NUMBER A. B. FILE NUMBER SS# 201-16-6978 03/12/2001 DESCRIPTION AMOUNT 1 FUNERAL EXPENSES: Funeral Expense - Myers Harner Funeral Home, Inc. 4,775.00 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. 3. Attorney's Fees Michael L. Bangs, Esq. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Vickie Barkdoll Street Address 19 31 Kent Dr i ve City Camp Hill State PA Zip 17011 Relationship of Claimant to Decedent Daughter 3,500.00 3,500.00 4. Register of Wills 147.00 Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs Expense - Cumberland Law Journal (Advertising) 75.00 2 Expense - The Sentinel (advertising) 87.35 TOTAL (Also enter on line 9, Recapitulation) $ 12,084.35 (If more space is needed, insert additional sheets of the same size) Copyright (el 1996 form software only CPSystems.lnc. Form REV-1511 EX (Rev. 1-97) "t , . REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Jean A. Richards SCHEDULE I DEBTS OF DECEDENT, MORTGAGE liABiliTIES, AND liENS FILE NUMBER SSff 201-16-6978 03/12/2001 Include unreimbursed medical expenses. ITEM NUMBER 1 DESCRIPTION Expense - Metropolitan Medical, Inc. AMOUNT 29.00 2 Expense - Aetna, Inc. (reimbursement of overpayment) 413 . 97 TOTAL (Also enter on line 10, Recapitulation) $ 442.97 (If more space is needed, insert additional sheets of the same size) Copyrlght(c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) 10 REV-1513 EX +(1-97) COMMONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIAR IES Jean A. Richards NUMBER I. 1 SSII 201-16-6978 03/12/2001 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions): Cindy M. Barkdoll 1101 Columbus Avenue, Apt. 4 Lemoyne, PA 17043 2 Vickie J. Barkdoll 1931 Kent Drive Camp Hill, PA 17011 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Granddaughter Daughter Daughter Grandson Son t FILE NUMBER AMOUNT OR SHARE OF ESTATE one-twe1fth/re s idue one-quarter/re sidue one-quarter/re sidue one-twe1fth/re sidue one-quarter/re s idue ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON- TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 3 Judy C. Mou1 1922 Chatham Drive Camp Hill, PA 17011 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET S (If more space is needed, insert additional sheets of the same size) Copyright (e) 1996 form software only CPSystems,lne. 4 Jason C. Richards 2959 Robar Street Las Vegas, NV 89121 5 John H. Richards 1912 Chatham Drive B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 0.00 Form REV-1513 EX (Rev. 1-97) ~.. ~ Estate of: Jean A. Richards Soc Sec #: 201-16-6978 Date of Death: 03/12/2001 Continuation of Schedule J, Part I (Taxable Bequests) Item # Name and Address of Beneficiary Relationship Amount or Share of Estate Camp Hill, PA 17011 6 Cassandra N. Ullrich 14 Kensington Drive Camp Hill, PA 17011 Other 500.00 7 Michael J. Ullrich 14 Kensington Drive Camp Hill, PA 17011 Grandson one-twelfth/re s idue 8 Zachary B. Ullrich 14 Kensington Drive Camp Hill, PA 17011 Other 500.00 /'-.... ~ ~ '\ ,1 ~ ~ \\ . y-- ~ \-.J "-..j ~ \; tA' .. WILL OF JEAN A. RICHARDS I, JE~N A. RICHARDS, of Lower Allen Township, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, and any and all taxes and assessments imposed by any governmental body as a result of my death, whether on property passing under this will or otherwise, 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. ITEM II. I give and bequeath all of my household goods, automobiles, jewelry, and all other articles of household and personal use, equipment and ornament, together with all insurance thereon and relating thereto, to my children in equal shares, as survive my death by thirty (30) days, and the following specific bequests to my grandchildren: A. Five Hundred ($500.00) Dollars to Zachary Ullrich; and B. Five Hundred ($500.00) Dollars to Casandra Ullrich. ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my possessions and estate of every nature and wherever situate be divided in four 1 -. ~ ~ ~ ~\ ~\~ \~ (' ~ '~ ~ J \ '.~ (" \J j\ '- IJ~ equal shares to be distributed as follows: A. One (1) equal share unto my daughter, Vickie J. Barkdoll; B. One (1) equal share to my son, John H. Richards; C. One (1) equal share to Judy C. Moul; D. One (1) equal share to be divided equally among my grandchildren: Michael J. Ullrich, Cindy M. Barkdoll and Jason C. Richards. ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or attachment. ITEM V. I appoint my daughter, Judy C. Moul, executrix of this my last will. Should my said daughter predecease me or otherwise fail to qualify or cease to serve as executrix of this my last will, I appoint my son, John H. Richards to be the executor of this my last will. ITEM VI. In addition to the other powers and authorities granted to my personal representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby give to my personal representatives the following powers and authorities effective without court approval and until actual distribution of all property: to compromise any claim or controversy; to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as my personal representatives may determine and at valuations finally to be fixed by them; to 2 t'. '. invest in all forms of property, including any stock or other securities in any corporate fiduciary or its successor without restriction to investments authorized for Pennsylv.?lnia fiduciaries, as my personal representatives deem proper, without regard to any principle of risk or diversification; to retain any or all assets of my estate, real or personal, without regard to any principle of risk or diversification; to sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges, or leases, for such prices and upon such terms or conditions as my personal representatives deem proper; and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem proper in their sole discretion. ITEM VII. I direct that my personal representatives and fiduciaries 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 this 9' day of &..J~r /? {I , 1997. ~ a 2'~ C../~ - l .('~ JEfN A. RICHARDS '"" 3 ~}Jr. -- The preceding instrument, consisting of this and three other typewritten pages, each identified by the signature of the testator was on the date thereof signed, publjshed, and declared by JEAN A. RICHARDS, the testatrix therein named, as and for her last will, in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. <::-. '" ,\.. \,. . ~ '4 . \..'0J... ~ ~ q~~ 4 .. COMMONWEALTH OF PENN5YL VANIA ) ( 55: COUNTY OF CUMBERLAND ) The undersigned, being the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. J/-'A'/tl R~~ . WENDY S. CHe56 etJ ~V ",;ollc . ,i.ower Allen T'+!p ~M~ Co., PA . My Commlssio~l ::;I.~.i,:;.: i.\.::IY 10, 1999 COMMONWEALTH OF PENN5YLVA ) ( 55: COUNTY OF CUMBERLAND ) WE, ~ELL.Y L-. ULR-ltJI and ~-mIlf;G' (}UlCkEL , the 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 testatrix sign and execute the instrument as her last will; that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our knowledge, the testatrix was at that time 18 or more years of age, of sound mind, and under no constraint or undue influence. ~~~\1-. ::t. ~\.."h'$~' ~ ' ~~~ o y u,~ WENDY S. C t;RO, Notary Public Lo......r Allen T.....p., Cum$er\ancl Co., PA My Commi,~on Expires May 10. 1999 5 /(., - Q. {o - II REV-1500 EX + (6-00) CAPB HpRL EplO CRAC KOTK ES C P o 0 R N R 0 E E S N T C o M P T U A T X A T I o N REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT o E C E o E N T COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST,AND MIDDLE INITIAL) Richards Jean A. DATE OF OEATH (MM-DO-YEAR) FILE NUMBER 02/ " t.-- OFFICIAL USE ONLY 01 /J305 NUMBER COUNTY CODE YEAR SOCIAL SECURITY NUMBER 201-16-6978 THIS RETURN MUST BE FILED IN OUP\..ICA.TE W11H THE REGISTER OF WILLS SOILS YU 3 date of death . Remainder Return prior to 12-13-82) 5. Federal Estate Tax Return RequIred 8. Total Number of Safe Deposit Boxes Michael L. Ba.n FIRM NAME (If Applicable) 302 South 18th Street Camp Hill, PA 17011 o None 38,~Q,20 None None 896.84 4,853.98 None 12,084.35 442.97 x X X X .0 0 .045 .12 .15 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12- 12-82) 7. Decedent Maintaln&d a living Trust (Attach copy of Trust) 010. Spousal Poverty Credit 0 11. Election to tax under Sec. 9113(A) {dateoideath Pe1ween 12-31-91 and 1-1-95) (AttaCh Sch 0) 1::::[tiI$::S~!;;T'jQN::Mll$llrlil;l!;;'QMI1~gil,.:_~!i!i~$!!!:Iili:j~NP~...,!mlll!ijlf..TI~".. g!lt!:!lIi\(4\jjl1nf~'. '.:u~!!!:I!!Iiit!!.!!~~ili;t()"...... NAME COMPLETE MAILING ADDRESS 30- 1. Real Estate (Schedule A) Z. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage liabilities, & liens (Schedule J) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Sub'eet to Tax (Line 12 minus line 13) DATE OF BIR1H (MM~DD-YEAR) 05 07 1926 NAM LAST, I S ,AND MI L I IAL OFFICIAL USE ONLY ,. (8) 44,241.02 (11) 12.527.32 (1Z) 31,713.70 (13) (14) 31,713.70 (15) (16) (17) (18) (19) 0.00 1,427.12 0.00 0.00 1,427.12 VIVIN POU X 1. OrIginal Return 4. Limited Estate X 6. Decedent Died Testate (AttaCh copy of Will) o 9. Litigation Proceeds Received TEL.EPHONE NUMBER (1) (Z) (3) R E C A P I T U L A T I o N (4) (5) (6) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116{aX1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line '4 ta)(.able at sibling rate 18. Amount of line 14 taxable at collateral rate 19. Tax Due ZOo 31,713.70 Copyright (c) 2.000 10rm soHwaf6 only The Lack.ner C,10UP, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 1931 Kent Drive CITY I STATE I ZIP Camo Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page lUna 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 1,427,12 Total Credits ( A . B . C) (2) 0,00 Total Interest/Penalty ( D . E I (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. Enler the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 'iiiHHlii:iii!! ")::i!liii!ii" !::i::Hii!iii'" '!!iiUHl!:::l:l ,;',i]:";;,,,'" PLEASE ANSWER THE FOLl.OWING QUESTIONS sYPl.ACINGAN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and' a. retain the use or income of the property transferred; 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 beneficiary 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, 3. Interest/Penalty if applicable D. Interest E. Penalty 0,00 0,00 1,427,12 0,00 1,427,12 Yes No ~~ o o D [Xl ITJ [Xl Under penalties of perjury, I declare thai t have examined this return, Including accompanying sch&dules and statements, and to the best of my knowledge and belief. ills true correct and complete. Declarallon of preparer other than the personal representative Is bas&d on all Information of which prepareT has any knOWledge, SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Judy C. Mou1 1922 Chatham Drive - - -Carn-- -HiYi;- PA - - YiaiY - - - - - - - - - - - - - - - - - - - - - - - -- Michael L, Bangs, Esq, 302 South 18th Street -- -Carn---Hih; -PA --i-iaiY------- ----- - -- -- - -- -- - -- DATE /'-1 Jv--c.- ~O\)! DATE /'1~"'10D f For dates of death on or r July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers 10 or for the use of the surviving spouse is 3DID [7 P.S. 9116 (a) (1.1) (ill 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)]. The statute does not exempt a transfer 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 dales of death on or after July 1, 2000: The tax 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 decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S, 9116{ 1 ,2) [72 P.S. 9116(.X1 I]. The lax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(aX 1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Copyrlgnt(c)2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) AEV~1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS il ESTATE OF FILE NUMBER Jean A. Richards 5511 201-16-6978 03/12/2001 All property jointly..owned with right of survivorship must b. disclosed on Schedul. F. ITEM NUMBER 1 2 3 4 5 DESCRIPTION 9,000 shares Janney Montgomery Scott - FHLMC 1519-K Fixed Income Security 3,000 shares Janney Montgomery Scott - FHLMC #1464-G Fixed Income Security 5,298.4 shares Prudential Mutual Fund Services, LLC - MoneyMart Assets Fund #11139426 3,619.23 shares Prudential Mutual Fund Services, LLC - MoneyMart Assets Fund #2703512206 1,496.82 shares Prudential Mutual Fund Services, LLC - Active Balance Fund Class A #46773 UNIT VALUE .995 1.00 1. 00 1.00 11. 77 . (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form softwilre only CPSystems, Inc. TOTAL (Also enter on line 2, Recapitulation) VALUE AT DATE OF DEATH 8,955.00 3,000.00 5,298.40 3,619.23 17,617.57 38,490.20 Form REV-1503 EX (Rev. '~97) 4\ Janney Atndltlolll.fnuJlnIu.lnuI832 Mon!gomery Scott LLe March 30, 2001 Michael 1. Bangs Attorney At Law 302 South 18th Street Camp Hill, PA 17011 20 Erford Road Suite 315 Lemoyne, PA 17043-1109 (717) 731-4400 fax: (717) 731-4411 RE: Jean A. Richards Mr. Bangs, Enclosed please find the new account form, which will be needed to open the Estate Account for Jean A. Richards. We will need for the Executor to sign the form where indicated. We will also need a Short Certificate and an Affidavit of Domicile to establish the Estate Account. The two securities in the account at time of death are valued as follows: 9000 FHLMC 1519-K 7.00% 05/15/08 3000 FHLMC 1464-G 7.25% 12/15/21 99.50 100.00 The Money Market value was $896.84. Once we receive the required paperwork, we can move the assets to the Estate Account at which time they can be liquidated. If you have any turther questions, please feel free to contact me at 717- 731-4400. Sincerely, ~ Martin M. Chronister Vice President Investments MMCJdle Members: NYSE . NASDAO . SIPC It ~ Prudential Prudential Mulual Fund Services LLC P.O. Box 809B. Philadelphia. PA 19101 April 4, 200 I Michael L. Bangs 3025. 18th 51. CampHillPA 17011 Re: Jean A. Richards SSN# 201-16-6978 Dear Michael Bangs: Thank you for your recent correspondence regarding the individual referenced above. Our records indicate on March 12,2001 the accounts were valued as follows: FUND SHARES PRICE VALUE 11139426 MoneyMart Assets Fund 5,298.400 $1.00 $5,298.40 2703512206 MoneyMart Assets Fund 3,619.230 $1. 00 $3,619.23 46773 Active Balanced Fund Class A 1,496.820 $11.77 $17,617.57 The account balance is determined by multiplying the total number of shares in the account by the Net Asset Value (Price per share of the fund). Please keep in mind that the Net Asset Value ofthe fund fluctuates on a daily basis and therefore, the account value will also fluctuate daily. Please be advised the accounts are registered in the name of Jean A. Richards solely. In addition, the Prudential Global Total Return Fund Class A accounts numbered 11139426 and 2703512206 were closed due to exchanges into the Prudential MoneyMart Assets it Fund. The Prudential Balanced Fund Class A account number 46773 was closed due to an exchange into the Active Balanced Fund. We trust this information has been helpful. Should you have any questions, please feel free to write us at the above address or contact our Customer Service Division at 1-800-225-1852. Sincerely, ~~ Rachelle Emmons Customer Service Specialist ,", AEV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Jean A. Richards SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER SSiI 201-16-6978 03/12/2001 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION Janney Montgomery Scott - Money Market Account VALUE AT DATE OF OEA TH 896.84 TOTAL (Also enter on line 5, Recapitulation) $ 896.84 (If more space is needed, insert additional sheets of the same size) Copyright (e) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. t -97) REV-1509 EX ql-97) SCHEDULE F JOINTL V-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Jean A. Richards SSII 201-16-6978 03/12/2001 If an asset was made joint within one year of the decedent's data of death, it must be reported on Schedule G. H FILE NUMBER A. SURVIVING JOINT TENANT(S) NAME Judy C. Moul ADDRESS 1922 Chatham Drive Camp Hill, PA 17011 B. John H. Richards 1912 Chatham Drive Camp Hill, PA 17011 c. Josephine L. Swallow 1287 High Street Churchtown, PA RELATIONSHIP TO DECEDENT Daughter Son Sister JOINTLY-OWNED PROPERTY, LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial Institution and bank DATE OF DEATH DECO'S VALUE OF account number or slmllar IdentIfyIng number. NUMBER TENANT JOINT Attach deed for Jointly-held real estat.. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1 A 01/28/71 Allfirst Bank - Checking 3,992.18 50.00% 1,996.09 Account #0071722130 2 B 03/28/84 Allfirst Bank - Money 5,172.36 50.00% 2,586.18 Market Account #0094210179 3 C 12/28/84 Allfirst Bank - Checking 815.14 33.33% 271. 71 Account #0038307251 TOTAL (Also enter on line 6, Recapitulation) S 4,853.98 (If more space is needed insert additional sheets of the same size) CoPyrl9ht (cl 1996 form software only CPSystems, Inc. Form REV-1509 EX (Rev. 1-97) 04/02/01 11:15 ~1 302 93~ 2955 CIS n 1410021003 - - iii allflrst Allftm FlJllllcllll c.nw N.A PO Box 900 Mill"""" DB I ~66 April 2, 2001 Michael 1. Banis Attorney At Law 302 South lSlb Street Camp Hill, P A 17011 Re: Estate aU,an A. Richards Social Securi/)l: ~OI.I6-697B Dare o(Dearh: March 12.2001 Dear Sir or Madam: ~r your inquiry doted Marth 28, 2001 p\ell.!O be advised ~lat ill1bc lime of death. the abOv.-named decedent had on deposit wlth lhls 'oaIlk the followi1lg: 1. Typo of AccolD'ff AccOVlll N"",b., BlJSiC Chec1cing 1)()3830WI /')pcIing Date Bodan<< "" Do'" of fkDth Accrued /rrtere.rt J_A. Richards Swan Xa1I4jf Joroplrint [. Swallow 12/18184 MaN S 0.00 Owfl4rship (Norr.u oj) Total $815.14 2. Typt of AccoU/IJ ACCOWllNUJnbe' D.."", o.po!it Chocking 00717221J0 TOUJi JOiJI1A. RichmdJ J~ C. Mou/ all]8/11 13,992.18 $ 0.00 -IJ:992./a.----......... Ownenhip (Name:t oj) OponJngDatf Ba/anc. on DaI. of Dwrh ACC1Wd 1m.,.",' /02/01 11; 15 tr1 302 934 2955 C1S 19jUUJ,'uol J. Type oj ArxounJ Monll)l MalMI Chocking / ArxounJ Number 009#2/0/79 Owner,hlp (Nam.. oj) JumA. ~ John H. llia/wds OpDItns Dato OJ/28/84 BoJanc. On 0... of DeaJIz $5.1 7J.J6 A&cruui Inllul1.lt $ /.96 T%l ..'1J.mTr---.-----........ Thlu (lctCUhiIIC'I'1Y COI'IlIII,.,.tlp4lft llt, IItll'lIuiliot'l o{tmollw.,. ~<ltd ihMltHtfon. U.,y01Tll1tJZltl), ~ ar, IIMh. 10 ~II# 4111)' l1f!dnMlioIf p#1'lailting to 1M, Hid 1M GDQOU1t/1flU ,n4r14jotnt "nJi., .".,. tiofl fUJl inClurJ. D1TY QQCDVIftl in ~hJcIt tIMJ ~ md7 haw bWllil"' (/1 POlWr q AltQt'n()', Cw&1odi414 ofUPlifDf'llll r~l. ~'fflath<t 'qu, 0' Ttwldc 11""''' 'WrIt_A".".."" For' /M.,.tJu,. tlI:<cunt irrjrJl"ftZllfJrt, clO/W"r1 a~ ntll1l6wltfltfnt o/llIItd4 '(fer'~ below branch' WEST SHORE PLAZA OFFICE U04l MAJlXET STRUT LlMOYNE, PA 11043 '11._:1271 J SUO Klmblo Assistant III Cis Serv\ce$. (302) 934-2909 REV-1511EX+(1-97} SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESICENT DECEDENT " ESTATE OF Jean A. Richards SSII 201-16-6978 03/12/2001 FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES' 1 Funeral Expense - Myers Harner Funeral Home, Inc. 4,775.00 B. ADMINISTRATIVE COSTS, 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) I EIN Number af Personal Representative(s) Street Address City State Zip - Year(s) Commission Paid: 2. Attorney's Fees Michael L. Bangs, Esq. 3,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant Vickie Barkdoll Street Address 1931 Kent Drive City Camp Hill State PA Zip 17011 - Relationship of Claimant to Decedent Daughter 4. Probate Fees Register of Wills 147.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Expense - Cumberland Law Journal (Advertising) 75.00 2 Expense - The Sentinel (advertising) 87.35 TOTAL (Also enter on line 9, Recapitulation) S 12,084.35 (It more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97) ~{ REV-1512 EX t (1-97) COMMONWEA.L TH OF PENNSYLVA.NIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Jean A. Richards SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS FILE NUMBER 5511 201-16-6978 03/12/2001 Include un reimbursed medical expenses. ITEM NUMBER 1 Expense DESCRIPTION Metropolitan Medical, Inc. AMOUNT 29.00 2 Expense Aetna, Inc. (reimbursement of overpayment) 413 . 97 TOTAL (Also enler on line 10, Recoo!I"lo!!on) S 442.97 (11 more space is needed, insert additional sheets of the same size) Ccpyrlght(c) 1996 fcrmsoftware only CPSystems, Inc. Form REV-1512 EX (Rev. 'r97) REV-1513 EX + (1-97) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA. INHERITANCE TAX RETURN RESIDENT DECEDENT " ESTATE OF Jean A. Richards NUMBER I. 1 SSI, 201-16-6978 03/12/2001 FILE NUMBER AMOUNT OR SHARE OF ESTATE one-twe1fth/re sidue one-quarter/re sidue one-quarter/re sidue one-twe1fth/re sidue one-quarterjre sidue ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 1S THRU 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON- TAXABLE DISTRIBUTIONS, A. SPOUSAL OISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE RELATIONSHIP TO DECEDENT Do Not List Trustee(s) NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions)' Cindy M. Barkdoll 1101 Columbus Avenue, Apt. 4 Lemoyne, PA 17043 Granddaughter 0.00 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) Copyright (c) 1996 form software only CPSystems, Inc. 2 Vickie J. Barkdoll 1931 Kent Drive Camp Hill, PA 17011 Daughter 3 Judy C. Mou1 1922 Chatham Drive Camp Hill, PA 17011 Daughter 4 Jason C. Richards 2959 Robar Street Las Vegas, NY 89121 Grandson 5 John H. Richards 1912 Chatham Drive Son B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Form REV-1513 EX (Rev. 1-97) H Estate of: Jean A. Richards Soc Sec #: 201-16-6978 Date of Death: 03/12/2001 Continuation of Schedule J, Part I (Taxable Bequests) Item II Name and Address of Beneficiary Relationship Amount or Share of Estate Camp Hill, PA 17011 6 Cassandra N. Ullrich 14 Kensington Drive Camp Hill, PA 17011 Other 500.00 7 Michael J. Ullrich 14 Kensington Drive Camp Hill, PA 17011 Grandson one-twelfth/re sidue 8 Zachary B. Ullrich 14 Kensington Drive Camp Hill, PA 17011 Other 500.00 '" ~ , ~ \\ ~ \..' .~ "-.) ~ " r ':, \~ '~ ~ \; tL, WILL OF JEAN A. RICHARDS I. JE~N A. RICHARDS, of Lower Allen Township, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, and any and all taxes and assessments imposed by any governmental body as a result of my death, whether on property passing under this will or otherwise, 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. ITEM II. I give and bequeath all of my household goods, automobiles, jewelry, and all other articles of household and personal use, equipment and ornament, together with all insurance thereon and relating thereto, to my children in equal shares, as survive my death by thirty (30) days, and the following specific bequests to my grandchildren: A. Five Hundred ($500.00) Dollars to Zachary Ullrich; and B. Five Hundred ($500.001 Dollars to Casandra Ullrich. ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my possessions and estate of every nature and wherever situate be divided in four 1 ~ '\ ~ ~. ~, \~ \~ r ~ '~ ~ ~ " , J', , .If-''. equal shares to be distributed as follows: A. One (1) equal share unto my daughter, Vickie J. Barkdoll; B. One (1) equal share to my son, John H. Richards; C. One (1) equal share to Judy C. Moul; D. One (1) equal share to be divided equally among my grandchildren: Michael J. Ullrich, Cindy M. Barkdoll and Jason C. Richards. ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or attachment. ITEM V. I appoint my daughter, Judy C. Moul, executrix of this my last will. Should my said daughter predecease me or otherwise fail to qualify or cease to serve as executrix of this my last will, I appoint my son, John H. Richards to be the executor of this my last will. ITEM VI. In addition to the other powers and authorities granted to my personal representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby give to my personal representatives the following powers and authorities effective without court approval and until actual distribution of all property: to compromise any claim or controversy; to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as my personal representatives may determine and at valuations finally to be fixed by them; to 2 ., invest in all forms of property, including any stock or other securities in any corporate fiduciary or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my personal representatives deem proper, without regard to any principle of risk or diversification; to retain any or all assets of my estate, real or personal, without regard to any principle of risk or diversification; to sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges, or leases, for such prices and upon such terms or conditions as my personal representatives deem proper; and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem proper in their sole discretion. ITEM VII. I direct that my personal representatives and fiduciaries 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 this 9' day of v,~dp Ii v ,1997. (/-#~tl- /f<;'~ J'f'N A. RICHARDS 3 '" The preceding instrument, consisting of this and three other typewritten pages, each identified by the signature of the testator was on the date thereof signed, pubUshed, and declared by JEAN A. RICHARDS, the testatrix therein named, as and for her last will, in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. ~~,\.. \.,' :i ~ q~{[~ "--~~ 4 ~...~ COMMONWEALTH OF PENNSYLVANIA } ( SS: COUNTY OF CUMBERLAND ) The undersigned, being the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. J/~/t2 K~~~ . WENDY S. CHe;6eD ~Yf'"blic , Lowsr Allen TwJ." &;.M.~ ~., PA . My Commllsio;l i;l.~,j....~ ,',:\,:)y 10, 1999 COMMONWEALTH OF PENNSYLVA } ( SS: ) COUNTY OF CUMBERLAND WE, ~EU.Y t. ULt-tetl and ~-rn/J/JG' I)WCk8- ,the 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 testatrix sign and execute the instrument as her last will; that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our knowledge, the testatrix was at that time 18 or more years of age, of sound mind, and under no constraint or undue influence. ~~ ~ \. l, ';:t \\\. \."h" c\___ ~ ' (~~~ o Y u j WENDY S. C . i?RO, Notary Public lower Allen Twp" Curnberiand Co., PA My Commission Expir.s May 10, 1999 5 v Register of Wills of CUMBERLAND County, Pennsylvania INVENTORY Estate of Jean A. Richards No. 21-01-0305 also known as Date of Death 03/12/2001 , Deceased Social Security No. 201-16 - 6978 Judy C. Mou1, Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I /We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Personal Representative Signature: Wd ~ CJrurvi., . y C Moul Name of Michael L. Bangs Attorney: 1.0. No.: 41263 Address: 302 South 18th Street Camp Hi 11 , PA 17011 Telephone: 717/730-7310 Signature: Address: 1922 Chatham Drive Camp Hill, PA 17011 Telephone: 717/761-5038 Dated: Description Value (See continuation page(s) attached) (Attach additional sheets if necessary) Total: 39,387.04 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. FormflRW-7 (1992) INVENTORY Estate of: Date of Death: County: Jean A. Richards 03/12/2001 Cumberland CASH: Janney Montgomery Scott - Money Market Account 896.84 896.84 STOCKS/LISTED: 9,000.00 shares Janney Montgomery Scott - FHLMC 1519-K Fixed Income Security 8,955.00 3,000.00 shares Janney Montgomery Scott - FHLMC #1464-G Fixed Income Security 3,000.00 5,298.40 shares Prudential Mutual Fund Services, LLC - MoneyMart Assets Fund #11139426 5,298.40 3,619.23 shares Prudential Mutual Fund Services, LLC - MoneyMart Assets Fund #2703512206 3,619.23 1,496.82 shares Prudential Mutual Fund Services, LLC - Active Balance Fund Class A #46773 17,617.57 38,490.20 ---------------- TOTAL RECEIPTS OF PRINCIPAL............... 39,387.04 ---------------- ---------------- -1- /(;-;2/Y -II COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE .r SK- c,/ * BUREAU OF INDIVIDUAL TAXES INHERITANC~ TAX DIVISION DEPT. 286601 HAR~I~BURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX REV-1547 EX AFP (12-00> DATE OF DEATH 03-12-2001 FILE NUMBER 21 01-0305 ~" , -COUNTY CUMBERLAND MICHAEL L BANGS ESQ ACN 101 302 S 18TH ST I Allount Rellitted I CAMP HILL PA 17011 " 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=is4j-Ex-iFP-n'2:00Y-NOYiCE--OF-YNHEiiiTANCi-YAx-'APPR'AisEMENY-,--iLrOWANCi-oi----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF RICHARDS JEAN A FILE NO. 21 01-0305 ACN 101 DATE 07-23-2001 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) (1) .00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) 38,490.20 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Hortgages/Notes Receivable (Schedule D) (4) .00 of this form with your 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) (5) 896.84 tax paYllent. 6. Jointly Owned Property (Schedule F) (6) 4,853.98 7. Transfers (Schedule G) (7) .00 8. Total Assets (8) 44,241.02 APPROVED DEDUCTIONS AND EXEMPTIONS: 12,084.35 9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H) (9) 10. Debts/Hortgage Liabilities/Liens (Schedule I) (10) 442.97 11. Total Deductions (11) 12.527 32 12. Net Value of Tax Return (12) 31,713.70 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax (14) 31, 713.70 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 ~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) .00 X 00 = .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 31, 441. 99 X 045 = 1,414.89 17. Amount of Line 14 at Sibling rate (17) 135.86 X 12 = 16.30 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 135.86 X 15 = 20.38 19. Principal Tax Due (19)= 1,451.57 TAX CREDITS: PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-14-2001 AA496729 .00 1,427.12 PAYMENT MUST BE MADE BY 12-12-2001~. TOTAL TAX CREDIT 1,427.12 BALANCE OF TAX DUE 24.45 INTEREST AND PEN. .00 TOTAL DUE 24.45 !Ii IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A ""CREDIT"" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) DATE ESTATE OF 07-23-2001 RICHARDS JEAN A REV-1470 EX (6-88) . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME INHERITANCE TAX EXPLANATION OF CHANGES FILE NUMBER REVIEWED BY ACN 2101-0305 101 Jean A. Richards John Kuchinski SCHEDULE ITEM NO. EXPLANATION OF CHANGES F 3 Jointly held assets are taxable to the survivors. No deductions can be claimed against joint property, as it was not the responsibility of the survivors to pay the debts. Accordingly, Yz of the decedent's 1/3 interest in this account ($135.86) has been taxed to the sister at the 12% tax rate and the other Yz has been taxed to the niece at the 15% tax rate. ROW Page 1 MICHAEL L. BANGS ATTORNEY AT LAW 302 SOUTH 18TH STREET CAMP HILL, PA 17011 PHONE 717-730-7310 FAX 717-730-7374- E-mail: bangslaw@paonline.com August 13,2001 Mary C. Lewis, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 RE: Estate of Jean A. Richards File No. 21-01-0305 Dear Mrs. Lewis: Enclosed please find a check in the amount of $24.45 to pay the additional inheritance tax shown to be due on the enclosed assessment. Kindly return a paid receipt to me in the enclosed, stamped, pre-addressed envelope. Thank you very much. ,vetMry truly yours, 1/ k, ~iChael L. Bangs wsc Enclosure cc: Mrs. Judy C. Moul <C "" - ~ ~..... ... c x Z ... ~ <C c .. LLJ , "'") > ... " <C 1-4 Z <C >11I ..J:::;) >-Z en III Z> ZIII ilia: Q, u. 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"'0 .f::t- 00..... ;j~ ..... . ..ciS == c Q., 00 El IN ~ ;;u COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: BANGS MICHAEL L 302 S. 18TH STREET CAMP HILL, PA 17011 -------- fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: SSN: 201-16-6978 FILE NUMBER: 21-2001- 0305 DECEDENT NAME: RICHARDS JEAN A DATE OF PAYMENT: 08/14/2001 POSTMARK DATE: 08/13/2001 COUNTY: CUMBERLAND DATE OF DEATH: 03/12/2001 ACN ASSESSMENT CONTROL NUMBER 101 TOTAL AMOUNT PAID: REMARKS: MICHAEL L BANGS ESQUIRE CHECK#1080 SEAL INITIALS: CW RECEIVED BY: REV-1162 EX(11-96) NO. CD 000151 MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS AMOUNT $24.45 $24.45 ~~. 0/' REGISTER OF WILLS OF CUMBERLAND COUNTY REPORT OF STATUS OF ADMINISTRATION (For Resident Decedents Dying after July 1, 1984) ESTATE NO. 21- 01 -- 0305 Name of Decedent: Social Security No.: Jean A. Richards 201-16-6978 Date of Death: March 12,2001 Name of Personal Representative: Judy A. Moul 1922 Chatham Drive Camp Hill, PA 17011 Capacity (check one) Executor Administrator x Administrator c.t.a. Administrator d.b.n. Is the administration of the estate complete? Yes_X_ No If "Yes", how was the administration ended? (check one) By court accounting By account stated to parties in interest X Did the parties release the personal representative? Yes Other (explain) Total amount paid to date to creditors and for funeral and $9,864.89 administrative expenses Total value of distributions to date to beneficiaries $39,827.63 If administration is not complete, estimated value of assets $ still in administration NOTE: This status report is due no later than the due date for filing of the Pennsylvania inheritance tax return or, if no inheritance tax return is required, nine (9) months after the date of death; if the administration of the estate has not been concluded, a summary report shall be filed annually thereafter until the administration is complete. I certify under penalty of perjury that the foregoing information is correct to the best of my knowledge, information and belief. Date: <;;~ ~ 1-0 l FROM : BANGS L~W OFFICE . F~X NO. 717+730+7310 Feb. 11 2003 03:22PM .~4 .. . REGISTER OF WILLS OF CUMBERLAND COUNTY REPORT OF STATUS OF ADMINISTRA nON (For Resident Decedents Dying after July 1, 1984) ESTATE NO. 21- 01 -- 0305 Name of Decedent: Social Security No.: . Jean A. Richards 201-16-6978 ~F'I L E Date of Death: March 12, 2001 Name of Personal Representative: Judy A. Moul 1922 Chatham Drive Camp Hill, PA 17011 Capacity ( check one) Executor _X Administrator Administrator c.t.a. Administrator d.b.n. Is the administration of the estate complete? Yes_X_ No_ If "Yes", how was the administration ended? ( check one) By court accounting By aCcoWlt stated to parties in interest _X_ Did the parties release the personal representative? Yes Other (explain) Total amount paid to date to creditors and for funeral and . $9,864.89 administrative expenses Total value of distributions to date to beneficiaries $39,827.63 If administration is not complete, estimated value of assets $ still in administration NOTE: This status report is due no later than the due date for filing ofthe Pennsylvania inheritance tax return or~ if no inheritance tax return is required, nine (9) months after the date of death; if the administration of the estate has not been concluded, a summary report shall be fIled annually thereafter until the administration is complete. I certify under pe~ty of perjury that the foregoing information is correct to the best of my knowledge, information and belief. Date: <?- 7..1"0 l (;dj)/hd/~ Attorney for Estate MICHAEL Le BANGS ATTORNEY AT LAW 302 SOUTH 18TH STREET CAMP HILL, P A 17011 PHONE 717-730-7310 FAX 717-730-7374- E-mail: bangslaw@paonline.com August 27,2001 Mary C. Lewis, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 RE: Estate of Jean A. Richards File No. 21-01-0305 Dear Mrs. Lewis: Enclosed please find eight (8) Receipts and Releases that I file as a part of the above- referenced estate together with a check in the amount of $56.00 to pay the filing fee. I am also enclosing a Final Status Report indicating that once these documents are filed, the administration of the estate is concluded. Please file this Report accordingly and close your records. If you have any questions or require anything further, please contact me directly. Thank you for your attention to these matters. , Very truly yours, /L/\J\ _, . Michael L. Bangs wsc Enclosures cc: Mrs. Judy C. Moul ...... " ...... c( 0- CJ ~ f cr ~\~ - ~; CD (J) - " 0::: tl: ~ < 'I: ( ,. ~.. ;... -~ ~~I &:': ". ~': td .~ (~~; ... (I) ~ z -< ~ =J .j ~ ~ ~ ~ E -< .s =< \.,.) - ~ r/) :::::: <l) ....... r/) ~ g 4-;~ o 1:: l-4 ;::S E 0 <l) .~ u ta b1) ...... ;::S <l)90"r"l ~:::CI)""" r/)~ g <l) 0 ....... u r/) t- ~ ;::S ...... <l) "0 0 ~~,€<e _;::so-' U. l-4 ~ <l) 0 <l) ;>-...n U ~ l-4 a ....... C\l ;::S <l) "'i:: ~u:::C\l au ,.~ ~..... Ill..... l-< 0 ...t- en..... .s< ;:s~ ...== == o en Q., N = o ~ MU ,..... N ""~ lZi I..., (.'J D <( : ~~. ~ 0-. ft., ~\l~. ~ rz t~ \'r. .... t.~: '~i ,,~. Ii> .,;. ~, l":?;' ~:; ., r'" ..1,. f'""'4 "'0 o l~; t0~;. ..".., It:~~:r -. ESTATE OF JEAN A. RICHARDS, Deceased ) IN THE COURT OF COMMON PLEAS OF ) CUMBERLAND COUNTY, ) PENNSYLVANIA ) ) ORPHANS' COURT DIVISION ) ) NO. 21-01-0305 INRE: RECEIPT AND RELEASE I, MICHAEL J. ULLRICH, guardian for CASSANDRA N. ULLRICH, the undersigned, being a legatee under the Will of JEAN A. RICHARDS, deceased, do hereby: 1. State and acknowledge that I am an adult individual; 2. Waive the filing of an Account or Schedule of Distribution by the personal representative of the Estate; 3. Acknowledge that CASSANDRA N. ULLRICH has received all sums of money to which she is entitled as an heir of the Estate of JEAN A. RICHARDS under Item II(B) of the Will; 4. To the extent of said distribution, release mDY C. MOUL, Executrix, ofthe Estate of JEAN A. RICHARDS, and her heirs and personal representatives, from all liabilities, whether due to her negligence or otherwise, which she may have by reason of her administration of the Estate; 5. Agree to refund to the Estate and to the said mDY C. MOUL, Executrix, any portion ofthe distribution to which I am not properly entitled, and, to the extent of said distribution, to indemnify her and the Estate for claims made against her and to reimburse her and the Estate all expenses and costs incurred in connection with any such claim; and 6. Declare that this instrument shall be legally binding upon me, my personal representatives, and assigns. IN WITNESS WHEREOF, I have hereunto set my hand and seal this '27 day of ;;:;:'u.J r ,2001. LRICH Cassandra N. Ullrich COMMONWEAL TH OF PENNSYLVANIA ) ( SS: COUNTY OF ) On this, the c:2 ~ day of ).,A .A/A Ltr- , 2001, before me, the undersigned officer, personally appearedMid!AEL 'J. ULLRICH, guardian for Cassandra N. Ullrich, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that (s)he executed same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. .~~ NOTARIAL seAL WENDY S. CHeSlRO, Noiary PubIc Lower Allen Twp., Cumberland County Nty Commilllon ExpiNI.<May 10, 2003 ESTATE OF JEAN A. RICHARDS, Deceased ) IN THE COURT OF COMMON PLEAS OF ) CUMBERLAND COUNTY, ) PENNSYLVANIA ) ) ORPHANS' COURT DIVISION ) ) NO. 21-01-0305 RECEIPT AND RELEASE INRE: I, MICHAEL J. ULLRICH, guardian for ZACHARY B. ULLRICH, the undersigned, being a legatee under the Will of JEAN A. RICHARDS, deceased, do hereby: 1. State and acknowledge that I am an adult individual; 2. Waive the filing of an Account or Schedule of Distribution by the personal representative of the Estate; 3. Acknowledge that ZACHARY B. ULLRICH has received all sums of money to which he is entitled as an heir of the Estate of JEAN A. RICHARDS under Item I1(A) of the Will; 4. To the extent of said distribution, release JUDY C. MOUL, Executrix, ofthe Estate of JEAN A. RICHARDS, and her heirs and personal representatives, from all liabilities, whether due to her negligence or otherwise, which she may have by reason of her administration of the Estate; 5. Agree to refund to the Estate and to the said JUDY C. MOUL, Executrix, any portion of the distribution to which I am not properly entitled, and, to the extent of said distribution, to indemnify her and the Estate for claims made against her and to reimburse her and the Estate all expenses and costs incurred in connection with any such claim; and .- 6. Declare that this instrument shall be legally binding upon me, my personal representatives, and assigns. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 2- 7 day of 1/v~5 ( ,2001. (SEAL) COMMONWE'}JiH OF PENNSYLVANIA ~ SS: COUNTY OF llb~ ) On this, the {J 'l;..t( day of ju ~ IA ~ , 2001, before me, the undersigned officer, personally appeared .&11E'~'ULLRICH, guardian for Zachary B. Ullrich, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that (s)he executed same for the purposes therein contained. IN WITNESS WHEREOF, I have here to set my hand and official seal. NOTARW. SEAl WENDY s. CHESIRO. ~fY ~ lower A!Ien Twp.. ~mberiond County Illy CommiMlon ExpI,. Mrciy 10. 2003 =-"-"~~\.',,,,--..-,,,,.,-.:,<,..~_. INRE: ) IN THE COURT OF COMMON PLEAS OF ) CUMBERLAND COUNTY, ) PENNSYLVANIA ) ) ORPHANS' COURT DIVISION ) ) NO. 21-01-0305 ESTATE OF JEAN A. RICHARDS, Deceased RECEIPT AND RELEASE I, JOHN H. RICHARDS, the undersigned, being a legatee under the Will of JEAN A. RICHARDS, deceased, do hereby: 1. State and acknowledge that I am an adult individual; 2. Waive the filing of an Account or Schedule of Distribution by the personal representative of the Estate; 3. Acknowledge that I have received all sums of money to which I am entitled as an heir of the Estate of JEAN A. RICHARDS under Item In(B) of the Will; 4. To the extent of said distribution, release JUDY C. MOUL, Executrix, of the Estate of JEAN A. RICHARDS, and her heirs and personal representatives, from all liabilities, whether due to her negligence or otherwise, which she may have by reason of her administration of the Estate; 5. Agree to refund to the Estate and to the said JUDY C. MOUL, Executrix, any portion of the distribution to which I am not properly entitled, and, to the extent of said distribution, to indemnify her and the Estate for claims made against her and to reimburse her and the Estate all expenses and costs incurred in connection with any such claim; and 6. Declare that this instrument shall be legally binding upon me, my personal representatives, and assigns. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ day of CUj~ ,2001. ~ ~~ . i~'_//.. " - _ i /JOHN H. RICHARDS (SEAL) COMMONWEALTH OF PENNSYLVANIA ) ( SS: COUNTY OF ) On this, the I~ day of CUM u...aL , 2001, before me, the undersigned officer, personally appeared .T5BN H. RICHARDS, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that (s )he executed same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. Notarial Seal Gena K. Fairfax, NJtary Public City of Harrisburg, Dauphin County My Commission Expires Mar. 30, 2002 ~. PenrMll'lveniaAiiQdatiOnof Notari811 INRE: ) IN THE COURT OF COMMON PLEAS OF ) CUMBERLAND COUNTY, ) PENNSYLVANIA ) ) ORPHANS' COURT DIVISION ) ) NO. 21-01-0305 ESTATE OF JEAN A. RICHARDS, Deceased RECEIPT AND RELEASE I, MICHAEL J. ULLRICH, the undersigned, being a legatee under the Will of JEAN A. RICHARDS, deceased, do hereby: 1. State and acknowledge that I am an adult individual; 2. Waive the filing of an Account or Schedule of Distribution by the personal representative of the Estate; 3. Acknowledge that I have received all sums of money to which I am entitled as an heir of the Estate of JEAN A. RICHARDS under Item HI(D) ofthe Will; 4. To the extent of said distribution, release JUDY C. MOUL, Executrix, of the Estate of JEAN A. RICHARDS, and her heirs and personal representatives, from all liabilities, whether due to her negligence or otherwise, which she may have by reason of her administration of the Estate; 5. Agree to refund to the Estate and to the said JUDY C. MOUL, Executrix, any portion of the distribution to which I am not properly entitled, and, to the extent of said distribution, to indemnify her and the Estate for claims made against her and to reimburse her and the Estate all expenses and costs incurred in connection with any such claim; and 6. Declare that this instrument shall be legally binding upon me, my personal representatives, and assigns. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 21 day of A.-tJ.V 51' , 2001. ?t1f! ~ (SEAL) MICHA. . LLRICH COMMONWEAJ1H OF PENNSYL VANIA COUNTYOF l'u~d On this, the ~ day of , 200 I, before me, the undersigned officer, personally appeared I AEL J. ULLRICH, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that (s )he executed same for the purposes therein contained. ) ( ss: ) IN WITNESS WHEREOF, I have here,o set my.. hand ~d official seal. tJA:iA f~~ Notary Public N01A;jAi.-~""":j W!NOY s. CHeseao, !\'<<~'}' ~~. Low. AIen Twp., Q.."Ilibericnd CIiIlU!':t)' My Commls&Ion ExpIreG Meiy 10, 2OV3 INRE: ) IN THE COURT OF COMMON PLEAS OF ) CUMBERLAND COUNTY, ) PENNSYLVANIA ) ) ORPHANS' COURT DIVISION ) ) NO. 21-01-0305 ESTATE OF JEAN A. RICHARDS, Deceased RECEIPT AND RELEASE I, JASON C. RICHARDS, the undersigned, being a legatee under the Will of JEAN A. RICHARDS, deceased, do hereby: 1. State and acknowledge that I am an adult individual; 2. Waive the filing of an Account or Schedule of Distribution by the personal representative of the Estate; 3. Acknowledge that I have received all sums of money to which I am entitled as an heir of the Estate of JEAN A. RICHARDS under Item III(D) of the Will; 4. To the extent of said distribution, release JUDY C. MOUL, Executrix, of the Estate of JEAN A. RICHARDS, and her heirs and personal representatives, from all liabilities, whether due to her negligence or othenvise, which she may have by reason of her administration of the Estate; 5. Agree to refund to the Estate and to the said JUDY C. MOUL, Executrix, any portion of the distribution to which I am not propeJ1y,entitled, and, to the extent of said distribution, to indemnify her and the Estate for claims made against her and to reimburse her and the Estate all expenses and costs incurred in connection with any such claim; and 6. Declare that this instrument shall be legally binding upon me, my personal representatives, and assigns. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 'terN day of /4l.J C, (/ s-( , 2001. ~.r--~(SEAL) o . CHARDS MICHELLE GILMORE Notary PubRc . N8Wlda No. 98-1381-1 My appt. e>q:l. Apt. 1, 2002 STATE OF NEVADA ) ( SS: COUNTY OF C/o../I< ) On this, the ~ day of /t,;~ ,2001, before me, the undersigned officer, personally appeared JA~ RICHARDS, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that (s )he executed same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. Notary Public ," INRE: ) IN THE COURT OF COMMON PLEAS OF ) CUMBERLAND COUNTY, ) PENNSYLVANIA ) ) ORPHANS' COURT DIVISION ) ) NO. 21-01-0305 ESTATE OF JEAN A. RICHARDS, Deceased RECEIPT AND RELEASE I, JUDY C. MOUL, the undersigned, being a legatee under the Will of JEAN A. RICHARDS, deceased, do hereby: 1. State and acknowledge that I am an adult individual; 2. Waive the filing of an Account or Schedule of Distribution by the personal representative of the Estate; 3. Acknowledge that I have received all sums of money to which I am entitled as an heir of the Estate of JEAN A. RICHARDS under Item III(C) of the Will; 4. To the extent of said distribution, release JUDY C. MOUL, Executrix, of the Estate of JEAN A. RICHARDS, and her heirs and personal representatives, from all liabilities, whether due to her negligence or otherwise, which she may have by reason of her administration of the Estate; 5. Agree to refund to the Estate and to the said JUDY C. MOUL, Executrix, any portion of the distribution to which I am not properly entitled, and, to the extent of said distribution, to indemnify her and the Estate for claims made against her and to reimburse her and the Estate all expenses and costs incurred in connection with any such claim; and I 6. Declare that this instrument shall be legally binding upon me, my personal representatives, and assigns. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 15 day of Au 31.L6f ,2001. ~(l/r\nuL Y C OUL (SEAL) COMMONWEALTH OF PENNSYLVANIA COUNTY OF CwYtberla.ncJ.-- ) ( SS: ) Notarial Seal Sherrie A. Shindel, Notary Public Camp Hill Boro, Cumberland County My Commission Expires May 31, 2004 On this, the \ ~ day of ~ lA.& -t , 2001, before me, the undersigned officer, personally appeared Y C. MOUL, known to me (or satIsfactonly proven) to be the person whose name is subscribed to the within instrument and acknowledged that (s)he executed same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. ~a.~ Notary Public .' INRE: ) IN THE COURT OF COMMON PLEAS OF ) CUMBERLAND COUNTY, ) PENNSYLVANIA ) ) ORPHANS' COURT DIVISION ) ) NO. 21-01-0305 ESTATE OF JEAN A. RICHARDS, Deceased RECEIPT AND RELEASE I, CINDY M. BARKDOLL, the undersigned, being a legatee under the Will of JEAN A. RICHARDS, deceased, do hereby: 1. State and acknowledge that I am an adult individual; 2. Waive the filing of an Account or Schedule of Distribution by the personal representative of the Estate; 3. Acknowledge that I have received all sums of money to which I am entitled as an heir of the Estate of JEAN A. RICHARDS under Item III(D) ofthe Will; 4. To the extent of said distribution, release JUDY C. MaUL, Executrix, of the Estate of JEAN A. RICHARDS, and her heirs and personal representatives, from all liabilities, whether due to her negligence or otherwise, which she may have by reason of her administration ofthe Estate; 5. Agree to refund to the Estate and to the said JUDY C. MaUL, Executrix, any portion of the distribution to which I am not properly entitled, and, to the extent of said distribution, to indemnify her and the Estate for claims made against her and to reimburse her and the Estate all expenses and costs incurred in connection with any such claim; and 6. Declare that this instrument shall be legally binding upon me, my personal representatives, and assigns. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ! lu day of ----1\u Gus "1 \ , 2001. M~tv1~ C DY . BARKDOLL (SEAL) COMMONWEALTH OF PENNSYLVANIA COUNTYOFCw~ On this, the ) l.tJ +tA. day of , 2001, before me, the undersigned officer, personally appeared C Y M. BARKDOLL, known to me (or satisfactorily proven) to be the person whos e is subscribed to the within instrument and acknowledged that (s)he executed same for the purposes therein contained. ) ( SS: ) IN WITNESS WHEREOF, I have ereunto set my hand and official seal. :rARIAL seAL WENDY S. CHESBRO, NoIory PuWIc: Lower Allen Twp., CumborIand County My CommiNlon Exp!Nt INfo; 10, 2003 INRE: ) IN THE COURT OF COMMON PLEAS OF ) CUMBERLAND COUNTY, ) PENNSYLVANIA ) ) ORPHANS' COURT DIVISION ) ) NO. 21-01-0305 ESTATE OF JEAN A. RICHARDS, Deceased RECEIPT AND RELEASE I, VICKIE J. BARKDOLL, the undersigned, being a legatee under the Will of JEAN A. RICHARDS, deceased, do hereby: 1. State and acknowledge that I am an adult individual; 2. Waive the filing of an Account or Schedule of Distribution by the personal representative of the Estate; 3. Acknowledge that I have received all sums of money to which I am entitled as an heir of the Estate of JEAN A. RICHARDS under Item III(A) ofthe Will; 4. To the extent of said distribution, release JUDY C. MaUL, Executrix, of the Estate of JEAN A. RICHARDS, and her heirs and personal representatives, from all liabilities, whether due to her negligence or otherwise, which she may have by reason of her administration of the Estate; 5. Agree to refund to the Estate and to the said JUDY C. MOUL, Executrix, any portion of the distribution to which I am not properly entitled, and, to the extent of said distribution, to indemnify her and the Estate for claims made against her and to reimburse her and the Estate all expenses and costs incurred in connection with any such claim; and - 6. Declare that this instrument shall be legally binding upon me, my personal representatives, and assigns. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 110 day of !)lfM~ ,2001. 'tJ~Cl ~ (SEAL) VICKIE J~ARKDOLL COMMONWEA71H O. F PENNSYLVANIA COUNTY OF lli On this, the ILR~ day of , 2001, before me, the undersigned officer, personally appeared VI E 1. BARKDOLL, known to me (or satisfactorily proven) to be the person whose e is subscribed to the within instrument and acknowledged that (s)he executed same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. () NOTAItIAL SEAL WENDY s. CHESIRO, NGIary PuYe ...,.... AIen Twp., CumlMrIand County 11ft CoMmIIIIon ExpIresMa110, 2003 '\. /t-~/'-II 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-l'07 EX AFP 112-001 MICHAEL L BANGS ESQ 302 S 18TH ST CAMP HILL P.A 17011 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-17-2001 RICHARDS 03-12-2001 21 01-0305 CUMBERLAND 101 JEAN A AlIOunt Relli Heel 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 forll with your tax pay.ent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ... REY=i6o'-i3f-AFP--n'2-:0oy------...--fNiiERITANcE--fAx--STA-fEME-tif-cfF'-Accouiif--.-..--------------------- ESTATE OF RICHARDS JEAN A FILE NO. 21 01-0305 ACN 101 DATE 09-17-2001 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-23-2001 PR I NCI PAL TAX DUE: ........................................................................................................................................................................................................................... 1,451.57 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-14-2001 AA496729 .00 1,427.12 08-13-2001 CDOOO151 .00 24.45 TOTAL TAX CREDIT 1,451.57 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IE IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )