The URL can be used to link to this page

Home My WebLink About01-0477 PETITION FOR PROBATE and GRANT OF LETTERS Estate of MARY H. TAYLOR No. also known as , Deceased. To: 21-01-477 Register of Wills County of Cumberland in the Commonwealth of Pennsylvania Social Security No. 198 -14 -1548 The petition of the undersigned respectfully represents that: Your petitioner, who is 18 years of age or older, is the personal representative named in the last will of the above decedent, dated April 16, 1997. Decedent was domiciled at death in LOWER ALLEN TOWNSHIP, Cumberland County, Pennsylvania, with her last family or principal residence at 139 Columbia Road, Enola, Cumberland County, Pennsylvania 17025. Decedent, then 80 years of age, died April 20, 2001, at Bethany Village, Mechanicsburg, Cumberland County, Pennsylvania. 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. Decedent at death owned property with estimated values as follows; (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: TOTAL $ 38,300.00 $ $ $ 61,900.00 $ 100,192.00 WHEREFORE, petitioner respectfully requests the probate of the last will presented herewith and the grant of letters testamentary thereon. ~ 'Y\J,~ PHILIP N. TA LOR 3542 Schoolhouse Lane Harrisburg, PA 17109 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND The petitioner above-named swears that the statements in the foregoing petition are true and correct to the best of the knowledge of petitioner and that as personal representative of the above decedent petitioner will well and truiy administer the eS~ing to law. + Sworn to and subscribed 1) . 3 before me this ~ day of PHILIP N. TAYLOR May, 2001. Register I Co - ~ 30 - ) "3 Estate of MARY H. TAYLOR, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW, May 16 , 2001, in consideration of the petition attached hereto, satisfactory proof having been presented before me, IT IS DECREED that the instrument dated April 16, 1997, described therein, be admitted to probate and filed of record as the last will of MARY H. TAYLOR, Letters Testamentary are hereby granted to PHILIP N. TAYLOR. Register of Wills FEES Probate, Letters, Etc. $ 235.00 Short Certificates $ 18.00 HAROLD S. IRWIN III (I Renunciation $ 35 East High Street x-pa<;res & J~ $ 11.00 Carlisle, PA 17013 TOTAL $ 264.00 Filed: May 16,2001 717 -243-6090 HI05.80S REV 9/8(1 This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the Srate Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. 21-01-477 No. ,7.~? vi;::: Fee for this certificate, $2.00 p 7296823 AE.R 2 3 2001 Date \'J \o..V-\ w t~ I. ( 5. '43 Rev. 2181 COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECOROS CERTIFICATE OF DEATH _OF DECEDEHTlfw... _. ,..., .. Mary H. Taylor _llOllIlinn<loyt UNDER'YEAIl - lleyo SEX lemale $TAlE Fill: NlNKR SOC,.... SECuR1T"t NUMBER ..198 - 14 - 1548 DAlE OF CEAl'H ._. 0.... ._, 4Apr . 20,2001 CUmberland Co. UNDER . OM -!- lIlRTHPlACE (c..,""" Stale Of fCfe.gn COUf'lII'YJ =""0 DECEDEHT'SUSUAl.~ (Giooe_.._dOnOdulona.- h ........; do....... ,_ell, ousew~re " 111t. lIECEIlEHT'S lIAlllHG AOORESS (51<... 00,1bon. SIaIt. Z..C~ 325 Wesley Dr. Mechanicsburg, PA 17055 own hane l'WIllt'CEllt'NT E\lER IN u.s. ARMED FORCES? ...0 No~ E~ .~. IWUTAl swus._ --.-. wi~">l ... .7..0 _.__.. SUAIIMNG SPOUSE (I.... QMI tNMden I'IWnef .e. MrHEJI'S_IF...._. LUll . Jerry INfOIlIoIAHrS_ (T_....., Donna Marshalek IlETHOO OF llt'CEllt'NT'S ACTUAl. RESlOENCE lSeo..-- on oINt...~ ".. _ ppnn!':y1 vrmi '" Cumber land Did - ""in. _? .... '7l>. ".. 110.-=,=.. Lower Allen MOT~"1'lan~~s.........) . IIll' 03 ~~":";~~urg,PA17055 PlACE OF llISI'OIlITION. _..~. Cl_ lOCRlON.~ _.:tIpCodo i~rantown Gap Nat. Cern. Annville,PA17003 21c. 21 . ""-". Machek 01 .. D!A-IlI tA/.2CItl/rMA. --tta6afr1k DUE 10 (OIl AS A COHSEQUEHCE Of): I~ . inIemlI....... : GftMI and i 1tAA. PART .: I: DUE 10 toR AS A COHSEOUENCE Ofl: DUE 10 (OIl AS A COHSEOUEHCE Of): WEllE AUTOPSYF..-s MAHNEROFDE;;;-- -..eLEPAlDAlO COMPlETION OF CAUSE 0 OF !lEAI'H? -.. ........... -.. 0 -..~ 0 YooO NoD - 0 Couki noI be deIen'ntned 0 DAlE OF INJURY 1-. Day. -, TIME OF INJURY INJURY RWQAK? DESCRI8E HOW INJURY OCCURAEO. Yoo 0 NoD -- -- _f~"""'cnoI .CIII1'_PllY_(Ph_c~_"_ __ _.......Ill('nc..ncod_onoCompIOIfOd_Z31 Te..._oI...,................._.........._.lond................... .......................... ....... ... '" ....... ..... 8. . ... PlACE OF INJURy. At home. tarm. saf'HI. tldofy. oMce lI<>iIcIing....._, _. *flRONOUNCIHG AND CEftllfYINQ PWlSICIAN (Physoan boItl j)fOOOUOClnO 0NI1 ~ c~ to cause at oealhl 1'o........OII..y ..............occWNCf............... andpteu., aftCI d.""" ltauMt.) and manne'......ICI.. ........................ ..ulCAL EllAIIINEllICOROHER =~..::::.~~.~':':~~~~~t~:~~..,.~.~:~~~~~~ ~~~~..~~t~~~.~~~~ ~.~~~~~~~).~ 0 ~1L REGlSTIWl'SSIClNJllUlIE ~ >>~ ft2 ~~__#,)-,-: ~/'<I/.( I 34 LAST WILL AND TESTAMENT I, MARY H. TAYLOR, of 139 Columbia Road, Enola, Cumberland, Pennsylvania 17025 do hereby make, publish and declare this to be my last will and testament, hereby revoking all wills heretofore made by me. 1. I direct my personal representative to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. 2. I authorize and empower my personal representative to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefor, in fee simple, as I could do if living. My representative is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said representative. 3. I give, devise and bequeath all of my estate of whatever nature and wherever situate to my spouse, Peryl T. Taylor. 4. If my spouse does not survive me by a period of at least sixty (60) days, then my estate I give, devise and bequeath to my children, Donna Marshalek, Pearl Marie Harms, Mary Richards, Jerry T. Taylor, Philip N. Taylor, and Carol A. Wagner, share and share alike, or the survivors thereof 5. I nominate and appoint my son, Philip N. Taylor, to be the personal representative of my estate, to serve without bond. If he cannot or does not serve, then I appoint my son, Jerry T. Taylor, to be the substitute personal representative, also without bond. 6. I suggest that my personal representative retain the services of Harold S. Irwin, III, Carlisle, Pennsylvania in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ day of April, 1997. ~~.~A~ (SEAL) Signed, sealed, published and declared by the above-named person as and for a last will and testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as subscribing witnesses. e#-~~/ II,J}t$7J q ACKNOWLEDGMENT AND AFFIDAVIT WE, MARY H. TAYLOR, GAY L. IRWIN and JOY S. ZERANCE, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her last will and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. /Jtt /J ~ MAR~TAYLQ1{ ~A;~/ COMMONWEALTH OF PENNSYLVANIA :ss: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by MARY H. TAYLOR, the testatrix herein, and subscribed and sworn to before me by GAY L. IRWIN and JOY S. ZERANCE, witnesses, this ~ day of April, 1997. Notarial Seal Harold $. Irwin III, Notary Public Carlisle Boro, Cumberland County My Commission Expires Sept. 14, 1998 Member, Pen. ,,,;;~iiJlia'AssOCiation of Notaries E - CERTIFICATE OF NOTICE UNDER RULE 5.6(!!l Name of Decedent: TAYLOR, MARY H. Date of Death: APRIL 20, 2001 Will No. 2001-0477 Admin. No. 21-01-0477 To the Register: I certify that notice of beneficial interest or estate administration required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on May 24, 2001. Name Address PHILIP N. TAYLOR 3542 SCHOOLHOUSE LANE HARRISBURG PA 17109 DONNA MARSHALEK 903 COCKLIN STREET MECHANICSBURG PA 17055 PEARL MARIE HARMS 691 LASH ROAD SHERMANSDALE PA 17090 MARY RICHARDS 644 GATES LANE ENOLA PA 17025 JERRYT. TAYLOR 100 BERWYN DRIVE HARRISBURG PA 17112 CAROL A. WAGNER 6486 HEATHERFIELD WAY HARRISBURG PA 17112 Notice has now been given to all persons entitle thereto under Rule 5.6(a) except: None May 24, 2001 35 East High Street, Carlisle, PA 17013 717.243.6090 Attorney for Estate of Mary H. Taylor Inventory of the real and personal estate of MARY H. TAYLOR, deceased 1. HOUSE AND LOT AT 139 COLUMBIA ROAD, ENOLA, PA 17025 (Value based on $ 61,900 00 sale price negotiated prior to death of decedent) 2. TAX PRO-RAnON FROM SALE OF HOME 16 49 3. SEWER I TRASH PRO-RATION FROM SALE OF HOME 3 54 4. PNC TRUST - Pre-paid funeral fund 4,75 00 5. PNC BANK - Checking Account No. 51-4010-9801 (Value based on '/z date of death balance - jointly owned with one daughter) 4,832 72 6. PNC BANK - Money Market Account No. 50..Q350.2797 (Value based on 1/3 date of death balance - jointly owned with two daughters) 14,618 21 7. THE VANGUARD GROUP - Money Market Account No. 9938512250 (value based 14,014 43 on 1/3 date of death balance - jointly owned with two daughters) _. .. , .. "... TOTAL $ 1 00,321 39 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 IRWIN HAROLD S III 35 EAST HIGH STREET SUITE 201 CARLISLE, PA 17013 -------- fold ESTATE INFORMATION: SSN: 1 98- 14- 1 548 FILE NUMBER: 21-2001- 0477 DECEDENT NAME: TAYLOR MARY H DATE OF PAYMENT: 07/05/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 04/20/2001 NO. CD 000015 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $3,506.31 I I I I I I I I TOTAL AMOUNT PAID: $3,506.31 REMARKS: HAROLD S IRWIN ESQ CHECK# 4216 SEAL INITIALS: DO RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS IG~ - ;Ide) --13 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT HAROLD S IRWIN STE 201 202 35 E HIGH ST CARLISLE DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN c;t '* C-/ REV-I'D? EX AFP (!2-DDl 08-06-2001 TAYLOR 04-20-2001 21 01-0477 CUMBERLAND 101 MARY H Allount Rellitted PA,17013 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 ~ REV=i61fj-e3r-AFP--fi2"=ocir------...--iNifERITANCE-YA3r-STATEMENY-ifF'-ACCOU'NT--...--------------------- ESTATE OF TAYLOR MARY H FILE NO. 21 01-0477 ACN 101 DATE 08-06-2001 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: 07-30-2001 P R I NC I PAL TAX DUE: ................._...................._..........._.................................__........................................................................................................................_.._.. PAYMENTS (TAX CREDITS): 3,690.85 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 07-05-2001 CDOOOO15 184.54 3,506.31 TOTAL TAX CREDIT 3,690.85 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 .. SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. 1 \'/b-~~-^3 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX HAROLD S IRWIN STE 201 202 35 E HIGH ST CARLISLE DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-06-2001 TAYLOR 04-20-2001 21 01-0477 CUMBERLAND 101 *' RE~-1547 EX AFP Cl~-aol MARY H AlIOunt Remitted PA 17.013 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 ~ ii"fi=is4;-'Ex-iFP-n'2-:00Y-NOYic'E--OF-YNHEifiTANCE-YAX-A-ppi7risEifENi'-:--iLioWANCE-O"R----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF TAYLOR MARY H FILE NO. 21 01-0477 ACN 101 DATE 08-06-2001 TAX RETURN WAS: (X) ACCEPTED AS FILED CHANGED NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: IS. AlIOUnt of Line 14 at Spousal rate (IS) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. A..ount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due T X C DIT AY ENT DISC (+) DATE INTEREST/PEN PAID (-) .00 X 00 = .00 82,018.88 X 045 = 3,690.85 .00 X 12 = .00 .00 X 15 = .00 (9)= 3,690.85 AMOUNT PAID RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets U) (2) (3) (4) (S) (6) (7) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad... 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) 61.900.00 .00 .00 .00 4,956.03 33,465.36 .00 (8) 14,301.81 4,000.70 Ul) (2) (3) (14) TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE PAYMENT MUST BE MADE BY 01-20-2002*. * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. NOTE: To insure proper credit to your account, submit the upper portion of this forll with your tax paYllent. 100,321.39 18.302 51 82,018.88 .00 82,018.88 .00 3,690.85 .00 3,690.85 ( 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 THT~ ~nDM ~nD TU.,................... . !~;---d3{) -- /3 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT sl- C/ REV-ln7 EX AFP (l2-0D) HAROLD S IRWIN STE 201 202 35 E HIGH ST CARLISLE DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-13-2001 TAYLOR 04-20-2001 21 01-0477 CUMBERLAND 101 MARY H Amount Remitted C". PA' 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=i6cfj-E3f-AFP-fi'2=iioY------...--INHERITANc'E-YAX--STAfE~iENY-b-F-Ac-coriNT--._i.--------------------- ESTATE OF TAYLOR MARY H FILE NO. 21 01-0477 ACN 101 DATE 08-13-2001 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: 07-30-2001 PRINCIPAL TAX DUE: __________ 3,690.85 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 07-05-2001 CDOOOO15 184.54 3,506.31 TOTAL TAX CREDIT 3,690.85 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 IE 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. ) \ /b -02&:J- P' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLONANCE OR DISALLONANCE OF DEDUCTION~, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-15(8 EX /.Fp tl2-DD) DONNA M MARSHAL~K 903 COCKLIN ST MECHANICSBURG PA 17055 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 10-01-2001 TAYLOR 04-20-2001 21 01-0477 CUMBERLAND 198-14-1548 01002590 AlIOunt Ralli Had MARY H 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 ~ ii[i=isi;i-i)f-AFii-fi1f=ool------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 10-01-2001 ESTATE OF TAYLOR MARY H DATE OF DEATH 04-20-2001 COUNTY CUMBERLAND FILE NO. 21 01-0477 TAX RETURN WAS: 5.S/D.C. NO. 198-14-1548 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01002590 FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 5003502797 TYPE OF ACCOUNT: (X> SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 12-27-1999 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 43,854.62 0.166 7,309.25 .00 7,309.25 .45 328.92 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) PAYMENT MUST BE MADE BY 01-21-2002~. TOTAL TAX CREDIT .00 BALANCE OF TAX DUE 328.92 INTEREST AND PEN. .00 TOTAL DUE 328.92 . IF PAID AFTER THIS DATE, SEE REVERSE 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. "'~P" ftra......._.. -..-... -po -..-- ---... --- -....-.--..------- - L STATUS REPORT UNDER RULE 6.12 Name of Decedent: MARY H. TAYLOR Date of Death: APRIL 20, 2001 Will No. 21 - 01 - 0477 Admin No. 2101 - 0477 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above- captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to NO.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: N/A c. Did the personal representative state an account informally to the parties in interest? Yes X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached t . this eport. November 13, 2001 Harold S. Irwin, III Attorney for Estate 35 East High Street Carlisle, PA 17013 717 -243-6090 ~ REV-1500 EX (6-00) CO~'MONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV.1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY / t:> - ;;( :2 ~- I 3 FILE NUMBER . 21 COUNTY CODE 01 YEAR 0477 NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) TAYLOR, MARY H. SOCIAL SECURITY NUMBER DATE OF DEATH DATE OF BIRTH 198 -14 -1548 APRIL 20, 2001 JUNE 14, 1920 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER l1. Original Return _ 2, Supplemental Return 4. Limited Estate _ 4a. Future Interest Compromise (for dates of death after 12-12-82) _ 7. Decedent Maintained a Living Trust (Attach copy of Trust) _ 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 3. Remainder Return (dates of death prior to 12-13-82) 5. Federal Estate Tax Return Req X 6. Decedent Died Testate - (Attach copy of Will) EX. A 9. Litigation Proceeds Received _ 8. Total No. of Safe Deposit Boxes 11. Election to tax (Sec. 9113(A)) (Attach Sch 0) NAME HAROLD S. IRWIN, III TELEPHONE NUMBER 717-243-6090 1. Real Estate (Schedule A) COMPLETE MAILING ADDRESS 35 EAST HIGH STREET, SUITES 201/202 CARLISLE, PA 17013 (1) OFFICIAL USE 0 2. Stocks and Bonds (Schedule B) (2) 61,900.00 0.00 0.00 0.00 4,956.03 ,~ 33,465.36 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages and Notes Receivable (Schedule D) (4) 5. Cash, Bank Dep & Mise Personal Property (Sched E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers / Misc. Property(Schedule G) (Schedule L) (7) 8, Total Gross Assets (total Lines 1-7) 10. Debts, Mortgage Liabilities & Liens (Schedule I) (8) 100,321.39 (9) 14,301.81 (10) 4,000.70 (11) 18,302.51 (12) 82,018.88 (13) 0.00 (14) 82,018.88 x. - = (15) 0.00 $82,018.88 x .045 = (16) 3,690.85 x .12 = (17) 0.00 $ x .15 = (18) 0.00 (19) 3,690.85 9. Funeral Expenses & Administrative Costs (Sched H) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests (schedule J) 14. Net Value Subjectto Tax (Line 12 minus Line 13) 15. Amount of line 14 taxable at the spousal rate 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 I :~' Com~ote A'''''''' 1,39 COLUMBIA ROAD . ENOLA I ~T~TE Tax Payments and Credits: 1. Tax Due (Page 1 Line 18) 2. Credits I payments A. Spousal Poverty Credit B. Prior Payments C. Discount $184.54 I ~';025 1 (1) $ 3.690.85 Total Credits (A+B+C) (2) $ 184.54 3. Interest I Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (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. II Line 1 + Line 3 is greater than Line 2. enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. (5A) (5) $3.506.31 B. Enter the totai 01 Line 5+5A. This is the BALANCE DUE. (5B)$3.506.31 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use of 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 on or before December 123, 1982, did decedent within two years preceding death transfer property without receiving adequate consideration? If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................... 3. Old decedent own an "In trust for" or payable upon death bank account or security at his or her death? ...................................................................................................... 4. Old decedent own an individual retirement account, annuity, or other non-probate property? ...... No ---1L ~ ~ ~ N/A ~ -1L 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 pe~ury, I declare that I 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 preparer other than personal representative is based on all infonnatlon of which pre parer has any knowledge. SIG LE FOR FILING RETURN ;/9 DATE JUNE , 2001 NE, HARRISBURG, PA 17109 Ol: N PERSONAL REPRESENTATIVE '7ADATE CARLI LE, PA 17013 JUNE .v { ,2001 For dates of death on or after ,994 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 P.S. Section 9116 (a)(1.1)(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 .5. Section 9116 (a)(1.1 )(Ii)]. The statute does not exemot 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. Section 9116 (a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedenfs lineal beneficiaries is 4.5%, except as noted In 72 P .5. Section 9116 (1.2)[72 P.S. Section 9116 (a)(1)). The tax rate imposed on the net value oltranslers to or lor the use 01 the decedenrs siblings is 12% [72 P.S. Section 9116 (a)(l.3)). A sibling Is deflned. under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX + (12-85) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MARY H. TAYLOR 2001 - 0477 (Property jointly-owned with Right of Survivorship must be disclosed on Schedule F) All real estate should be reported at fair market value which is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. ITEM DESCRIPTION NUMBER SCHEDULE A REAL ESTATE VALUE AT DATE OF DEATH 1. HOUSE AND LOT AT 139 COLUMBIA ROAD, ENOLA, PA 17025 (Value based on sale price negotiated prior to death of decedent. See HUD-1 settlement statement attached as Exhibit "B") $ 61,900.00 TOTAL (Also enteron Line 1, Recapitulation) $ 61,900.00 (If more space is needed, inserladditionaJ sheets of same size.) REV-1503 EX + (4-86) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MARY H. TAYLOR (All property jolntly-owned with Right of Survivorship must be disclosed on Schedule F.) ITEM DESCRIPTION NUMBER SCHEDULE B STOCKS AND BONDS FILE NUMBER 2001 - 0477 VALUE AT DATE OF DEATH NONE TOTAL (Also enter on Line 2, Recapitulation) NONE (If more space is needed, insert additional sheets of same size.) REV-1504 EX + (3-92) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MARY H. TAYLOR ITEM NUMBER NONE SCHEDULE C CLOSELY HELD STOCK PARTNERSHIP AND PROPRIETORSHIP FILE NUMBER 2001 - 0477 DESCRIPTION TOTAL (Also enter on Line 3. Recapitulation) (If more space is needed. insert additional sheets of same size.) VALUE AT DATE OF DEATH NONE REV-1507 EX + (6-86) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES AND NOTES RECEIVABLE ESTATE OF MARY H. TAYLOR (All property jointly-owned with Right of Survivorship must be disclosed on Schedule F.) ITEM DESCRIPTION NUMBER FILE NUMBER 2001 - 0477 VALUE AT DATE OF DEATH NONE TOTAL (Also enter on Line 4, Recapitulation) NONE (If more space is needed, insert additional sheets of same size.) REV-1508 EX + (2-87) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY ESTATE OF MARY H. TAYLOR (All property jointly-owned with Right of Survivorship must be disclosed on Schedule F.) ITEM DESCRIPTION NUMBER FILE NUMBER 2001 - 0477 VALUE AT DATE OF DEATH 1. PNC TRUST - Pre-paid funeral fund (Value based on statement attached at Exhibit "e") $ 4,750.00 2. TAX PRO-RATION FROM SALE OF HOME 163.49 3. SEWER I TRASH PRO-RATION FROM SALE OF HOME 36.54 TOTAL (Also enter on Line 5, Recapitulation) $ 4,956.03 (If more space is needed, insert additional sheets of same size.) REV-1509 EX + (12-88) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MARY H. TAYLOR SCHEDULE F .JOINTLY.OWNED PROPERTY FILE NUMBER 2001 - 0477 Joint tenant(5): NAME ADDRESS RELATIONSHIP TO DECEDENT A. DONNA M. MARSHALAK 903 COCKLIN STREET MECHANICSBURG PA 17055 DAUGHTER B. CAROL A. WAGNER 6486 HEATHERFIELD WAY HARRISBURG, PA 17112 DAUGHTER c. Jolnlly-owned property. ITEM LETTER DATE DESCRIPTION OF PROPERTY TOTAL DECO'S DOLLAR NO. FOR MADE VALUE % INT. VALUE OF JOINT JOINT OF ASSET DECEDENT'S TENANT INTEREST 1. A. 01/18/00 PNC BANK- Checking Account No. 51-4010-9801 (Value based on statement attached as Exhibit "D") $ 9,665.43 50% $ 4,832.7 2. AlB 12/27/99 PNC BANK - Money Market Account No. 50-0350-2797 (Value based on statement attached as Exhibit "D") 43,854.62 331/3% 14,618.2 3. AlB 01/02/00 THE VANGUARD GROUP - Money Market Account No. 9938512250 (value based on statement attached as Exhibit "En) 42,043.28 331/3% 14,014.4 TOTAL (Also enter on line 6, Recapitulation) $ 33,485.36 (If more space ;s needed, insert additional sheets of same size.) REV-151Q EX + (2-87) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MARY H. TAYLOR 2001 - 0477 THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OF THE COVER SHEET IS YES. SCHEDULE G TRANSFERS ITEM DESCRIPTION OF PROPERTY EXCLUSION TOTAL DECD.'S DOLLAR NUMBER Include name of/he transferee, their relationshIp to decedent, date of transfer VALUE %OFINT. VALUE OF OF ASSET DECEDENT'S INTEREST NONE TOTAL (Also enter on Line 7, Recapitulation) NONE (If more space is needed. insert additional sheets of same size.) REV-1511 EX + (7-88) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES ESTATE OF MARY H. TAYLOR FILE NUMBER 2001 - 0477 ITEM DESCRIPTION AMOUNT NUMBER A. Funeral Expenses: 1. MUSSELMANS FUNERAL HOME $ 4,750.00 2. REV. TERRY FORD 75.00 3. OLD COUNTRY BUFFET 194.47 4. B. Administrative Costs: 1. Personal Representative Commissions: Social Security Number of Personal Representative:: Year Commissions Paid: 2. Attorney Fees: HAROLD S. IRWIN, III 3,009.64 3. Family Exemption: Claimant Relationship Address of Claimant at decedent's death: Street Address City State Zip Code 4. Probate Fees: REGISTER OF WILLS 264.00 C. Miscellaneous Expenses: 1. REGISTER OF WILLS - File Inventory and Appraisement 25.00 2. HAROLD S. IRWIN, III - Notary Fees 15.00 3. 2001 COUNTVITOWNSHIP REAL ESTATE TAXES 187.50 4. TERMITE TREATMENT AT RESIDENCE 551.20 5. RSR I REAL TV EXECUTIVES - Real Estate Commission 4,333.00 6. RSR - Transaction Fee 75.00 7. HAROLD S. IRWIN, III - Attorney Fee on Sale of Home 200.00 8. SECURED LAND TRANSFERS - Tax Certification 3.00 9. RECORDER OF DEEDS - Real Estate Transfer Taxes 619.00 10. 11. 12. 13. 14. 15. 16. 17. TOTAL (Also enter on Line 9, Recapitulation) $ 14,301.81 (If more space is needed, insert additional sheets of same size.) REV-1512 EX + (1-93) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MARY H. TAYLOR ITEM NUMBER SCHEDULE I DEBTS OF DECEDENT, MORTGAGES, LIABILITIES AND LIENS FILE NUMBER 2001 - 0477 DESCRIPTION AMOUNT 1. 2. 3. BETHANY VILLAGE - Nursing Home Bills ALERT PHARMACY - Medical Bills $ 3,795.36 30.02 UTILITY BILLS 175.32 TOTAL (Also enteron Line 10. Recapitulation) $ 4,000.70 (If more space is needed, insert additional sheets of same size,) REV-1513 EX + (2-87) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MARY H. TAYLOR SCHEDULE J BENEFICIARIES FILE NUMBER 2001 - 0477 ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR NUMBER SHARE OF ESTATE A. Taxable Bequests: 1. DONNA M. MARSHALAK DAUGHTER 1/6 RESIDUE 903 COCKLIN STREET MECHANICSBURG PA 17055 2. PEARL MARIE HARMS DAUGHTER 1/6 RESIDUE 691 LASH ROAD SHERMANSDALE PA 17090 3. MARY RICHARDS ITA YLOR) DAUGHTER 1/6 RESIDUE 644 GATES LANE ENOLA PA 17025 4. JERRYT. TAYLOR SON 1/6 RESIDUE 100 BERWYN DRIVE HARRISBURG PA 17112 5. PHILIP N. TAYLOR SON 1/6 RESIDUE 3542 SCHOOLHOUSE LANE HARRISBURG PA 17109 6. CAROL A. WAGNER DAUGHTER 1/6 RESIDUE 6486 HEATHERFIELD WAY HARRISBURG PA 17112 ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE B. Charitable and Governmental Bequests: NONE TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on Line 13, Recapitulation) NONE (If more space is needed. insert additional sheets of same size.) . ""' ., LAST WILL AND TESTAMENT I, MARY H. TAYLOR, of 139 Columbia Road, Enola, Cumberland, Pennsylvania 17025 do hereby make, publish and declare this to be my last will and testament, hereby revoking all wills heretofore made by me. I. I direct my personal representative to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. 2. I authorize and empower my personal representative to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefor, in fee simple, as I could do if living. My representative is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said representative. 3. I give, devise and bequeath all of my estate of whatever nature and wherever situate to my spouse, Peryl T. Taylor. 4. If my spouse does not survive me by a period of at least sixty (60) days, then my estate I give, devise and bequeath to my children, Donna Marshalek, Pearl Marie Harms, Mary Richards, Jerry T. Taylor, Philip N. Taylor, and Carol A. Wagner, share and share alike, or the survivors thereof. , '. , S. I nominate and appoint my son, Philip N. Taylor, to be the personal representative of my estate, to serve without bond. If he cannot or does not serve, then I appoint my son, Jerry T. Taylor, to be the substitute personal representative, also without bond. 6. I suggest that my personal representative retain the services of Harold S. Irwin, ill, Carlisle, Pennsylvania in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this .i(;!:. day of April, 1997. .";7~ Lf ~;f~ MAR . TAYL (SEAL) Signed, sealed, published and declared by the above-named person as and for a last will and testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as subscribing witnesses. ~~,/u,L IIJ ;#/?~ ~<' , , , - ACKNOWLEDGMENT AND AFFIDAVIT WE, MARY H. TAYLOR, GAY L. mWIN and JOY S. ZERANCE, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her last will and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. /Jtt /J ~ MAR~TAYL~ ~/"~bA;Al J ~ COMMONWEALTH OF PENNSYLVANIA :ss: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by MARY H. TAYLOR, the testatrix herein, and subscribed and sworn to before me by GAY L. mWIN and JOY S. ZERANCE, witnesses, this ~ day of April, 1997. '. Notarial Seal Harold S. Irwin III, Notary Public Carlisle Boro, Cumberland County My Commission C'xpires Sept. 14, 1998 Mer'rt8', Pen. ..../'...&:ia Asscciation of Notaries A. US. DEPARTMENT OF HOUSING and VRBA!\,I DEVELOPMENT OMBNo.2502-0265 SETTLEMENT STATEMENT TITLEPRO lasa'pri...l SECURED LAND TRANSFERS, INC. B. TYPE OF LOAN 5006 East Trlndle Road 1.1 I FHA 2.1 JFMHA 3.1 I CONV. UNINS Suite 203 4.1 IliA 5.\ ] CONY, INS Mechanicsburg, PA 17055 6. FILE NUMBER: I 7. LOAN NUMB!':R: 502488 Phone: (717) 591-8500 FAX: (717) 591-8506 8. MORT. INS. CASE NO.: C NOTE: This form is furnished to give you a statement of actual seltlemenl costs, Amounts paid to and by the setllement agent are shown Items marked '(p.Q,c,)' were paid outside the closing; they are shown here for informational purposes and are nol included in the tolals. D. NAME AND ADDRESS OF BORROWEFl E, NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER Tri County Housing Mary H. Taylor Estate Cash Development Corporation G, PROPERTY LOCATION: H. SETTLEMENT AGENT' I. SETTLEMENT DATE: 139 Columbia Road Secured Land Transfers, Inc. 05.'23/01 East Pennsboro TOWNSHIP PLACE OF SETTLEMENT' CUMBERLAND County 427 N. Enola Drive, Enola PA 17025 J. SUMMARY OF BORROWER'S TRANSACtiON: K. SUMMARY OF SELLER'S TFlANSACTION: 100, GROSS AMOUNT DUE FROM BOflROWER 400, GROSS AMOUNT DUE TO SELLER 101. Contract sales price b1"00.00 401,Contract sales price 619lYO :-00 102, Personal property 402.Personal property 103. Seltlement Charges to borrower (line 1400) 1b/O.25 ." '" '" '" ." Adjustments lor items paid by seller in advance Adjustments for ilems paid by seller in advance l06.Cily/Townla_ to 406,CilylTownw <0 107,Counlyta_ 05,23 01<012/31/01 11b.37 401,Counlyla_ OS/23/01<012/31 01 116.37 HI8,Assessments <0 4(l8,Auessments <0 'oo Sc/1.ool o 57'<71ato 6 30/01 53.1. '" School 051.3/U1.0 Ob/30 01 53.12 It, Swr/Re ,S87.75 q end 6/30 36.54 <I' Swr/Ref,S87.75/q end 6.3 10 36.54 '" '" It, '" 1211, GROSS AMOUNT DUE FROM BORROWER 63784.28 4211 GROSS AMOUNT DUE TO SELLER 62106.03 200 AMOUNTS PAID BY OR IN BEHALF OF BORROWER 5011, REDUCTIONS IN AMOUNT DUE TO SELLER 201 Deposit or earnest money 1000.00 501,Excess deposit (sea instructions) 202, Principal amount of new Joan{s) 502.SetUemant charges to seUer (line 1400) 5235.0 203, Existing loan(s) taken subject \0 503,Exisling loan(s) taken subjecllo ,,, 504,Payofl or First Mortgage Loan NONE . 505.Payolf of Second Morlgage Loan ,,, ,,, ~S) - (B) Term1te reatme t 551.20 5116 (S) - (B) errm. te Treatme t 551.~ ,,, "" ,,, '" 209 '" Adjustments lor items unpaid by seller Adjustments lor items unpaid by seller 21o,CltyfTownlll_ to 5toCltytTowntaJ( to 21 1. Counll' lax <0 !l\\.Ci:lunll'\aJ( '0 212, Assessmenls <0 512.AsS&ssmenls <0 '" School '" :>13 School <" ,,, >t. ,,, '" '" '" '" '" '" >t, ,,, '" 220 TOTAL PAID B'(IF=OR BORROWER 1551.20 !tlo,TOTAL REDUCTiON AMOUNT DUE SELLER 5786.20 3W CASH AT SETTLEMENT fROM OR TO BORROWER 600 CASH AT SETTLEMENT TO OR FROM SELLER 30\ Gross amount due tram borrower (line 120) 3784.<8 601GrO$S amount due \0 setler (line 420) 621 6. 3 302 Less amounl paid by/for borrower (line 220) 1551'.20 602 less reduclion amount due seller (line 520) 5786.20 303 CASH tOO FROM) ([ ] TO) BORROWER 62233.08 603 CASH (00 TO) ([ ) FROM) SELLER 56319.83 Buyer or BOlrower'sSlg1ature Sollor'sSignatufe HUO.1~v.5IJj6 US, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT OMB No. 2502-0265 L. sETTLEeAENTCHARGES 502488 700 TOTAL. SALES/BROKER'S COMMiSSION bu.d on prlc. $ 61900.00 7.0 Division of Commission (line 700) as follows Total: $4,333.00 701 $ 2191,50 10 Rothman Schubert & Reed 702 $ 2141.50 to Realt Executives 703 Commission paid at Sanlement 704. Trans Fee Rothman Schubert & Reed 8-00. ITEMS PAVABL.E IN CQNHECl'lOH WITH "'O~N 801. Loan Origination Fee % 802 Loan Discount % 803. Appraisal Fee 10 804 Credit Aeportlo 805. Lenders Inspection Fea 806. Mortgage Insurance Application Fee to 6<l1. ASSumplKm Fee 606 809. 810. 611 900. ITEMS REaUIRED BY LENDER TO BE PAID IN ADVANCE 901 Interest from 05 23 01 to05 31 01 @$ 902, Mor\glige Insurance Premium lor mo. 10 903. Hazard Insurance Premium lor yrs, to 904. YfS, to 905, /day 001. 002. 1003. 1004. 005. 1006 007. 1008. 100, TiTlE CHARGES 1101. Selllement or Closing taelo 102. Abstract or title search 10 1103. Title el'.am~r.ation \0 104. TiUe insurance binder to 106. Document preparation \0 1106. Notary fees to 107. Allorney'stees to (includes above items No.:) j lOB. Tille Insurance to (includes above items No :) 109, Lender's coverage $ 1110. Owner's coverage $ 1111 Tax Cert RESERVES DEPOSITED WITH LENDER FOR Hazard Insurance mo, @$ Mortgage Insurance mo. @ $ CilyfT own lax mo. @$ Counly lax mo, @$ ASS-ElsSfllents mo,@$ mO.@$ mo.@S mo,@$ /mo. Imo /mo. Imo Imo {mo Imo Imo 1000. Cash Harold S. Irwln, III 2.00 5.00 200.00 Secured Land Transfers 1105 Secured Land Transfers 61,900 112 \13. 1200. 1201. 1202. 203 204. 205. 1300. 301. 1302 303. 304. 1306. 1400. TOTAL SETTLEMENT CHARGES GOVERNMENT RECORDING AND TRANSFER CHARGES Recording tees: Deed $ 26 . 50 Mortgage $ City/county tax/stamps Deed $ 619 , 00 Mortgage $ State tax/stamps' Deed $ 619. OOMoflgage.$ Mise,$ 26.50 619.00 619.00 ADDITIONAL SETTLEMENT CHARGES Survey to Pestlnspeellon to Radon Ins A raisal All Amerlcan Termlte TCS Industries, Inc. Advanced Statlstlcal 35.00 95.00 300.00 (Qnl(lronhno,> t03anct502.S.o'<.\ior.sJanol\\ l678.25 5235.00 Pa,h~a ~Il'''U lh..l '"' h..bll;Cy i6 u~"",..d by S"III..",,,,,t AI/""'1", '10" .,CCU,,,q 01 ,,,10'''''''''''' 1"",iI;lI..d by oU,a,s U shown "n Ihu ItUO.j S"III"""",I Stah.mant SHIII..",.",I Allam hll,..by up,,,...1y '''....'''~''tll..r1gI'IIQdeVOslt8''y..rn''..''lsc..lI..ch.d''''d'.b..,''amanl;nllnif'la"",lblla,inll"cco"nlin..F"dll",lIylr,s..tadlnsl,t"tion..ndtoc'..dil"nyinl..'.."tsoe.."'..dto;lsow"..cc"..nt.... llddllionat C<>Il'l>"l\~I...l\"""",ic""';l"I\h;"\llms~clion HUD CERTIFICATION OF BUYERS AND SELLERS 1 ha.vc carefuliYloviewod tho HUD.l Sotllomont Slatolllllnl and to Iho bost of my knowledge and beliof, it III II Irue and aceu/ala stalemanl of al!/ecoipls and disbursements made 00 my acCQunt by nw (n It\i$ \lal\l:.ac\iQI\. \ hlllhel callily \hal I havo received a copy ot the HUQ.l Selllomant Slatoment. ~~\)N-o ~\..'fu. \('>{~\'\ \=tlL ~'1\.\9oj S~:.e 1'\. f~ 8..~et..tB<lIt<l"""f'.S'g",.I..,.. t1..yet'.Add,ess&PI..",.. S..IIIIt'.N"wAdd,..""&Pho,,e, CCOU'" ..!II,;sl'''''$>Icl;"n,; hll\l..ca..u~:~":"aJOL..di~LU's..dinaCCO,dllnc..with'hi.slsl..rnUrot Oala mll"ts 10 H'.. Unit"d Slal68 on Ihis 0' a"~ simiia, 'o,m PI,n"ttillS. upon co,,,,,,,lio,, C.." includil .. ~in.. ~nd ''''1-''\50'''''''''\ FUl du\..~s s.... fllOIO HUD.lltu\I.5/86 I SecuIChoiceTM 7441 Allentown Blvd.' Harrisburg, PA 17112 July 3, 2000 Ms. Mary Helena Taylor 139 E. Columbia Road Enola PA 17025 Re: SecurChoice - Pre-Need and Individual Trust Agreement Dear Ms. Taylor: PNC Bank, N.A. has received and accepted the Pre-Need and Individual Trust Agreement for Mary Helena Taylor, Account 29052. This Irrevocable Trust, funded with $4,750.00, is a participant in the Master Pre-Need Trust of Musselman Funeral Horne Inc.. If you have any questions, please consult with your funeral director. Very truly yours, nt I~ /3./-'- M. Kenneth Baylor SecurChoice Trust Administrator Enclosure cc: Mr. Brian Musselman Musselman Funeral Horne Inc. 324 Hummel Avenue Lemoyne PA 17043 PQE-NEEJ) TRUST OFFICE: 1-800..692'6068. (717) 545-7215. FAX (717) 545-7360 PRE-NEED INSURANCE OFFICE: 1-800-627-7526 .(717) 540-1303. FAX (717) 540-1496 Website: www.prda.org SeculC:hoice TM ~A?o/OO ~() YJ700/ &9Q.5C? PART I Pre-Need and Individual Trust Agreement ("The Agreement") This Agreement is made this , / :2 7 /0 0 DATE Funeral Home ~ U-.>re.! m LI\ Fu-tt etz I 1-10 "U ". NAME I ~ Address 3;;1 y 4v -e. '/ A.eJ1A. ~ -tlt-f r ss tDrtAESS <oJ I I\A. , /31 ?;~.e.. NAME by and between 4 , "13 C'f6 SOCIAL SECURITY II S- (MG and the Purchaser (hereinafler "You") for the Benefit of (if Beneficiary is different from the Purchaser) a...cs. AD RE$S ct.b 00 .e O/O/B SOCIAL SECURITY /I (M) (F) ADDRESS ANNUAL PERCENTAGE RATE FINANCE CHARGE Amount FInanced The amount of credit provided to You or on Your behalf. Total 01 Paymanta The amount You will have paid alter You have made all payments as scheduled. Total Sale Price 0.00% $0.00 $ $ 'f, 7St) , The cosl of Your credit as a yearly rate. The dollar amount the credit will cost You. If not paid in full, Your Payment Schedule will be: No. of a ments Amount of Pa ments When Pa ments Are Due itemization 01 Amount Financed Cash Price $ Monthly beginning ~ ~ ~ $ See reverse side lor any additional inlormalion about rlonnaymenl ami default. Total Downpayment -$ Unpaid Balance of Cash Price & Amount Financed .. $ You hereby agree to buy and the Funeral Home hereby agrees to sell the funeral goods;';.MlMchaDdis,'J and funeral services ("Services") which are described in itellJ1Zed list attached as Exhibit A far a Total Sale Price of $ ~../....r t:'J..__ Arrangement Fee: $ U. This fee Is separate and distinct from the Total Sale Price and will be deposited in the Trust. After payment of the Total Sale Price and all other payments required to be made, the Funeral Home will render, upon the death of the Beneficiary, all the Merchandise and Services described on attached Exhibit A. This Agreement is subject to the terms and conditions shown above and on the reverse side of this page, which You have read and accepted. You hereby elecllhallhis Agreement shall be: )(lrrevocable upon payment In full of the Total Sale Price '(~u and the Funeral Home agree that the prices shown on Exhibit A are: ~ Guaranteed by the Funeral Home upon timely payment of the Total Sale Price 0 Not guaranteed by the Funeral Home EXCLUSION OF WARRANTIES: THE FUNERAL HOME IS NOT PROVIDING TO YOU ANY WARRANTY OF MERCHANTABILITY OR WARRANTY OF FITNESS FOR A PARTICULAR PURPOSE FOR THE MERCHANDISE. The only wlrrlntles You Ire receiving lor the Merchandise are the express written warrantl.., If any, which are provided by the manufacturers of the Merchandise sold to You under this Agreement. Only the mlnullcturer Ihln hIve Iny nlblllty to You undlr such wlrrlntllS. You and the Funeral Home have signed this Agreement on the day and year written above and Intend to be legally bound. By signing this Agreement, the Funeral Homl, as aglnt for the Purchaser, hereby Igrles to estlbllsh an Individual trust with the Trustee under the Master Pre-Need Trust Agreement (the "Mastlr Trust") between the Funeral Home and the Trultee (the "Trust"). 11 UJrd,'VJ,..... tultfrV fJ-M P. Y;; c' ...., FUNERAL HOME NA F' ' o Revocable by You al Your option at all times )C d)!fcYyf-l rr ~t..... , PUR ASER ., 0PNCBAN< Decedent Reporting Firstside Center P7-PFSC-04-F 500 First Avenue Pittsburgh, P A 15219-3128 /SCP June 18,2001 Mrs Jerome Marshalek 903 Cocklin St Mechanicsburg, P A 17055-3955 RE: Estate of Mary H Taylor Deceased SSN: 198-14-1548 DOD: 04-20-2001 Dear Mrs Marshalek: Please find the date of death balances you have requested listed below. CHECKING ACCOUNT #5140109801 Established 01-18-2000 MARYHTAYLOR DONNA M MARSHALEK DOD Balance: $9,664.71 + $0.72 accrued interest SA VlNGS ACCOUNT #5003502797 Established 12-27-1999 MARY H TAYLOR DONNA MARSHALEK CAROL WAGNER DOD Balance: $43,819.19 + $35.43 accrued interest Page 1 of2 A member of The PNC Financial Services Group One PNC Plaza 249 Fifth Avenue Pittsburgh Pennsylvania 15222 2707 (. . o PNCBAN< Our office only provides date of death balances for IRA's, CD's, Checking and Savings accounts. We do NO Financial Transactions or Statement Orders. For Further information please call1-800-4-BANKER or your local PNC Branch and ask to speak with a Financial Services Representative. Sincerely, ~,.z Al-~ Erica L. Schlegel 1-800-762-1775 Page 2 of2 A member of The PNC Financial Services Group One PNC Plaza 249 Fifth Avenue Pittsburgh Pt'nnsylvania 15222 2707 . . ~""'.. .' ". .'..... . ' THEVanguard:;ROUP, DONNA M MARSHALEK 903 COCKLIN STREET MECHANICSBURG PA 17055 May 29, 2001 Prime Money Mkt Fund 09938512250 Dear Ms Marshalek: Weare responding to your letter requesting the value of the above referenced account Please accept our sincere condolences for the loss of Mary Taylor. As of April 20, 2001, the number of shares, the price per share, and the value of the account were as follows: Mary H Taylor & Donna M Marshalek & Carol A Wagner .IT TEN WROS Fund Name 9938512250 Prime Money Mkt Fund Accrued Dividends: $116.33 Shares Price Value 42,043.280 $1.00 $42,043.28 Through past experience, we realize that the ensuing financial details of such a loss can be difficult and confusing. To ease your burden and assist you as much as possible with the details of changing ownership of the above referenced account, we have attempted to enclose all relevant information and forms necessary to effect the transfer. We invite you to call a membci of the '/oyager Service Team with any questions or concerns you may have. To process the transfer of this account, we need you and the other surviving joint account owner to complete the enclosed Change of Ownership ofNonretirement Shares form. The transfer form will provide us with the new registration and Social Security number. It also will let you choose options for your new account NOTE: If you will be adding a new joint tenant, we will need you to have your signature guaranteed in Section #3. All new account owners should sign the form in Section #9. 14321 North Northsight Boulevard, Scottsdale, Arizona 85260 www.vanguard.com , . A signature guarantee verifies a signature. Most commercial banks, savings banks, credit unions, trust companies, or member firms of a U.s. stock exchange offer this service. A Notary Public cannot provide a signature guarantee. . For a signature guarantee to be valid it must appear in the following format: "Signature(s) Guaranteed" By (Signature & Title) Institution's Name In addition, we will need a LOI (Letter of Instruction) signed by each surviving joint account owner, stating that a certified copy of Mary Taylor's death certificate is on file. This will prevent us from requesting another certified copy from you. Finally, since the registration of your account will be changing, we will not be able to carry the Checkwriting option over to your new account. Please complete section #8 to establish checkwriting on your new account. When you return the requested documents, we will process the transfer and send a statement listing your new account number. Please refer to the new account number in any future correspondence concerning your account. We have enclosed a postage-paid envelope for your converuence. If you have any questions, please call us at 1-800-662-2739. One of our associates will be pleased to assist you. Sincerely, K~ Mfj.v- Kimberly Bollinger Voyager Registered Representative Enclosure(s): 2 Change of Ownership ofNonretirement Shs 2 Vanguard Return Envelope 00130363 I '.:~~~.::'.~f~tt:7:~~~J~~ff~~};:}"~~:f~r~'i_~~:"~~~!':. ' '^ '" ,,~.ftt4.~~''Yl:f_ '-""'""C'"-"':'J':.,"!,'_:'",,,,,,. f;' ,;;,"_:'~W~.ift*~'\M, . . ~ 1...111...111....1.1..1.1...11.1.1...1.1..1.1.11"".11.1...11 MARY H TAYLOR & DONNA M MAR5HALEK JT TEN WR05 903 COCKLIN 5T MECHANIC5BURG PA 17055-3955 Trade date Transaction Beginning balance 11 03 Cneck purchase 1/11 Check purchase For prompt service when calling please provide your Statement number: 012946215 (800) 662-2739 - Client Services (800) 662-6273 - Tele-Account Fund number: 30 Account number: 9938512250 ACCOUNT VALUE On 1/11/2000 $ 33,000.00 Dollar amount Share price Shares transacted Total shares owned .000 10,000,000 33,000,000 $ 10,000.00 23,000,00 $ 1.00 1,00 10,000.000 23,000,000 YOU CAN REDEEM PURCHASED SHARES AT ANY TIME. YOUR REDEMPTION REQUEST Will BE PROCESSED AT THE NEXT-DETERMINED NET ASSET VALUE AFTER IT IS RECENED, HOWEVER, WE WILL NOT SEND YOU THE REDEMPTION PROCEEDS UNTIL THE RJND COLLECTS PAYMENT FOR YOUR PURCHASE, INVEST-BY-MAIL Do not a~er this slip, Use only to purchase additional shares in: Vanguard Prime Money Market Fund Fund number: 30 Account number: 9938512250 Make checks payable to: The Vanguard Group - 30 List each check separately, $ $ $ Total amount enclosed $ 0030 09938512250 30 MARY H TAYLOR & DONNA M MARSHALEK JT TEN WROS 903 COCKUN ST MECHANICSBURG PA 17055-3955 o Check box if changing your address; note new address on reverse, THE VANGUARD GROUP PO BOX 7800 PHILADELPHIA PA 19101-9892 2 1- 1 018226 6528 DLY Q1 2[]< II11I11 HII 0111111 mill mlllU 1111'11 Hlmlll It~d66- /3 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* fY/ dUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 ~ . INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN REY-ln4 EX AFP (12-00) '02 DONNA M MARSHALEK 903 COCKLIN ST MECHANICSBURG APi~ -s t.: ~ :00 03-27-2002 TAYLOR 04-20-2001 21 01-0477 CUMBERLAND 198-14-1548 01002590 Allount Rellitted MARY H PA.::17:D55-0000 C;ul'n:~;. MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE3 PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ --------------------------------------------------------------------------------------------------------------.- REV-1604 EX AFP (12-00) __ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 03-27-2002 ESTATE OF TAYLOR MARY H DATE OF DEATH 04-20-2001 COUNTY CUMBERLAND FILE NO. 21 01-0477 ADJUSTMENT BASED ON: S.S/D.C. NO. 198-14-1548 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 01002590 FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 5003502797 TYPE OF ACCOUNT: (X) SAVINGS () CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 12-27-1999 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.166 .00 .00 .00 .45 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR HONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT.II TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE 00 . IF PAID AFTER THIS DATE. 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)3 - --- __....n..., "'Tn" n" TIITf:. ~nDM I=nR YNSTRUCTIONS.) REV-1470 i:X (6-88) '* INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME MARY H TAYLOR FILE NUMBER REVIEWED BY Department of Revenue/CLAUDIA MAFFEI ACN 2101-0477 01002590 ITEM SCHEDULE NO. EXPLANATION OF CHANGES Above-referenced ACN(s) are being adjusted to reflect zero tax due since they have been reported on the probate return. ROW Page 1 ~ / b - .;2.:30 - A3 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* NOTICE OF INHERITANCE TAX APPRAISEKENT~ ALLOHANCE OR DISALLOHANCE OF DEDUCTION~, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REY-1548 EX AFP 101-021 'O;;~ :'~~6 :j SJ DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSNI'DC ACN 07-29-2002 TAYLOR 04-20-2001 21 01-0477 CUMBERLAND 198-14-1548 01002591 Allount Rellitted MARY H CAROL WAGNER 325 WESLEY DR MECHANICS BURG PA ~1.055 ~. ./ t ! . 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 ~ R:iv=is~8-E)f-AFFi-(Oi~02)------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-29-2002 ESTATE OF TAYLOR MARY H DATE OF DEATH 04-20-2001 COUNTY CUMBERLAND FILE NO. 21 01-0477 TAX RETURN WAS: S.S/D.C. NO. 198-14-1548 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01002591 FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 5003502797 TYPE OF ACCOUNT: ()() SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 12-27-1999 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.166 .00 .00 .00 .15 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. · ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. TI: Tnnl mn" IS REFLECTED AS A "CREDIT" ( CR), YOU HAY BE DUE A REFUND. - ------..----...- ." C H Z C >111 ..I:;:) >Z (1)111 Z> ZIII 1110: a. II. 11.0 o ... %Z ...111 ..IZ: C'" 1110: :aC Za. 0111 Z:A z: o U ~z zO <x x< S~tIl x~"-t; <<Otll ~~~tIl wcz< tJ W Z IlU: t; ~o~~ HWWIlil IliItJtIl~ WZtllllil i;i<o HS@9 "-~<w 0< ..= W -.uJ ~~l!i~ ~!iH~ o ~Z Z tJH tIl~O HC'":l <W IliIC 0. 0."- <0 ell w X < .... ...Iz = ~~ ~ s: E ~ Hc:l ,.. i~ : 101... l2. ... .....LLlO ... OU-D<ll ~e~; W<< -M lll:!I!li:~ i~lU % > It: <C 2: ~~'-I';" .... "'~/~, ~!\ ~ '^' . f"l:-. v-.:. ~ '- co .... ....,...Q~ Cl Cl,...Zll\ Cl =~<C""= N NCl....llo.. I It: 1 1D:::~ll\ ....CCl....UJ....N Cl....lNClI:QICl 1>1 2:COCl Cl<C~"":;:)o...... ........ClNU....Cl % ... CO: 111111 ILAIIQ o z: 11.:;:) IIIOZ>U ... "'A IIICIIIIIIZ' ...........I:;:)ZZ C(I)CHO(l)U AIIIAILU(I)C ':<.< ~~ ..J ~~ ~ " ~ '" ll\ ll\ Cl ,... ~ .... UJ ....I <C <C Q.. :c (/) D::: <C.... 2:(/)(!) D::: 2:%:;) ~I:Q ....I(/) ~U U~ CZ <CU<C % ::t: %/i)U CClUJ =0..2: - I .. o ... ... Z III z: > o : tt; z: III 0: A Z C III ..I IIQ C > : ~ U III % U III ~ ~ .c.. "^ ~ ~ \- UJ (/) :;) C :c ..../i) It:.... :;:)Cl 0,... U.... (/) ....I ....I ~ 3:0 U<C u.. Q.. 0= % .. D:::<CUJ UJ....I....I ....It:(/) (/)UJ~ ~I:Q....I (!)2:D::: UJ:;:)<C D:::UU , (I) A 0: o U ,III 0: 0: :;:) o > 0: o II. Z o H ... 0:: 0' a.' a: III 3: o ..I Z H 4( ... III Ill: , III' Z H ..I (I) H % l- CD Z o ..I 4( l-' ;:)' U: