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Home My WebLink About01-0493 CUMBERLAND COUNTY REGISTER OF WILLS PETITION FOR GRANT OF LETTERS Estate of Russell, Louise B. No. :J..., J --0' , - lJ q-3 also known as , Deceased Social Security No 207345986 Nancy Carroll Mullett Petitioner(s), who is/are 18 years of age or older, apply)ies) for: (COMPLETE "A" OR "B" BELOW:) GJ A. Probate and Grant of Letters and aver that Petitioner(s) is/are the executriX Decedent, dated 2/26/91 and codicil( s) dated M a"..r t, named in the Last Will of the ~, 119s , 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 incapacitated: o 8. 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 the Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence I (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at West Shore Health & Rehab. Center, East Pennsboro Township (list street, number and municipality) Decedent, then 91 years of age, died May 7 2001 at West Shore Health & Rehab. Center , - , (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA All personal property ......................................... $ (if not domiciled in PA Personal property in Pennsylvania .................... $ (if not domiciled in PA Personal property in County.............................. $ Value of real estate in Pennsylvania ........................................................................................ $ Total .............. ................................ .................... ......................................... .......... $ 200,000.00 200,000.00 Real Estate 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 appropriate form to the undersigned: Typed or printed name and residence Nanc Carroll Mullett 3943 Newdale Rd. #LL-14 Chev Chase MD 20815 (6;, - d 3 I ~ / J Oath of Personal Representative : Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer % estate a~rding to law. (..,/,J~ ' Sworn to and affirmed and subscribed 3 W(1.y rhtMA-f-f ~ fjJp ~ 4. N y Carroll Mullett before me this / 7 day of Yl>>Jrtt!. ~J ;I d' ~~4 DECREE OF REGISTER Estate of Russell. Louise B. Deceased No. 21-01-493 also known as Social Security No:207345986 Date of Death: 5/7/01 AND NOW, MAY 21, 2001 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters l&I Testamentary 0 of Administration ((c.I.a., d.b.n.c.t.; pendente lite; durante absentia; durante minoriate) are hereby granted to Nancy Carroll Mullett in the above estate and that the instrument(s), if any, datecFebruary 26,1991 CODICIL DATED MARCH 31. 1995 described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. FEES Letters .................................... $ 235.00 /l)Jkf'.l'! .I6JJ~IJM. C'{t f~7;-u> 4.1 fJu.~ ' Register of ills I , Short Certificates(s) .....?........ 15.00 Extra Pages ( 7 ) ............... $ ~Ul .CODICIL........... $ $ $ $ $ $ $ 10 ~o ?1 00 I. T.R....................................... Signature JCP Fee ................................. 5.00 Attorney: Brown, Edward M. 1.0. No: 59018 Address: HC 60, Box 531 Orbisonia Inventory............................... . Other..................................... . PA 17243 TOTAL ............................$ 286.50 Telephone: 814-447-3455 DATE FILED: MAY 21. 2001 MAILED LETTERS AND ORDERS TO ATTORNEY MAY 21, 2001 I t ertl' ~, that the information here given is correcrly copied from an original certificate of death duly filed with me as , Ilh is 0 C 1) '. f' - fT I oed Registrar.' The original certificate will be forwarded to the State Vital Records 0 hce tor permanent ) mg. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. ,ijl'(~"OFPE}~~ .,,\ ~/ ~'1'J'L___\ II' ~ / '.-,-. - '$ ~I fI1.a.~<L. \. i~/ ..,~. \,?~ ~ S:,1:: . ;~~ L. '/*1 ~"'4~' /""~\\\ ~rA "" //~,.,\\ -;. ~1I1il'-'-- (. ~~ " """" I" EN1 \\, ",'III!.--- ,,.,/"'~ ~.-4V /Jt ~~r - Local Registrar l fee for this cenitlcate, 52.00 p 729~QL MAY 0 9 2001 Date 4J Rev 2187 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH NAME OF DECEDENT (f,rSl MICl<lle, lasl} SEX STAlE FILE NUMBER SOCiAl SECURITY NUMBER DAlE OF DEATH ,Mcrnh. Da~. ....., 1. AGE (Las! 8w1hoay) UNDER 1 YEAR Monlha Daya Louise B. UNDER 1 OM HounI Minut.. PlXE OF DEATH (Cl>eck oNy 0I>e - .... .nsllucLonll on othel _I HOSPITAL: fnpabent 0 ... FACILITY NAME (II nol ,nsl.IIJt"",. 9",e SI'eel and numbe" BIRTHPlXE (C.ly and Slale 01 fcreogn Ccunlly) ERIOutpallent 0 ~O g:ofy}O .. Ie. E. Pennsboro Twp West SHore Health & Rehab. .... KIND OF 8USINESSilNDUSTRY 2. Female 3. 207 - 34 5986 .. Ma 7, 2001 5. 91 COUNTY OF DERH y,. DECEDENT'S USUAl OCCUp,Q'1ON (~=:.:'~~':::zt:f . 11.. Psychologist I1b. School DIstrict DECEDENT'S MAIUNG AOOReSS (SI,eet. Cllyna-.. ~. Zip CO<leI DECEDENT'S ACTUAl RESIDENCE (See onslruc1DlS OIl Q\t>e< Sldel '/IIPoS DECEDENT eVER IN US. ARMED FOACES? 'I'U 0 No~ loIAAlTAl STATUS . ~ Ne_ M."'ed, Widowed. Divorced (Spec:oIy) 1.. Widowed RACE . Amencan Indian. Black. White. et-: (Speedy) 10. WHite SURVIVING SPOUSE (It WIle. 91" maoOen narntll Cumberland 59 Circle Drive 1.. Canp Hill, PA 17011 fAJHEA'S NAME (Fwsl. MtddIe. LaSl) Harry 12. 13. 17a. Slate pennsylvania 17b. Coun Cumberland No, _lived 17c1.0 within actuallimJ\s of MOTHER'S NAME iFwSl. ModdIe. Maw:ten Su.namel Did dac_ 1M.... township? 17C.19 'lW, dacedent lived in E. Cllylt 1', 1Nf000000'S NAME (l ypelP'."l E. Brown Bessie M. Stairs METHOD OF DISPOSITION ~ Cremallon 0 00naIi0n D Otha< (Sp<<1Iy . 21.. SfGNRURE OF FUNE 22a. c-.-.. oC....s 23a~ ._ pftpocaan . ROC Ava ~-WY_of_ ~_..... 24-28 mlllt be compIated by ._paqonwho~_tfI. .,- 15 , resptratory afl8sl. shock or heart failure 21. I Approximate : inlartal between . aRM! and dealll I l PART II, OUter signifIcanC c:o.--. concributing to death, but ROC rasuftir'!I irt lite undotrIying ca.- giveR irt ""'" I. _ClATE CAUSE (F..... 0SM58 Of conclttlOfl '-*'II on 08lIIh)- ~L~~. ~72:,~2-~ /kJ ~- DUE 10 (OR AS A CONSEOUENCE Of)' r~k= ~ "'CORdIt""", il8I'\O, IaMiftg 10 _.a _. e- UNDEALYIHQ CAUSE (0...- or ...y ...--- r-*'ll on ll8eth) LAST DUE 10 (OR AS A CONSEOUENCE OF): d ~ AN AUTOPSY WERE AUTOPSY FINDINGS PERFOAMEO? A"""LAlll.E PRIOR 10 COMPlETION Of' CAUSE OF DERH? _ 0 No~ __ (2Ib. CERTIFIER (Check onty onel -CERTIF'YING PHYSiCIAN ~Phys.clafl cefblytOg cause c:J death wtleJ1..Jnottl~r phVSK,;lan hdS pconOlJnceo Clealh ana complt:leo!tern 23) To _ _ of "'y knowlecfp, death occunad _10 11>0 cau..(s) and mannor as Slated. . . . . . . . . . . . . . . . . . .. .... Yea 0 MANNER Of DEATH _ural ~ HomICIde 0 Accodenl [J Pendl"lllnveslK,jSlion 0 Suocode [J Could not be delermlned 0 DATE OF INJURY (MOIlIt! Day. Yea.) liME OF INJURY INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED. Vee 0 NoD l~/~I/( I 29. 3011. PLACE Of INJURY. AI home, larm. Slraet. factCHy,olfica building. otc ,Spec,lv) 308. M. 3Oc. NoD - '!!!!:;II '-=:'II 'PltONOUNCING ANQ CERTIFYING PHYSICIAN tPhy>IC",n bolt: ~'o"o'"oc'n<1 oedl" dnd cerltlyong 10 CdUse of deal"l ~ To _ beal of my knowledg". cleatfl occurred al__. date. ind pliCO. and due to tha cause(s) and manner i. ..ated.. .I 'MEDICAl EXAMINERJCORONER On the baai. of o.aminallon andlo, IRvesligalion. in my oponlon. death occurred at the lime. dale, and place. and due 10 the cause(s) and manne, a. slaled.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. ..... ....................................................... 31a. l33 REGIST~E~M~ ~ . ~._.._----_.~-----_. o 34. ~ --1T~(2-t!..~____ 21-01-0493 LAST WILL AND TESTAMENT OF LOUISE B. RUSSELL I, LOUISE B. RUSSELL of East Pennsboro Township, Cumberland County, pennsylvania, declare this to be my Last will and Testament, hereby revoking any will previously made by me. I - I direct the payment of all my just debts and funeral expenses out of my estate as soon as may be practical after my death. II - I bequeath certain items of my tangible personal property, not including cash and securities, in accordance with a written list made by me during my lifetime. In the absence of such a list or desig- nation on said list, I bequeath all of my tangible personal property to my daughter, Nancy Carroll Mullett. Should my said daughter predecease me, then I direct that such of my articles of tangible personal property which are not designated on a written list be sold and the proceeds added to the residue of my estate. III - I devise and bequeath all the rest, residue and remainder of my estate as follows: A. I bequeath 5% of said residue unto my grandson, Edward Martin Brown. II -\- - /' J ~~:.../,</~ .~ / (' _ ,/)C/;:rr:;/../ ,/";1 /' ::,;..Y '-/ -) ,,/ .C, ~,__' v::..c~..e .,/' -'7 / Page 1 ARNOLD & SLIKE, ATTORNEYS-AT-LAW, 2109 MARKET STREET, CAMP HILL, PA 17011 . ' , ' B. I bequeath the remaining 95% of said residue to my trustee hereinafter named, IN TRUST, nevertheless, for my daughter, Nancy Carroll Mullett. My trustee shall pay all of the expenses of the trust and shall distribute the balance of the net income to her in at least quarter-annual installments. In addition, my trustee shall have the power, at its sole and absolute discretion, to make further dis- tributions from principal for her maintenance and support should such expenditures become necessary. Should my said daughter become a widow prior to her death, the trust shall terminate and the balance of the trust estate shall be distributed to her, including both principal and accumulated and undistributed income. Should my said daughter die prior to the distribution of the balance of the trust, then the remaining trust estate, including principal and income accumulations shall be distributed as follows: 1. 50% of said trust estate shall be distributed to my grandson, Edward Martin Brown, or his issue per stirpes. 2. 10% of said trust estate shall be distributed to the Camp Hill Presbyterian Church. 3. 10% of said trust estate shall be distributed to Shippensburg University Foundation. 4. 10% of said trust estate shall be distributed to the American Red Cross. 5. 10% of said trust estate shall be distributed to the Harrisburg Chapter of the Salvation Army. II/.V~/= / ~,~--- t_ -f /X 2:::; / / ' " / /':/ /-., />~// .I <_" "'-,._ t - ~_>!!",.P, ".,.G -_ / , , / Page 2 ~/ ARNOLD & SLIKE, ATTORNEYS-AT-LAW, 2109 MARKET STREET, CAMP HILL, PA 17011 6. 10% of said trust estate shall be distributed to Goodwill Industries of Harrisburg, pennsylvania. IV - In addition to the powers above provided for, and those given by law, trustee, without any order of court and in its sole dis- cretion, may: A. Retain any property received hereunder and invest and rein- vest in any prudent investment, including but not limited to, common or diversified trust funds maintained by trustee and any form of life insurance, annuity or endowment policies; settlor's dwelling house or other real estate; and in so doing settlor's trustee may act without restriction to so-called legal investments and without responsibility for diversification. B. Keep reasonable amounts of cash in bank uninvested. c. Purchase investments at premiums and charge premiums to income or principal or partly to each. D. Subscribe for stocks, bonds or other investments; exercise any stock option or similar right; join in any plan of lease, mortgage, merger, consolidation, reorganization, foreclosure of voting trust and deposit securities thereunder; and generally exercise all the rights of security holder of any corporation. E. Register securities in the name of a nominee in such manner that title shall pass by delivery. F. Vote in person or by proxy, securities held by it and in such connection to delegate its discretionary powers. G. Repair, alter, improve or lease for any period of time any property and give options for leases. H. Sell at public or private sale, for cash or credit, without or with security, and exchange or partition property and give options for sales or exchanges. I. Borrow money from any person, including any executor or trustee,. and mortgage or pledge any property. II ~~.. .~/ 1./-t'-:.....,>':';~/ / , ..-/..". . . /-~) \... .:.......-' f"" ~ ,.---;;~;f>" .{)/~//' ,,-:.J..--;:Z--.'C--c/ _' ,.1 ,/' Page 3 ARN OLD & SLIKE, ATTORNEYS-AT-LAW. 2109 MARKET STREET, CAMP HILL, PA 17011 J. Compromise claims. K. Add to the principal of any trust created hereunder any property received from any person by deed, will or in any other manner. L. Pay premiums of any life insurance, annuity or endowment policies which may have been retained or purchased herein and exercise any right, option or privilege thereunder. M. In the exercise of its discretion with respect to the use of I principal for any beneficiary, take into account other property and income available to such beneficiary; in so doing, trustee may con- clusively rely on written representations made to it by such benefic- iary, and the judgment of trustee as to the amount of principal so used and the extent to which other resources are considered shall be con- clusive as to all parties in interest. N. Advise with settlor's executor in the choice of a date for valuing property in settlor's gross estate which it deems most advisable without adjustments between any beneficiaries in consequence of the exercise of such discretion. o. Advise with settlor's executor in the use of expenses and losses as deductions for federal income tax or estate tax purposes, or party for each, as it shall be deemed advisable, without adjustments between income and principal in consequence of the exercise of such discretion. P. Treat as income all income accrued and unpaid on assets at the time such assets become a part of this trust. Q. Purchase assets from settlor's estate at fair market value and loan money to said estate. R. Make distribution in cash or in kind or partly in each. S. Exercise all power, authority and discretion given by this trust after termination of any trust created herein until the same is fully distributed. T. Settlor's fiduciary shall be entitled to compensation for services hereunder in accordance with the standard schedule of charges currently in effect at the time the services are called upon, and from time to time during the period over which such services are performed. II __,l:-~e " .l~-;~/J/ / - ~/. // ) ;/'~) . /I;/~.~-::<~~:("">/::...~ Page 4 ARNOLD & SLIKE, ATTORNEYS-AT-LAW, 2]09 MARKET STREET, CAMP HILL, PA 17011 v - I hereby appoint CCNB Bank, N.A., Camp Hill, Pennsylvania, Trustee of the trust created herein. VI - I appoint my daughter, Nancy Carroll Mullett, Executrix of this, my Last will and Testament. Should my said daughter fail to qualify or cease to act as such, then I appoint John E. Slike, Esquire, to act in this capacity. Neither of my personal representatives shall be required to post bond in this or any jurisdiction. IN WITNESS WHEREOF, ;? 4' fl day of hereunto set my hand and seal on this the , 1991. '" /' c" ) "-- 1 L:;7j/," ,_,' "/,, ,/' c. -~ "< ~r' '-~;;' -"); / ld":>,,-l..~7-Lj".,~. /' Louise B:7Russell (SEAL) Signed, sealed, published and declared by LOUISE B. RUSSELL, Testatrix therein named, on this and four (4) other sheets of paper as and for her Last will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. i!~~~a:; ~ C. Name ~~' , <( /), ~L.'1:J I 1I~~li d. Addres$l' , II UJ i ;' ,. .E .~,;:~~, /IJ " Address Page 5 ARNOLD & SLIKE, ATTORNEYS-AT-LAW, 2109 MARKET STREET, CAMP HILL, PA \7011 COMMONWEALTH OF PENNSYLVANIA) SSe COUNTY OF CUMBERLAND) WE, the undersigned, the testatrix and the 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 Testament and that she signed willingly (or willingly directed another to sign for her), and that she executed it as her free will and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix signed the will as witnesses 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. '/ ~. .1;~':~2C- ~'.{) ~(// /, j / j;':,_~....;.7~.:.:>C-<-___" Testatrix Witness (!, ~I witness Subscribed, sworn to and acknowledged before me by the te~t~rix, and SUbsc~~~rn to bef~r~9~~.bY both witnesses, this -<~~ day of I~~.ct:~ Notary Public II Nor ARIAL SEAL THELMA S. McCAUSU~J, Nota.ry Public Camp Hill, PA Cumber \~d COljnl~ My Commission Expires July 3, 1Q92 ARNOLD & SLlKE, ATTORNEYS^TL-\W. 2J09 MARKET STREET. CAMP HILL. PA 170/1 SAIDIS, GUIDO, SHUFF & MASLAND 2109 Market Street Camp Hill, PA 21-01-0493 CODICIL TO THE LAST WILL AND TESTAMENT OF LOUISE B. RUSSELL I, LOUISE B. RUSSELL of Cumberland County, Pennsylvania, declare this to be the sole codicil to my Last Will dated Febru- ary 26, 1991. I - I hereby amend Paragraph III-B. of my said Last Will and Testament to read as follows: III-B. I bequeath the remaining 95% of said residue to my trustee hereinafter named, IN TRUST, nevertheless, for my daughter, Nancy Carroll Mullett. My trustee shall pay all of the expenses of the trust and shall distrib- ute the balance of the net income to her in at least quarter-annual installments. In addition, my trustee shall have the power, at its sole and absolute discretion, to make further distributions from principal for her maintenance and support should such expendi- tures become necessary. Should my said daughter become a widow or be unmarried prior to her death, the trust shall terminate and the balance of the trust estate shall be distributed to her, including both principal and accumulated and undistributed income. Should my said daughter die prior to the distribution of the balance of the trust, then the remaining trust, including principal and income accumulations shall be distributed as follows: 1. 95% of said trust estate shall be distributed to my grandson, Edward Martin Brown, or his issue per stirpes. 2. 5% of said trust shall be dis- tributed to the Camp Hill Presbyte- rian Church. '.' l j - / / 1./ :/ ~ !./t", Page 1 SAIDIS, GUIDO, SHUFF & MASLAND 2109 Market Street Camp Hill, PA II - In all other respects I hereby ratify, confirm and republish my Last will dated February 26, 1991, together with this sole codicil as and for my Last Will. IN WITNESS WHEREOF, I have hereunto set my hand and seal on . (.A-I"' };k~ this, the 6 - day of , 1995. "\ ""-,1-.- ,,/,") /) ; -' r. ~ I \ . . . . >\. _,v"'. / ,,/ \)('." ) .' ,/ ( . / v ~t~~~'se B. '~~Js~lI"/ 1.1) (SEAL) ~ Signed, published and declared on the date thereof by the above- named LOUISE B. RUSSELL, Testatrix as and for the sole codicil to her Last will dated February 26, 1991 in the presence of us, who at her request, in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses hereto. (' \ .\:) ~./ '-, Name j)\c \\\-Y \\ Address + u {) ~ Na'me (> .J ~~ /idll /ej , Address r SAIDIS, GUIDO, SHUFF & MASLAND 2109 Market Street Camp Hill, PA COMMONWEALTH OF PENNSYLVANIA) SSe COUNTY OF CUMBERLAND) WE, the undersigned, the testatrix and the witnesses, respectively, whose names are signed to the foregoing instru- ment, being first duly sworn, do hereby declare to the under- signed authority that the testatrix signed and executed the instrument as the sole codicil to her Last Will and Testament and that she signed willingly (or willingly directed another to sign for her), and that she executed it as her free will and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix signed the will as witnesses 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. ....., _/ Subscribed, sworn to and acknowledged before me by the testatrix, and ..,subscribed and swor!!__t:b before me by both wit- nesses, this -::::>/PT day of .::JJL8---'lC () , 1995. \ I. . j1 ci.,,;;:,) /< ' ';i:. 6rxcJ, ' " n ,- a-e~4.-e<-,~ INotary Public NOTARIAL SEAL THElMA S, McCAUSLIN, Notary Public Camp ~jll,. CU~lb~rland County My,g?mmISSlon, txpires ,Iuly 3,1996 .-..>>-....,.."-........,H.y,.......,.....-...."..""'-'._."'""'l'.._ _~.~. ~ ._."., CUMBERLAND COUNTY REGISTER OF WILLS E --- CERTIFICATION OF NOTICE UNDER RULE 5.6Ia) Name of Decedent: Louise B. Russell Date of Death: 5/7/01 Estate No. SSN: 207345986 File No. 2001-00493 Date Letters Granted: 5/21/01 Will or Administration No. To the Register: I certify that Notice of 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 006/3/01 Name Nancy Carroll Mullett Address 3943 Newdale Road #LL-41 Chevy Chase HC 60, Box 531 Orbisonia MD 20815 Edward Martin Brown PA 17243 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except NONE Date: 6/3/01 ~~{. ~~ Signature Edward M. Brown Name (Please type or print) HC 60. Box 531 Address Capacity: Personal Representative X Counsel for Personal Representative Orbisonia PA 17243 Telephone No. 814-447-3455 CUMBERLAND COUNTY REGISTER OF WILLS v INVENTORY Estate of Russell, Louise B. No.21 01 0493 , Deceased Date of Death 5/7/2001 Social Security No. 207345986 also known as 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 the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. l!We vi3(if'l that tha statements m3de in this invento;y ara true and correct. I/\^/e understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Personal Representative: Name of Attorney: Brown, Edward M. 1.0. No.: 59018 ?fvxo/ (1J:lAAMJ ~~ Nancy Carroll Mullett er/:l3/al , , Address: HC 60, Box 531 Dated Orbisonia PA 17243 Telephone: 814-447-3455 or 814-643-2012 Description Cash, Bank Deposits, & Misc. Personal Property Value Checking account #5140054564, PNC Bank, 140 Camp Hill Shopping Mall, Camp Hill, PA 17011. 4,412.09 Louise B. Russell Trust account #16-27-027-3131589, PNC Advisors, Two PNC Plaza, 620 Liberty Ave., Pittsburgh, PA 15222. 182,404.93 Total (Attach Additional Sheets if necessary) 186,817.02 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. RW-4 ~ /~ -d23/<// BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG I PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-1607 EX AFP (12-00) ReCOi': --- Ref}. DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 12-03-2001 RUSSELL 05-07-2001 21 01-0493 CUMBERLAND 101 LOUISE B .01 Ole 17 P12 :02 EDWARD M BROWN ESQ HC 60 BOX 531 ORBISONIA pC,;;!€2.r12'43 - C b - - - t'~P, ,lUll -eda;:U Allount Rellitted 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 paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ rffv: i6oj-E:3f-AFP--fi'2-:0(Jr------...--iNifERITANc"E--TA3f-sTA-fEM"E-tiT-i:.-F"-AC-couiff--...--------------- - -- - -- ESTATE OF RUSSELL LOUISE B FILE NO.21 01-0493 ACN 101 DATE 12-03-2001 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 PAYMENTS1 THE CURRENT BALANCE} AND} IF APPLICABLE} A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-26-2001 P R I N C I PAL TAX DUE: .uu.uuu.u.........U..U....muuuuuuuuuuumuu.uu.u..u...................mnmm.mmnmmum..m....m............................................................................... 13/081.13 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-01-2001 CDOOOI05 509.47 91680.00 08-01-2001 CDOOOI06 144.59 2}780.00 11-19-2001 REFUND .00 32.93- TOTAL TAX CREDIT 13/081.13 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" (CRJ} YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J /6 -c2...:3 /- / / COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX Reco;c'er; or Regisrer c; '/11118 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-26-2001 RUSSELL 05-07-2001 21 01-0493 CUMBERLAND 101 .01 EDWARD M BROWN ESQ HC 60 BOX 531 ORBISONIA NOV 30 P 3 :21 C~rtt243 (~.-oJn C{itnoerianej \~_-:O'I PA *' REV-1547 EX AFP (12-00) LOUISE B Anount Renitted CHANGED (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 186,817.02 .00 113,280.98 (8) MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=is4j-ix-AFP--fi"2-:ofiY-Nfifici--OF-'rNHEififAifcE-TAX-A-PPRA-isEMENT-:--ALi-oWAifcE-oi----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF RUSSELL LOUISE B FILE NO. 21 01-0493 ACN 101 DATE 11-26-2001 TAX RETURN WAS: (X) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Hortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule EJ 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governnental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax If an assessment was issued previoUSly, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: NOTE: 7.,801.50 1.604.58 (1ll (12) (13) (14) (9) (10) .00 X 00 = 290,691.92 X 045= .00 X 12 = .00 X 15 = NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax paynent. 300.,098.00 9.406 OR 290.,691.92 .00 290,691.92 (19)= .00 13.,081.13 .00 .00 13.,081.13 PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 08-01-2001 CDOOOI05 509.47 9.,680.00 08-01-2001 CDOOOI06 144.59 2,780.00 11-19-2001 REFUND .00 32.93- TOTAL TAX CREDIT 13.,081.13 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1., NO 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.) 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 BROWN EDWARD M HC 60 BOX 531 ORBISONIA, PA 17243 ____n__ fold ESTATE INFORMATION: SSN: 207-34-5986 FILE NUMBER: 21-2001- 0493 DECEDENT NAME: RUSSELL LOUISE B DA TE OF PAYMENT: 08/02/2001 POSTMARK DATE: 08/01/2001 COUNTY: CUMBERLAND DATE OF DEATH: 05/07/2001 NO. CD 000105 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $9,680.00 I I I I I I I I TOTAL AMOUNT PAID: $9,680.00 REMARKS: NANCY C MULLETT C/O EDWARD M BROWN ESQUIRE CHECK#10 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS 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 BROWN EDWARD M HC 60 BOX 531 ORBISONIA, PA 17243 n____n fold ESTATE INFORMATION: SSN: 207-34-5986 FILE NUMBER: 21-2001- 0493 DECEDENT NAME: RUSSELL LOUISE B DATE OF PAYMENT: 08/02/2001 POSTMARK DATE: 08/01/2001 COUNTY: CUMBERLAND DATE OF DEATH: 05/07/2001 NO. CD 000106 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $2,780.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: NANCY C MULLETT C/O EDWARD M BROWN ESQUIRE CHECK#1602 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS $2,780.00 MARY C. LEWIS REGISTER OF WILLS STATUS REPORT UNDER RULE 6.12 Name of Decedent: Louise B. Russell Date of Death: 5/7/01 Will No. 2001-00493 Admin. No. 21-01-0493 Pursuant to Rule 6 . 12 of the Supreme Court Orphans I 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. account with the Court? Did the personal representative file a final Yes No X b . The separate Orphans' Court No. (if any) for the personal representative I s account is : c . Did the personal representative state an account informally to the parties in interest? Yes X No d . Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans I Court and may be attached to this report. C;::/Ut,.. ~ Signature Date: 9/29/02 Edward M. Brown. Esa. Name (Please type or print) He 60, Box 531 Orbisonia PA 17243 Address ( 814 ) 4473455 Tel. No . Capacity : Personal Representative x Counsel for personal representative ~~ ~ rEV-1500 EX.+ (&-00) '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT 280601 HARRISBURG, PA 17128.0601 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I OFFICIAL USE ONLY I&; 23 I -I I FILE NUMBER 21-010493 ""COWTrCOOE -YEA/l- --~R-- f- Z W Cl W U W Cl DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Russell Louise B. DATE OF DEATH {MM-DD-Year} SOCIAL SECURITY NUMBER DATE OF BIRTH (MM-DD-Year) 207-34-5986 THIS RETURN MUST BE FilED IN DUPLICATE WITH THE REGISTER OF WILLS 05/07/2001 11/02/1909 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER w ~ ",_Ul u"'''' w..u "aD U"'-' ..Ill ~ [Xl 1. Original Return D 4. limited Estate [Xl 6. Decedent Died Testate (AttachcopyofWiI) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest CompromIse (dale of dealh after 12-12-82) D 7, Decedent Maintained a living Trust (Attach copy of Trust) o 10. Spousal Poverty Credit {daleafdealhbetweoo 12-31-91 and 1-1.95} o 3. Remainder Relurn (date ofdealh pfiarlo 12.13-82) o 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes o 11. Election to tax under See, 9113(A) (AIIachSch0) TlllSSEciioNMlls'tBEcbMPtE'tl:tiiAi:iicbRRIlSPONoENceANbcoNl<jtii1NtIAiifAXiNFdtlMATlOi'fSlliJUilililaDiRECTEOtb, NAME COMPLETE MAILING ADDRESS Brown Edward M. HC 60, Box 531 FIRM NAME (If App""'") Edward M. Brown Es . P.C. TELEPHONE NUMBER 814-447-3455 or 814-643-2012 Orbisonia PA 17243 I- Z W o z o .. Ul W '" '" o u z o f- <( ...J :::J f- a: <( u w 0:: OFFICIAL USE ONLY 1. Real Estate (Schedule A) (1) 2. Slocks and Bonds (Schedule B) {2} 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) (6) D Separate Billing Requested 4. Mortgages & Noles Receivable (Schedule D) (4) (5) 186,817.02 7.lnler-Vivos Transfers & Miscellaneous Non.Probale Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1.7) 113,280.98 (8) 300,098.00 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 7,801.50 1,604.58 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) (11) (12) (13) 9,406.08 290,691.92 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has nol been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus~Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o t= j:: :::J Q. :;;: o u >< <( f- 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable allineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amounl of Line 14 taxable al collaleral rale 19. Tax Due (14) 290,691.92 X 0-(15) 290,691.92 X 045 (16) X .12 (17) X .15 (18) (19) 13,081.13 13,081.13 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 20 0 . .. . ... >;. BE SURETOANSWERALL QUESTIONS ON REVERSESIOEANDRECHECKMATH<<.. . Elecedents omplete A ress: STREET ADDRESS West Shore Health & Rehab. Center 770 Poplar Church Rd. CITY Camp Hill I STATE I ZIP PA 17011 , C dd Tax Payments and Credits: 1 Tax Due (Page 1 Line 19) 2. CredllS/Paymenls A Spousal Poverty Credil 8. Prior Payments C. Discount (1) 13,081.13 12 460.00 623.00 Tolal Credlls (A + B + C) (2) 13,083.00 3. InleresUPenalty if applicable O. Interest E. Penalty T olallnteresVPenalty ( 0 + E ) (3) 4. II Line 2 is grealer Ihan Line 1 + Line 3, enler Ihe difference. This is Ihe 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 Ihe inleresl on Ihe tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) Make Check to: REGISTER OF WILLS, AGENT 1.87 0.00 0.00 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "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 Ihe property transferred or its incame.:.... 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 consideratlon?... 3. Did decedent own an "in trust for" or payable upon death bank account Of 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?... Yes No .........0 [Xl 0 [Xl 0 [Xl .0 [Xl 0 [Xl .0 [Xl [Xl 0 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 pena~les 01 peJ]ury, I declare that I halle examined this return. incLJdin~ accompa.'1~ng schedues Brld statements. and to the best o( my krowledge and bete!, it is true. correct and compete. Decl:Jratlon of preparer other than the personalrepreseniatl\18 IS based on allnformabooofv.tJlchpreparerhas any knowledge SIGNATU E OF PERSON RESPONSIBLE FOR FllIN RETURN DATE ;a.z ~ '?71 ADDRESS 3943 Newdale Road #lL-41 Chev Chase AR~ ~HAN HC 60, Box 531 MD 20815 DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 PS 39115 (a) (1.1) (I)]. For dales of dealh on or afler January 1. 1995. Ihe lax rale imposed on Ihe nel value of transfers 10 or IDr the use of the surviving spouse is 0% [72 P.S. 39115 (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. Fer 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, Dr a stepparent of the child is 0% [72 P.S. 19115(a)(l.2)). The lax rale imposed on Ihe nel value of transfers 10 or for Ihe use of Ihe decedent's lineal beneficiaries is 4.5%, except as noted in 72 P .S. S911€(l.2) [72 P .S. s911€(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedenfs siblings is 12% [72 P .S. 99116(a)(1.3)J. A sibling is defined, under Section 9102, as an indlvldua\ who has at leas~ olle parent in common with the decedent. w'hetner by blood or adoption. """0""''''''. COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Russell Louise B FILE NUMBER 21 01 0493 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 Checking account #5140054564, PNC Bank, 140 Camp Hill Shopping Mall, Camp Hill, PA 17011; see attached statement. VALUE AT DATE OF OEA TH 4,412.09 2. Louise B. Russell Trust account #16-27-027-3131589, PNC Advisors, Two PNC Plaza, 620 Liberty Ave., Pittsburgh, PA 15222; see attached statement. 182,404.93 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 186817.02 ''''''''"''0''''''. COMMONWEAlTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Russell Louise B FILE NUMBER 21 01 0493 This schedule must be completed and filed if the answer 10 any of questions 1lhrough 4 on the reverse side of the REV.1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY % OF ITEM INClUOETHE tw.EOfTHETAANSFERB:.TH':fl.RELATIONSHP10DECEDENTANOHEOATE Of TRANSFER. DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE NUMBER ATTACH A COPY Of nE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (FAPPLICA8lE) 1. Annuity policy #C61012157, Union Central Insurance and 24,975.23 100. 24,975.23 Investments; estate named beneficiary; see attached statement. 2. Annuity policy #C61012509, Union Central Insurance and 23,543.30 100. 23,543.30 Investments; estate named beneficiary; see attached statement. 3. Annuity policy #C61 005883, Union Central Insurance and 39,230.58 100. 39,230.58 Investments; daughter Nancy C. Mullett named beneficiary; see attached statement. 4. Annuity policy #C61012728, Union Central Insurance and 23,422.71 100. 23,422.71 Investments; daughter Nancy C. Mullett named beneficiary; see attached statement. 5. Individual Retirement Account #C14731816T, Union 2,109.16 100. 2,109.16 Central insurance and Investments; daughter Nancy C. Mullett named beneficiary; see attached statement. . TOTAL (Also enter on line 7, Recapitulation) $ 113 280.98 '".,"",.,""W COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Russell Louise B FILE NUMBER 21 01 0493 Debts 01 decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: 1. Myers-Harner Funeral Home, Camp Hill, PA; professional services, facilities, 6,258.00 automotive equipment, merchandise, newspaper notices, death certificates, clergy, flowers. 2. Rolling Green Cemetery, open vault, stone inscription. 728.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s} I EIN Number of Personal Representative(s) Street Address Cily Slale Zip Year(s) Commission Paid: 2. Attorney Fees NONE 3. Family Exemption: (If decedent's address is nollhe same as claimanl's, aUach explanalion) , Claimant Street Address City Slale Zip Relationship of Claimanllo Decedent 4. Probate Fees Cumberland County Register of Wills, Petition for Probate, codicil, 286.50 short certificates, JCP fee 5. Accountant's Fees 6. Tax Return Prepare~s Fees 7. The Patriot News, estate advertisement 204.00 8. Cumberland County Law Journal, estate advertisement 75.00 9. Reserve for filing fees and estate closing costs 250.00 TOTAL (Also enter on line 9, Recapitulation) $ 7 801.50 .. (If more space IS needed, Insert additional sheets of the same size) ;"""""'01"'''. COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Russell Louise B. FILE NUMBER 21 01 0493 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 672.15 1. PharMerica Harrisburg, medical expense 2. Wildeman and Q'Brock, CPA's, preparation of 2000 individual income tax returns 265.00 3. Holy Spirit Hospital, medical expense 50.88 4. West Shore Health & Rehab. Center, medical expense 410.04 5. Phil haven, medical expense 14.90 6. West Shore Emergency Medical Services, medical expense 79.95 7. Travelers, insurance premium 77.49 B: Quantum Imag. & Thera. Assoc. (Holy Spirit), medical expense. 34.17 TOTAL (Also enter on line 10, Reoapiluration) $ (If more space is needed. Inserl additional sheets of the same size) 1 604.58 '''V'''''''.'HOW COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER RUoooll n"loe R ?1 n1 0493 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1. Nancy Carroll Mullett daughter 95% residue 3943 NewdaJe Rd. LL-41 Chevy Chase, MD 59018 2. Edward Martin Brown grandson 5% residue HC 60, Box 531 Orbisonia, PA 17243 , ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. - TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEE' $ (If more space IS needed, Insert additional sheets of the same size) 21-01-493 CODICIL TO THE LAST WILL AND TESTAMENT OF LOUISE B. RUSSELL I, LOUISE B. RUSSELL of Cumberland County, Pennsylvania, declare this to be the sole codicil to my Last will dated Febru- ary 26, 1991. I - I hereby amend paragraph III-B. of my said Last Will and Testament to read as follows: III-B. I bequeath the remaining 95% of said residue to my trustee hereinafter named, IN TRUST, nevertheless, for my daughter, Nancy Carroll Mullett. My trustee shall pay all of the expenses of the trust and shall distrib- ute the balance of the net income to her in at least quarter-annual installments. In addition, my trustee shall have the power, at its sole and absolute discretion, to make further distributions from principal for her maintenance and support should such expendi- tures become necessary. Should my said daughter become a widow or be unmarried prior to her death, the trust shall terminate and the balance of the trust estate shall be distributed to her, including both principal and accumulated and undistributed income. Should my said daughter die prior to the distribution of the balance of the trust, then the remaining trust, including principal and income accumulations shall be distributed as follows: ~IDIS, GUIDO, SHUFF & MASLAND ~ 1 09 Market Street Camp Hill. PA 1. 95% of said trust estate shall be distributed to my grandson, Edward Martin Brown, or his issue per stirpes. 2. 5% of said trust shall be dis- tributed to the Camp Hill Presbyte- rian Church. , //~ ,/ I -- ~ Page 1 "'IDIS, GUIDO, SHUFF & MASLAND ~109 Market Street Camp Hill. PA II - In all other respects I hereby ratify, confirm and I republish my Last Will dated February 26, 1991, together with this sole codicil as and for my Last will. IN WITNESS WHEREOF, _ I A.-r this, the 6 - day I have hereunto set my hand and seal on }/h~ of , 1995. ~~~~l<4~ Louise (SEAL) Signed, published and declared on the date thereof by the above- named LOUISE B. RUSSELL, Testatrix as and for the sole codicil to her Last Will dated February 26, 1991 in the presence of us, who at her request, in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses hereto. Iv\)- Name _~)\G\\\ y ~ Address Name () ,/ .J ~~h~\/q /' Address c j:) u 'IS, GUIDO, HUFF & ASLAND Market Street mp Hill, PA COMMONWEALTH OF PENNSYLVANIA) SS. COUNTY OF CUMBERLAND) WE, the undersigned, the testatrix and the. witnesses, respectively, whose names are signed to the foregoing instru- ment, being first duly sworn, do hereby declare to the under- signed authority that the testatrix signed and executed the instrument as the sole codicil to her Last will and Testament and that she signed willingly (or willingly directed another to sign for her), and that she executed it as her free will and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix signed the will as witnesses 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. '--~-'- "..:~j / /' ---{'<' '-..J e-pt~iJ<; . - ~vl,~ .;'- _J_> Subscribed, sworn to and acknowledged testatrix, and subscribed and sworn_~o before nesses, this -3(I-TT day of c:h1.!J-'-C () before me by the me by both wit- , 1995. >ftmJ) ~;'fi~4L~<-': INotary Public NOTARIAL SEAL THELMA S McCAUSLIN. Notary Public Camp Hill. Cumberland County My Comml5S:CP €x,1i'es July 3.1996 ., ---. ~'-'_.--'. ,~--_.~,._-,~--- 21-01-0493 LAST WILL AND TESTAMENT OF LOUISE B. RUSSELL I, LOUISE B. RUSSELL of East pennsboro Township, Cumberland County, Pennsylvania, declare this to be my Last will and Testament, hereby revoking any will previously made by me. I - I direct the payment of all my just debts and funeral expenses out of my estate as soon as may be practical after my death. II - I bequeath certain items of my tangible personal property, not including cash and securities, in accordance with a written list made by me during my lifetime. In the absence of such a list or desig- nation on said list, I bequeath all of my tangible personal property to my daughter, Nancy Carroll Mullett. Should my said daughter predecease me, then I direct that such of my articles of tangible personal property which are not designated on a written list be sold and the proceeds added to the residue of my estate. III - I devise and bequeath all the rest, residue and remainder of my estate as follows: A. I bequeath 5% of said residue unto my grandson, Edward Martin Brown. II ..~~.~ , ;/ ,~--?' /r-; ,,7 .' ;;~ ,(:/7 ~<~~) .. ~ ~ ."'?'J- ':-~--r< .Y' Page 1 ARNOLD & SUKE, ...nORNE'{S-AT-lA...... 2109 MARKET STRUT C^~'P HILL. PA 17011 B. I bequeath the remaining 95% of said residue to my trustee hereinafter named, IN TRUST, nevertheless, for my daughter, Nancy Carroll Mullett. My trustee shall pay all of the expenses of the trust and shall distribute the balance of the net income to her in at least quarter-annual installments. In addition, my trustee shall have the power, at its sole and absolute discretion, to make further dis- tributions from principal for her maintenance and support should such expenditures become necessary. Should my said daughter become a widow prior to her death, the trust shall terminate and the balance of the trust estate shall be distributed to her, including both principal and accumulated and undistributed income. Should my said daughter die prior to the distribution of the balance of the trust, then the remaining trust estate, including principal and income accumulations shall be distributed as follows: 1. 50% of said trust estate shall be distributed to my grandson, Edward Martin Brown, or his issue per stirpes. 2. 10% of said trust estate shall be distributed to the Camp Hill presbyterian Church. 3. 10% of said trust estate shall be distributed to Shippensburg University Foundation. 4. 10% of said trust estate shall be distributed to the American Red Cross. 5. 10% of said trust estate shall be distributed to the Harrisburg Chapter of the Salvation Army. c_-- ~r~~= /:J~) ~)cc',,-,,;"ec// / -! Page 2 ARNOLD & SLIKE, ATTOR...EYS.Al.LA..... 2109 .\.\ARKET S1:\l,E.ET. CAMP HILl. PA 17(l11 6. 10% of said trust estate shall be distributed to Goodwill Industries of Harrisburg, pennsylvania. IV - In addition to the powers above provided for, and those given by law, trustee, without any order of court and in its sole dis- cretion, may: A. Retain any property received hereunder and invest and rein- vest in any prudent investment, including but not limited to, common or diversified trust funds maintained by trustee and any form of life insurance, annuity or endowment policies; settlor's dwelling house or other real estate; and in so doing settlor's trustee may act without restriction to so-called legal investments and without responsibility for diversification. B. Keep reasonable amounts of cash in bank uninvested. C. Purchase investments at premiums and charge premiums to income or principal or partly to each. D. Subscribe for stocks, bonds or other investments; exercise any stock option or similar right; join in any plan of lease, mortgage, merger, consolidation, reorganization, foreclosure of voting trust and deposit securities thereunder; and generally exercise all the rights of security holder of any corporation. E. Register securities in the name of a nominee in such manner that title shall pass by delivery. F. Vote in person or by proxy, securities held by it and in such connection to delegate its discretionary powers. G. Repair, alter, improve or lease for any period of time any property and give options for leases. H. Sell at public or private sale, for cash or credit, without or with security, and exchange or partition property and give options for sales or exchanges. I. Borrow money from any person, including any executor or trustee,. and mortgage or pledge any property. II /~~~~/~ / ./ /7 Y1 l ~ // ?/ //.CCl/;J<r:~ .. ~:-: ". - ".- - Page 3 ARNOLD & SUKE. ATTQR:"<EYS.AT-LAW. '210~ .\1ARKET STREET. CAMP HILL. PA 17011 J. Compromise claims. K. Add to the principal of any trust created hereunder any property received from any person by deed, will or in any other manner. L. Pay premiums of any life insurance, annuity or endowment policies which may have been retained or purchased herein and exercise any right, option or privilege thereunder. M. In the exercise of its discretion with respect to the use of principal for any beneficiary, take into account other property and income available to such beneficiary; in so doing, trustee may con- clusively rely on written representations made to it by such benefic- iary, and the judgment of trustee as to the amount of principal so used and the extent to which other resources are considered shall be con- clusive as to all parties in interest. N. Advise with settlor's executor in the choice of a date for valuing property in settlor's gross estate which it deems most advisable I without adjustments between any beneficiaries in consequence of the exercise of such discretion. O. Advise with settlor's executor in the use of expenses and losses as deductions for federal income tax or estate tax purposes, or party for each, as it shall be deemed advisable, without adjustments between income and principal in consequence of the exercise of such discretion. P. Treat as income all income accrued and unpaid on assets at the time such assets become a part of this trust. Q. Purchase assets from settlor's estate at fair market value and loan money to said estate. R. Make distribution in cash or in kind or partly in each. S. Exercise all power, authority and discretion given by this trust after termination of any trust created herein until the same is fully distributed. T. Settlor's fiduciary shall be entitled to compensation for services hereunder in accordance with the standard schedule of charges currently in effect at the time the services are called upon, and from time to time during the period over which such services are performed. II ,- . \,.:'->,....--' .-"', ~ ;,-'-// :J/ // ~ / / /j" ) '-21/"./'-/' . ------,<,_../:::.:;..-. ~:/.,-// .. 'j -- Page 4 ARNOLD & SLIKE, ATTOR~f.YS'AI-LA,^.lI04 M....RIi.ET STREET. CA.\lP HIl.L. P..... 1701 t v - I hereby appoint CCNB Bank, N.A., Camp Hill, Pennsylvania, Trustee of the trust created herein. VI - I appoint my daughter, Nancy Carroll Mullett, Executrix of this, my Last will and Testament. Should my said daughter fail to qualify or cease to act as such, then I appoint John E. Slike, Esquire, to act in this capacity. Neither of my personal representatives shall be required to post bond in this or any jurisdiction. IN WITNESS WHEREOF, d (p --/:L day of set my hand and seal on this the , 1991. ~ , / '~) !"~' /7 L?'V} ,',,,;/<2./, ':1''1; /j A"?.:2-<z/r::e/ Louise B~[Russell (SEAL) Signed, sealed, published and declared by LOUISE B. RUSSELL, Testatrix therein named, on this and four (4) other sheets of paper as and for her Last will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. -fvu P ,~, Name ~L.~ Name ' ~I /I.J j d. Address! ' II J6~~, //J Address Page 5 ARNOLD & SLl KE, ATTORr-iEYS.AT_LA..... 2109 MARKET STREET, CA.\IP HILL. P.A 17011 COMMONWEALTH OF PENNSYLVANIA) 55. COUNTY OF CUMBERLAND) WE, the undersigned, the testatrix and the 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 Testament and that she signed willingly (or willingly directed another to sign for her), and that she executed it as her free will and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix signed the will as witnesses 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. / ( , ~. ._'7 (/.) l../~ . // 7,] . / .:c<fr~ Testatrix " ~---// /? - / 0-"-'~~~ ~ . .I / c, ~-LJJ witness . Subscribed, sworn SUbsc~~~rn to to and acknowledged before me by the before me by both witnesses, this , 1991. te!)t.urix, and ~~;:JI day of /~~.ot:~ Notary Public NOTARiAL SEAL THELMA S. Mc.CAUSLlN. Notary Public Camp Hill, PA GU~1b-9( ,;l.~ COU~y 2 tJy Cornmis~jcn Expires July 3. 1;19 ARNOLD & SLlKE. ..., IOII...H\ AT LH... llU" .'.""./U<.[T ..l\l.HT.r........1I' HILl PA 1/011 JUN-11-200l 15:34 PNCBANK CIF DEPARTMENT 412 705 0057 P.Ol/0l 0PNCBAN< Decedent Reporting Firstside Center 500 First Avenue, 4th Floor Pittsburgh, P A 15219-3128 /SCP June 11,2001 Edward M Brown PO BOX 250 Orbisonia P A 17243 RE: Estate of Louise B Russell,Deceased SSN: 207-34-5986 DOD: 05/07/2001 Dear Mr. Brown: Please find the date of death balances you have requested listed below. CHECKING ACCOUNT #5140054564 Established 01/01/1978 LOUISE B RUSSELL DOD Balance: $4,412.09 + $0.00 (non into bearing) accrued interest Our office only provides date of death balances for IRA's, CD's, Checldng and Savings accounts. We do ~ Financial Transactions or Statement Orders. For Further information please call1-800-4-BANKER or your local PNC Branch and ask to speak with a Fiuancial Services Representative. Sincerely, Marian Donnelly 1-800-762-1775 Page I of1 A member of The PNC Financial Scrvicl:':i Group fiNe Bank. N.A. Pittsburgh P~nnsvlvanja El265 TOTAL P.Ol o PNCADVlSORS May 23, 2001 Mr. Edward Brown HC60 Box 531 Orbisonia, PA 17243 RE: Louise B. Russell Trust #16-27-027-3131589 Dear Mr. Brown: Enclosed is the date of death value for Louise B. Russell's Trust. Until the trust is closed, it will continue to receive income and dividend payments on the funds. Currently the trust value is $182,404.93. If you have any questions or concerns regarding this matter, please do not hesitate to call. Respectfully, /fi{t'/~;, r;;~G_<C----- Andrea Carlson Trust Administrator PNC Advisors Service Center Enclosure A member of The PNC Financial Services Group Two PNC Plal:1 620 Liberty Avenue Pittsburgh Pt'nnsylv,1ni:~ 15222 The Union Central Life Insurance Company l876 Waycross Road PO Box 40888 Cincinnati,OH 45240 (513) 595 2200 --------.11 UnlonCentlal InsurallC~ and Investments July 19,2001 EDW ARD M BROWN ESQ PC HC 60 BOX 531 ORBISONIA PA 17243 C147318161 C61005883 C61012157 C61012509 C61012728 Louise Russell Dear Mr. Brown: This is written in response to your letter of July 15, 200 I regarding the policies listed by number above. The values of these policies as of Ms. Russell's dale of death, 5-7-01, are as follows: C14731816T C61005883 C61012157 C61012509 C61012728 $2,109.16 $39,230.58 $24,975.23 $23,543.30 $23,422.71 Enclosed is our Claimant's Statement Form UC 3963 as requested. Please do not hesitate to contact me at 1-800-319-6302 if you should have any questions. Respectfully, /~~ )\ ffi,~ C"', j~ Becky Vonderhaar, FLHC ACS HIA Claims Specialist Individual Life Claims Enclosures brv cc: Agency 1691 Securities products offered through registered representatives of Carillon Investments, Inc., a subsidiary of The Union Central Life Insurance Company. P.o. Box 40409. Cincinnati, Ohio 45240-0409. (513) 595-2600