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Home My WebLink About01-0554 PETITION FOR PROBATE and GRANT OF LETTERS Estate of MARY M. KELSO also known as , Deceased. No. To: ~\-O\- 55~ Register of Wills County of Cumberland in the Commonwealth of Pennsylvania Social Security No. 203 - 10 - 8773 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 January 31,2001. Decedent was domiciled at death in HOPEWELL TOWNSHIP, Cumberland County, Pennsylvania, with her last family or principal residence at 121 Turnpike Road, Newburg, Cumberland County, Pennsylvania 17240. Decedent, then 78 years of age, died April 19, 2001, at Falling Springs Nursing and Rehabilitation Center, Chambersburg, Franklin 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 $ 1,500.00 $ $ $ 50,000.00 $ 51,500.00 WHEREFORE, petitioner respectfully requests the probate of the last will presented herewith and the grant of letters testamentary thereon. ~u-n cxy x5u {J~ 'SHARON L. BAER P.O. BOX 204, NEWBURG, PA 17240 '64J/A~,qzJ, 'liLs BRIAN W. KELSO 220 SHIPPENSBURG RD, SHIPPENSBURG, PA 17257 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 truly administer the estate according to law. Sworn to and subscribed . 4-~A/1 0;/ '-6c:/J!~1 before me this 26TIdlayof SHARON L. BAER ~~K 2001 . ~_~~NE @. . MARY LEWIS Register yg/Ua~l 'l./ ~(f=- BRIAN W. KELSO d" t lo -~ ?2lo - ~ m~ (Y) Estate of 8 . 'IL', KELSO, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW, 6/1 U 2001, in consideration of the petition attached hereto, satisfactory proof having been presented before me, IT IS DECREED that the instrument dated January 31, 2001, described therein, be admitted to probate and filed of record as the last will of MARY M. KELSO and Letters Testamentary are hereby granted to SHARON L. BAER and BRIAN W. KELSO, FEES Probate, Letters, Etc, Short Certificates ( 6 ; Renunciation J.cPAGES (3) TOTAL Filed: JUNE 12. $ 115.00 $ 18,00 $ $ ---5..:..8B-. $ 147 . 00 2001 HAROLD S, IRWIN III (ID NO 29920) 35 East High Street Carlisle, PA 17013 717 -243-6090 i.' . Called attorney on 6-12-01 LAST WILL AND TESTAMENT I, MARY M. KELSO, of 121 Turnpike Road, Newburg, Cumberland County, Pennsylvania, 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. I direct that all inheritance taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property, whether or not such property passes under this Will, shall be paid by my personal representative out of my estate. 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 therefore, 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 as follows: A. 20% to Sharon L. Baer; B. 20% to Brian W. Kelso; C. 10% to Wilbur T. Kelso, Jr.; and D. 50% to be divided equally among the following: 1.) Donnie E. Kelso 2.) Delores J. Stouffer 3.) Barbara A. Cooper 4.) Marinda K. Mathna 5.) Mary E. Rotz 6.) Gary L. Kelso 7.) Wanda R. Dunlap 8.) Phyllis E. Adkins 9.) Cyrus Michael 10.) James R. Kelso E. If any of my beneficiaries listed in subparagraphs 0.1. through 0.10 above predecease me, then the share of such deceased beneficiary I give, devise and bequeath to such beneficiary's children, share and share alike. 4. I nominate and appoint Brian W. Kelso, and Sharon L. Baer to be the co- personal representatives of my estate, to serve without bond. 5. I suggest that my personal representative retain the services of the Law Offices of Harold S. Irwin, III, Carlisle, Pennsylvania in the settlement of my estate. -"1.. ( \ Jf'" IN WITNESS WHEREOF, I have hereunto set my hand and seal this 7 day of January, 2001. -- HLI'~ r ) MA\v M. KELSO - Ivt ~ ,t1~ tL- -- (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. ~4~()1J lUff #~L W 4-b7-- ACKNOWLEDGMENT AND AFFIDA VIT WE, MARY M. KELSO, RHONDA S. VON KLlTZING and HEATHER A. BARBOUR, 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. I tb-1..-- M: j-KELSO &J:Ji/Wf) ~tf RHONDA S. VON KLlTZING <4\~~/Z: ~z-/a--- HEATH R A. EfAR OUR COMMONWEALTH OF PENNSYLVANIA :55: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by MARY M. KELSO the testatrix herein, and subscribed and sworn to before me by RHONDA S. VON KLlTZING and HEATHER A. BARBOUR, wit esses, this "]IV day of January, 2001. Notarial Seal Harold S. Irwin III, Notary Public Carlisle Boro, Cumberland county My Commission Expires Sept. 23, 2002 Member, Pennsylvania ASSOCiation ot Notanes REGISTER OF WILLS OF CUMBERLAND COUNT\' OATH OF WITNESS TO "'ILL EXECUTED BY MARK RHONDA S VON KLITZING k/n/a RHONDA S IRWIN and HEATHER A BARBOUR , (each) Xotit<<oH< a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that: testaLBLX- was unable tl1 sign ItE:B____ name thereto; testalR IX_ 's name was subscribed thereto In testat~__'s presence; testatRiX made h_ER_ mark thereon; testat-Rl-X- and deponent(s) ~)( (were) present when testatRIX___'s name was subscribed and witness(es). :t~\(iX:~ ~;jjiliii;:ign'd Zj~j when lestatRlL_ made hJ;B__ mark; and testatRIL_ Sworn to or affirmed and subscribed before me this 12TH (Name) day of (~ . / (Address) 'rt;;I/2j1~ 46~~/~ (Name) 1/3 ;lOti 7{2<c't /Jt2(f/Z/ /lZ(/V)LL~//4 , 172 ~( (Addres,) f - .s-- CERTIFICATE OF NOTICE UNDER RULE 5.6{M Name of Decedent: KELSO, MARY M. Date of Death: APRIL 19,2001 Will No. 2001-0~ Admin. No. 21-01-554 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 June iL, 2001. Name Address SHARON L. BAER PO BOX 204 NEWBURG PA 17240 BRIAN W. KELSO 220 SHIPPENSBURG ROAD SHIPPENSBURG PA 17257 DONALD E. KELSO 13672 WILLlAMSPORT PIKE GREENCASTLE PA 17225 DELORESJ.STOUFFER 13545 FORGE HILL ROAD ROXBURY PA 17251 BARBARA A. COOPER 149 TOPAZ DRIVE CHAMBERSBURG PA 17201 MARINDA K. MATHNA 163 GARDNER DRIVE SHIPPENSBURG PA 17257 MARY E. ROTZ 324 NOVA DRIVE GREENCASTLE PA 17225 GARY L. KELSO 221 WILLIAMS HILLTOP ROAD 96 SC 29666 WANDA R. DUNLAP 10639 TI M ROAD ORRSTOWN PA 17244 PHYLLIS E. ADKINS 1592 SKYLINE DRIVE ORRSTOWN PA 17244 CYRUS M. KELSO 8337 MCCLAYS MILL ROAD NEWBURG PA 17240 JAMES R. KELSO 4616 SOUTHLAND AVENUE ALEXANDRIA VA 22312 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None June 18,2001 35 East High Street, S . e 2 Carlisle, PA 17013 717-243-6090 Attorney for Estate of Mary M. Kelso -- -..... ~ .~ _".:.~ CERTIFICATE OF NOTICE UNDER RULE 5.6{M Name of Decedent: KELSO, MARY M. Date of Death: APRIL 19, 2001 Will No. 2001-05S4:- Admin. No. 21-01-554 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 June.ii:.-, 2001. Name Address SHARON L. BAER PO BOX 204 NEWBURG PA 17240 BRIAN W. KELSO 220 SHIPPENSBURG ROAD SHIPPENSBURG PA 17257 DONALD E. KELSO 13672 WILLlAMSPORT PIKE GREENCASTLE PA 17225 DELORESJ.STOUFFER 13545 FORGE HILL ROAD ROXBURY PA 17251 BARBARA A. COOPER 149 TOPAZ DRIVE CHAMBERSBURG PA 17201 MARINDA K. MATHNA 163 GARDNER DRIVE SHIPPENSBURG PA 17257 MARY E. ROTZ 324 NOVA DRIVE GREENCASTLE PA 17225 GARY L. KELSO 221 WILLIAMS HILLTOP ROAD 96 SC 29666 WANDA R. DUNLAP 10639 TIM ROAD ORRSTOWN PA 17244 PHYLLIS E. ADKINS 1592 SKYLINE DRIVE ORRSTOWN PA 17244 CYRUS M. KELSO 8337 MCCLAYS MILL ROAD NEWBURG PA 17240 JAMES R. KELSO 4616 SOUTHLAND AVENUE ALEXANDRIA VA 22312 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None June 18, 2001 35 East High Street, S . e 2 Carlisle, PA 17013 717 -243-6090 Attorney for Estate of Mary M. Kelso -r- 'S\ , ~; - - :: - - - - ~ - - ~ - - - - - - - - <:-> I I : (I'l f') 1" I ,., ... JAMES A. BALOGH (MN) GARY W. BECKER (MN, WI, FL, IL, DC) MICHAEL C. CONN (MN) CHELSEA A. JAGUSCH (MN, WI) ANGELA M. HORN (MN) BALOGH BECKER, LTD. ArrORNEYS AT LAW 3100 WEST LAKE STREET, SUITE 110 MINNEAPOLIS, MINNESOTA 55416 TOLL FREE: 1-888-762-9997 E-MAIL: ESTATE@CREDIT-COLLECTION.COM FAX: (612) 915-1231 OF COUNSEL: LUSTIG, GLASER & WILSON, P.C. (MA) October 9,2001 CUMBERLAND CTY PROBATE CT 1 COURTHOUSE SQUARE #102 CARLISLE P A 17013 RE: In the Estate of Probate Case No. Social Security No: Last known residence: Our Client: Account Number: Amount of Debt: MARY KELSO 21-01-554 201-09-8681 121 TURNPIKE RD NEWBURG PA 17240-9328 Sears, Roebuck and Co. 0558876150746 $1,515.89 Dear Sir or Madam: Enclosed please find a Creditor's claim to be filed in the record with the above-referenced Estate. Please return a file stamped copy of the claim in the enclosed self-addressed, stamped envelope. Thank you for your assistance. If you have any questions or concerns, please call our firm toll free at 1-888- 762-9997. Sincerely, /s/ Chelsea Jagusch Balogh Becker, LTD Attorney for Claimant N:/PCRTCOV Enclosures If applicable, a check for the filing fee cc: Attorney for Estate Personal Representative This communication is from a debt collector. COMMONWEALTH OF PENNSYLVANIA COURT OF COMMON PLEAS CUMBERLAND COUNTY ORPHANS' COURT DIVISION NOTICE OF CLAIM In Re: The Estate of: Mary Kelso Deceased Court File No: 21-01-554 TO: THE CLERK OF THE ORPHANS' COURT DIVISION: Notice of claim by creditor, Pursuant to Section 3532(b)(2) of the Probate, Estates, and Fiduciaries Code, 20 PA.C.S.A. 93532(b)(2). 1) Claimant's name: Sears Roebuck & Co. 2) Claimant's address: C/O Balogh Becker, Ltd. 3100 W. Lake St. Ste. 110 Minneapolis, MN 55416 3) Creditor listed below is the owner and holder of a claim in the amount of $1,515.89 4) The facts upon which this claim is based is a credit agreement between Creditor and Decedent, identified as account number which is evidenced by the attached Affidavit of Account Stated. 5) Decedent's address: 121 Turnpike RD, Newburg, PA 17240-9328 6) Date of Death: 04/19/2001 7) That the claim arose prior to the death of the decedent on or about 8) That the claim is secured by On behalf of the claimant, I do solemnly declare and affirm under the penalties of perjury that they Information and representations made herein are true and correct to the best f my knowledge, information and belief. Dated: Chelsea A. J gu ch/Angela M. Horn, Attorney f r C aimant Written notice of claim was given to Personal Representatl and/or his/her counsel as stated below: Sharon Bear Name c/o Harold E. Erwinn III. ESQ., 35 E High St. #201 Address Carlisle, PA 17013 City/State/Zip 0\ This "Backer" must be used in Montgomery, Luzerne & Allegheny Counties )> "'0 )> n m 0 ~ I 0 s;: (f) .., 0 0 ~ "C 2 ;;0 ...... ~ 3: OJ ...... m m )> m :J 0 * (f) 2 Vl_ * .. (f) --i 0 ........ CD " n ...." CD (f) I 0 OJ CD 2 c "C I 3:wn )> ;:+ -...J "C 0'1 .............- 3: 2 n N 200 m 0 OJ I 200J .. 0- U) m:E)> (f) U) N CD U) )>m' CD ....... '-" -...J "'O(f)O OJ 0 I ~--jG) .., m 0 Vl ......s;:I n ....... ,(f) OJ ;;0 m I 0 n )> U'1 3:^m CD (f) U'1 mn 0- s;: m ~ 2(f)^ c n ...... 0 U'1--j~ ^ 3: U'1(f) ~ ~--j~ n .......mO 0 0'1....... ....... 0 IN RE ESTATE OF: MARY KELSO AFFIDAVIT OF ACCOUNT The undersigned, being first duly sworn deposes and states the follows: 1. Your Affiant is authorized by the Claimant as its Attorney-In-Fact to make this Affidavit. 2. Your Affiant has reviewed the account records of the Claimant with respect to the decedent. Your Affiant is familiar with these records and accounts and reviews them as a regular part of her duties. 3. The Decedent purchased merchandise in the amount of $1,515.89 evidenced by account number 0558876150746. 4. The unpaid balance does not include any late payment charges, accrued interest, collection costs or attorney's fees. Further your affiant sayeth not u ch 303719 d. 31 00 West La treet, Suite 110 Minneapolis, MN 55416 Subscribed and sworn before me This ,'5 day of (}eJv~\/-' ,2001. ~~Q~~ - otary Public '-- N :/PCLMAFF 4"i.I""5,,,_ FER L PUGH ~~~i;; "i~'.:-.. JENNI . . 1~~.';.:."" Not~ry Public . '. ji~~, Minnesota "filij;~~; . My Commission Expires Jan 31, 2005 G ;/ Inventory of the real and personal estate of MARY M. KELSO, deceased 1. HOUSE AND LOT OF GROUND AT 121 TURNPIKE ROAD, NEWBURG. CUMBERLAND COUNTY. PENNSYLVANIA 17240 32,000 00 2. CASH ON HAND 965 73 3. CAPITAL BLUE CROSS - Medical Insurance Reimbursement 990 00 . 4. OLD GUARD INSURANCE -Insurance Refund 13 82 5. PA BLUE SHIELD -Insurance Refund 1 91 6. ADAMS ELECTRIC - Refund 3f6 74 7. PRUDENTIAL INSURANCE - Stock Dividend 625 68 8. HOUSEHOLD GOODS AND PERSONAL EFFECTS 798 00 9. REAL ESTATE TAX PRORATION ON SALE OF REAL ESTATE ~57 27 10. ORRSTOWN BANK - Checking Account No. 331449 262 73 , i -- ,~ -- TOTAL 36,301 88 COMMONWEALTH OF PENNSYLVANIA: :55: COUNTY OF CUMBERLAND SHARON L. BAER and BRIAN W. KELSO, being duly sworn according to law, depose and say that they are the executors of the estate of MARY M. KELSO, late of Hopewell Township, Cumberland County, Pennsylvania, deceased, and that the within inventory made by them, the said executors of the entire estate of said decedent, consisting of all of the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the inventory represent its fair value as of the date of decedent's death. Sworn to and subscribed before me ~~ Y ~) . Y of August, 2002 -SHARON L. BAER 9(~ ~~ttu. BRIA W. KELSO Executrix No rial Seal Harold S. I in III, Notary Public , Cumberland County My Commission Expires Sept. 23, 2002 Mem~9 Pennsylvania Association 01 Notaries APRIL Executor 2001 Date of Death: Day Month Year INSTRUCTIONS 1. An inventory must be filed within three months after appointment of personal representative. 2. A supplemental inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty. 4. See Article IV, Fiduciaries Act of 1949. REV-1500 EX (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 11-;};j 10 - ~ OFFICIAL USE ONLY (/,/ REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 COUNTY CODE 01 YEAR 0554 NUMBER DECEDENT'S NAME ( ST, IRSTANDMIDDlEINI IAll SOCIALS CURITYNUMBER KELSO, MARY M. 203 -10 - 8773 DATE F BIRTH DATE OF DEATH NOVEMBER 16, 1922 APRIL 19, 2001 (IF APPLICABLE) SURVIVING SPOU E'S NAME (LAST, FIRST AND MtDDL INITIAL) OCIAL ECURtTY NU BER 4. Limited Estate _ 2. Supplemental Retum _ 3. Remainder Return (dates of death prior to 12-13-82) _ 5. Federal Estate Tax Return Req l 1. Original Retum ..lL 6. Decedent Died Testate (Attach copy of Will) EX. A _ 9. Litigation Proceeds Received _ 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) NAME HAROLD S. IRWIN, III TELEPHONE NUMBER 717.243.6090 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages and Notes Receivable (Schedule D) 5. Cash, Bank Dep & Mise Personal Property (Sched E) 6. Jointly Owned Property (Schedule F) 7. Transfers I Misc. Property(Schedule G) (Schedule L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Sched H) 10. Debts, Mortgage liabilities & Liens (Schedule I) 11. Total Deductions (Iotal Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests (schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 15. Amount of Une 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 _ 8. Total No. Of Safe Deposit Boxes 11. COMPLETE MAILING ADDRESS 35 EAST HIGH STREET, SUITES 201/202 CARLISLE, PA 17013 (1) 32,000.00 (2) 0.00 (3) 0.00 (4) 0.00 (5) 4,301.88 (6) 0.00 (7) 0.00 (9) 15,791.16 (10) 11,619.20 OFFICIAL USE ONLY " l.C (8) 36,301.88 (11) 27,410.36 (12) (13) 0.00 (14) 8,891.52 x. - = (15) 0.00 $ 8,891.52 x.045 = (16) 400.11 X .12 = (17) 0.00 $ X .15 = (18) 0.00 (19) 400.11 Decedent's Complete Address: STREET ADDRESS 121 TURNPIKE ROAD CITY I STATE I ZIP NEWBURG PA 17240 Tax Payments and Credits: 1. Tax Due (Page 1 line 18) 2. Credits I payments A, Spousal Poverty Credit S. Prior Payments C. Discount (1) $400.11 3. Interest I Penalty if applicable D. Interest E. Penally Total Credits (A+B+C) (2) Total Interest/Penally (D+E) (3) 4. /fLine 2 is greater than Line 1 + Line 3. enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2. enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. (5A) (5) $400.11 B. Enter the total of Line 5+5A. This is the BALANCE DUE. (5B)$400.11 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. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ............ ......... ......... ..................... .................................... ......... ...... 4. Did decedent own an individual retirement account, annuity, or other non-probate property? ...... No ~ -X.. -X.. -X.. N/A -X.. -X..... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN Under penalties of perjury, I 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 information of which preparer has any knowledge. i-/3-a DATE AUGUST , 2002 DA}ljo AUGUST'..) 2002 For dates of death on or after Ju, 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 exemct a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and tiling a tax retum 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 .5. Section 9116 (a)(1.2)). The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. Section 9116 (1.2)[72 P.S. Section 9116 (a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P .5. Section 9116 (a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV.1502 EX. (12.85) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MARY M. KELSO 2001 - 0554 (Property jolntly-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 OF GROUND AT 121 TURNPIKE ROAD, NEWBURG, CUMBERLAND COUNTY, PENNSYLVANIA 17240 (Value based on sale price - see HUD-1 attached as Exhibit "B") $ 32,000.00 TOTAL (Also enteron Line 1, Recapitulation) $ 32,000.00 (If more space is needed, insert additional sheets of same size.) REV-1503 EX + (4-86) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MARY M. KELSO (All property jolntlv-owned with Right of Survivorship must be disclosed on Schedule F.) ITEM DESCRIPTION NUMBER SCHEDULE B STOCKS AND BONDS FILE NUMBER 2001 - 0554 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 INHERITAf'lCE TAX RETURN RESIDENT DECEDENT ESTATE OF MARY M. KELSO SCHEDULE C CLOSELY HELD STOCK PARTNERSHIP AND PROPRIETORSHIP FILE NUMBER 2001 - 0554 ITEM NUMBER DESCRIPTION NONE TOTAL (Also enter on Line 3. Recapitulation) (ff more space is needed, insert additional sheets of same size.) NONE REV-1507 EX + (6-86) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT OECEDENT SCH~DULE D MORTGAGES AND NOTES REC~IVABLE ESTATE OF MARY M. KELSO (All property jolntly-owned with Right of Survivorship must be disclosed on Schedule F.) ITEM DESCRIPTION NUMBER FILE NUMBER 2001 - 0554 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 M. KELSO (All property Jolntly-owned with Right of Survivorship must be disclosed on Schedule F.) ITEM DESCRIPTION NUMBER FILE NUMBER 2001 - 0554 VALUE AT DATE OF DEATH 1. CASH ON HAND $ 965.73 2. CAPITAL BLUE CROSS - Medical Insurance Reimbursement 990.00 3. OLD GUARD INSURANCE - Insurance Refund 13.82 4. PA BLUE SHIELD -Insurance Refund 1.91 5. ADAMS ELECTRIC - Refund 386.74 6. PRUDENTIAL INSURANCE - Stock Dividend. 625.68 7. HOUSEHOLD GOODS AND PERSONAL EFFECTS (Value based on appraisal allached as Exhibit lie") 798.00 8. REAL ESTATE TAX PRORATION ON SALE OF REAL ESTATE 257.27 9. ORRSTOWN BANK - Checking Account No. 331449 (Value based on account statement attached as Exhibit "0") 262.73 TOTAL (Also enter on Line 5. Recapitulation) $ 4,301.88 (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 M. KELSO SCHEDULE F .JOINTLY-OWNED PROPERTY FILE NUMBER 2001 - 0554 JOlntt.nant(s): NAME ADDRESS RELATIONSHIP TO DECEDENT A. NONE B. c. Jolnlly-own.d property: ITEM LETTER DATE DESCRIPTION OF PROPERTY TOTAL DECO'S DOLLAR NO. FOR MADE VALUE e;.INT. VALUE 0 JOINT JOINT OF ASSET DECEDENT'S TENANT INTEREST NONE TOTAL (Also enter on Line 6. Recapitulation) NON (If more space is needed, insert additional sheets of same size.) REV-1510 EX + (2-87) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MARY M. KELSO 2001 - 0554 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 INTERVIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ITEM DESCRIPTION OF PROPERTY DATE OF NUMBER Indud$ name of thfJ transferee, their relationship to dtJcedent, date of transfer DEATH Of. OF EXCLUSION TAXABLE VALUE OF DECO'S (if applicable) VALUE ASSET 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 M. KELSO FILE NUMBER 2001 - 0554 ITEM DESCRIPTION AMOUNT NUMBER A. Funeral Expenses: 1. HOFFMAN - ROTH FUNERAL HOME, INC. $ 6,558.90 B. Administrative Costs: 1. Personal Representative Commissions: SHARON BAER / BRIAN KELSO 2,500.00 Social Security Number of Personal Representative:: Year Commissions Paid: 2002 2. Estimated Total Attorney Fees: HAROLD S. IRWIN, III 2,500.00 3. Family Exemption: Claimant Relationship Address of Claimant at decedent's death: Street Address City State Zip Code 4. Probate Fees: REGISTER OF WILLS 147.00 C. Miscellaneous Expenses: 1. REGISTER OF WILLS - File Inventory and Appraisement 25.00 2. HAROLD S. IRWIN, III - Notary Fees 10.00 3. KAY HURLEY - Real Estate Appraisal 75.00 4. CUMBERLAND COUNTY - Real Estate Taxes 606.88 5. SHELLY & WITTER, INC. - Surveyor Report 50.00 6. DAN HERSHEY AUCTIONEERING SERVICE - Personal Property Appraisal 25.00 7. EBENER & ASSOC / HALE REAL ESTATE - Real Estate Commissions 1,920.00 8. HAROLD S. IRWIN, III - Attorney Fees on Real Estate 650.00 9. RECORDER OF DEEDS - Real Estate Transfer taxes 320.00 10. RECORDER OF DEEDS - Filing Fees for Quit Claim Deed 30.50 11. 372.88 HARRY KILLIAN, TAX COLLECTOR - 2002 Real Estate Taxes TOTAL (Also enter on Line 9. Recapitulation) $ 15,791.16 (If mora space is needed, insert additional sheets of S8me size.) REV-1512 EX.. (1-93) COMMONWEALTH OF PENNSYLVANIA INHERITANCE T~ RETURN RESIDENT DECEDENT ESTATE OF MARY M. KELSO ITEM NUMBER SCHEDULE I DEBTS OF DECEDENT, MORTGAGES, LIABILITIES AND LIENS FILE NUMBER 2001 - 0554 DESCRIPTION AMOUNT $ 414.25 625.00 7,899.06 849.94 241.00 1,515.89 74.06 1. DIAMOND PHARMACY SERVICES - Medical Bill 2. OUTLOOK POINTE AT SHIPPENSBURG - Nursing Home Bill 3. FALLING SPRING NURSING & REHABILITATION CENTER - Nursing Home Bill 4. COLUMBIA PROPANE - Propane Gas Service 5. OLD GUARD INSURANCE - Homeowners Insurance 6. SEARS - Revolving Credit Account 7. ADAMS ELECTRIC - Electric Bill TOTAL (Also enter on Line 10. Recapitulation) $11,619.20 (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 M. KELSO SCHEDULE .. BENEFICIARIES FILE NUMBER 2001 - 0554 ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR NUMBER SHARE OF ESTATE A. Taxable Bequests: 1. SHARON L BAER DAUGHTER 20% RESIDUE PO BOX 204 NEWBURG PA 17240 2. BRIAN W KELSO SON 20% RESIDUE 220 SHIPPENSBURG ROAD SHIPPENSBURG. PA 17257 3. DONALD E KELSO SON 5% RESIDUE 13672 WILLIAMSPORT PIKE GREENCASTLE PA 17225 4. DELORES J. STOUFFER DAUGHTER 5% RESIDUE 13545 FORGE HILL ROAD ROXBURY PA 17251 5. MARINDA K. MATHNA DAUGHTER 5"/. RESIDUE 163 GARDNER DRIVE SHIPPENSBURG PA 17257 6. MARY E ROTZ DAUGHTER 5"/. RESIDUE 23 CENTER SQUARE GREENCASTLE PA 17225 7. GARY L KELSO SON 5"/. RESIDUE 221 WILLIAMS HILL TOP ROAD 96 SC 29666 8. WANDA R DUNLAP DAUGHTER 5"/. RESIDUE 10639 TIM ROAD ORRSTOWN PA 17244 9. PHYLLIS E ADKINS DAUGHTER 5% RESIDUE 1592 SKYLINE DRIVE ORRSTOWN PA 17244 10. CYRUS M KELSO SON 5"/. RESIDUE 8337 MCCLA YS MILL ROAD NEWBURG PA 17240 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.) REV-1513 EX + (2-87) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MARY M. KELSO SCHEDULE J BENEFICIARIES FILE NUMBER 2001 - 0554 ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR NUMBER SHARE OF ESTATE A.. Taxable Bequests: 11. JAMES R KELSO SON 5% RESIDUE 4616 SOUTHLAND AVENUE ALEXANDRIA VA 22312 12. HARRY W. COOPER, JR. GRANDSON 5% RESIDUE 1193 SHAR- PEl DRIVE CHAMBERSBURG PA 17201 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 M. KELSO, of 121 Turnpike Road, Newburg, Cumberland County, Pennsylvania, 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. I direct that all inheritance taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property, whether or not such property passes under this Will, shall be paid by my personal representative out of my estate. 2. I authorize and empower my personal representative to sell any realty 3nd/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 therefore, in fee simple, as I could do if living. My representative is authorized and empowered to engage in any business in which 1 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 as follows: A. 20% to Sharon L. Baer; 8. 20% to Brian W. Kelso; C. 10% to Wilbur T. Kelso, Jr.; and D. 50% to be divided equally among the following: 1.) Donnie E. Kelso 2.) Delores J. Stouffer 3.) Barbara A. Cooper 4.) Marinda K. Mathna 5.) Mary E. Rotz 6.) Gary L. Kelso 7.) Wanda R. Dunlap 8.) Phyllis E. Adkins 9.) Cyrus Michael 10.) James R. Kelso E. If any of my beneficiaries listed in subparagraphs D.1. through D.10 above predecease me, then the share of such deceased beneficiary I give, devise and bequeath to such beneficiary's children, share and share alike. 4. I nominate and appoint Brian W. Kelso, and Sharon L. Baer to be the co- personal representatives of my estate, to serve without bond. 5. I suggest that my personal representative retain the services of the Law Offices 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 -?-r \' day of January, 2001. - H~;1- , 1 ~ M. KELSO ~. fA. /lll-IL- -- (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. 'rdivif 4W jI~ ~~LwiJ-~ ACKNOWLEDGMENT AND AFFIDAVIT WE, MARY M. KELSO, RHONDA S. VON KLlTZING and HEATHER A. BARBOUR, 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. I tb/l.-. M:'~KE:' N. AJUt...- Lf"\~fr? ~~h- HEA R A. !:fAR OUR COMMONWEALTH OF PENNSYLVANIA :ss: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by MARY M. KELSO the testatrix herein, and subscribed and sworn to before me by RHONDA S. VON KLlTZING and HEATHER A. BARBOUR, wit esses, this "']1 V day of January, 2001. Notarial Seal Harold S. Irwin Ill, Notary Public Carlisle 80ra. Cumberland County My Commission Expires Sept. 23. 2002 Member, Pennsylvania Association at Notaries SOUTH CENTRAl.. HOt-E' 717532855Z 08/1S/0Z 01142pm P. 00Z A SeltF~, 'ent Statement US Depaflment of Housing B. T-- of Loan and Urban o...,eioomenl OMS No. 2502-0265 l. OFHA 20fml-lA l OCOlw.lJnin~ I n rUcNumhcr J 7.l..oanNumhcr [ II M(Jftg~~ In~Ufancc Case Numllcr 4 nVA j nCon~ Ins 02BYERSABRAM C Note' .......~~!<'..::=...._....~_......""..,...",aI""'~_.._..-.::.-"'....lPl.w; WAANING:.io...._IO~_I....._""'.\o.....u",.e<I_....._/lt...,._'".......,Dm'l P_..'-'P<l" ........-.....__.1..._ ___ ,,"'__ 1...1I1U ~ c-SocI"", 1001_SK1oon 1010 D. NAME OF 9ORROWF.R: Abram L Byrrs and Leslie Jo Byers ADDRESS 100 Lovers Lane, Newburg, PA 17240 ~---- E. NAME OF SELLER: Estate of Mary M. Kelso ADDRESS: F. NAMF. OF LENDER; Orrstown B.,nk ADDR6SS: P. O. Box 250. Shippensburl!, PA 17257 G. PROPERlY ADDRESS: 121 Turnpike Road, Newburg, PA 17240 Hopewell Township H. SETTLEMENT AGENT' South Central Home Senlements.lnc., Telephone: 717.532-7387 Fax: 717.532-6552 PLACE OF SETTLEMENT: 126 East King Street, Shippensburg, PA 17257 I SETn..EMENT DATE: 0810112002 J. SUMMARY OF BORROWER'S TRANSACTION K SUMMARY OF SELLER'S TRANSACTION. '00 GROSS AMOUNT DUE FROM BORROWER 400 GROSS AMOUNT DUE TO SELLER' 101. 0-..._- 32 000 .00 '" ConlrXt.....l~ 3. 000.00 '" -~ '" Pe-wnelP......- '" ~-lDborrowwer-1"OO 1 B65. 00 .03 ". ." 'OS '" ~trnents for Items .....id b" seller In adllance Ad;ustments for items D.lid seller in advance 'DO c-......~ ... C""/lOWllIa~" 107. ,.......-.eues 08 01J2002 to 12'31'2002: 23.26 ." COUll'" h1~es DB 01/"on21O 12J':Il'''00 '':1.26 ". .....,n_ 08J01J20021o 06J':IOJ200 235.4.1 ... SdIoolh'.$ OB 01 200210 06l30J200 235.U ". ... '" .., '" , .., '" I '" <2. GROSSAMOUNTOUE FRQM BORROWER 34 123. .7 m GROSS AMOUNT DUE ,0 SELLER 32 25B.67 200. AMOUNTS PAID BV OR ON BEHALF OF BORROWER I '00 REDUCTIONS IN AMOUNT DUE TO SELLER 201 ~~orNm8S1 ..- 1 000. 00 .., EuzssOeDOS;l(see'ln$\rue1lO"sl "" pn=-atrUInlof""';~1 2< 000 .00 .., Sem.mentC!lll,On1Otellernine1<f,()(1 3177.17 "" ExlstiIVl_.iUkl!f15tlt>>dIO ~C3. E,oslln<lloanrs' liJ~~5UllN>d1o '" '''' PII\"Ol'!oIF,rslMortn_eLtwln -.-1 "" L 50S P.-oISeeof1dMoMr......LDI,I1 I '" , I", ,,, 50; "" r' ~ "" , I '" , "" i ! Ad'ustnlents for Items unnaid b" sel;~ Ad ustments for items u~ ~ Hllef 210. C..../lownlalc81 , -- '" CI1Y~_n~.es I '" eou;::-laIlCVS 1 '" COUIl"'la.el; - 212. SchooIT..es '" SCllooITlll<l!s 213. -- '" ,,. ,,, --- 21' r , '" ;+-- ~ '" '" m r '" _._~ '" ". I ". 5'~ 220. TOTAL PAID BVIFOR BORROlNER : TO,AL REDUCTION AMOUNT DUE SELLER I -- 25.000.00 520 3.177 77' 300 CASH AT SEffiEMENT FROM OR TO BORROWER 600 CASH AT SETTLEMENT TO OR FROM SelLER '" Gross amoonld\llillrom lxHTooorer"lll! 12{l r 34 :!.23.67 , "" GrOSSlOfl'IOlJlllduelOsel!e,rllne-"'CI 32 258.671 "" L_~----::::;-::Jfoftlc:lmMerlne2JO\ I 25..1000 00 '07 ~'''5re<lUCII()ll;omourlld''eierler Ilnl!5'P1 ~ 177.771 303. CASH FROM BORROWER 9 123. " , 603 CASH TO SELLER , 29 080.90 ~U8StlTU1E" FORM 10$9 S~Ll~R ;TATErr,oEN1 T.... .n'",,,....,,,,, .",.,,,,,,"',, no'e,n" ""PO'""'" "" """"',"on ~M" l><'.nq '''''".hM'~ 'no InW,,,,' I<henu. S..~"'. "yOw "'. ...Q....M 10 ".' ''''u'' lno"1ir~;;~~o::;:,~P~=If=:,.,......""",.r.""",",,,'Cllo-'.PO"."'ndnv-'IlS""te'''''n..'''a.''r.:.'r.~I""""rp.M""" lnpC"""'8"S.,.,.Pf''''''nCt>M'''''' ~~~~'~:n=~;;:"~sf=s=::;'"I).:':':'~~~~~'~" '" ["'f",,,...,,, p,.,c",ln~.a.."", '0' ,n. ;>a," ""'''Y~~' ."CO.... I.. '......r"". "'''''' "'n'.l'llC'~ ="-~"""'''''''''-.''''--~(~''' T..mHo .-lw~hY""'''''''''''''.._'''''n',!".,:..:'''n."n'... 1"o~"or""",o,,*l'OU'C""""".'_ .l""'1M\' 1UlIl'd1o_....~I~__~_ U---"'I""'~11""".tt..lr""\DX"'~""'h';I'.:1~~""""'''''''''''''.;.;r'~.c.ah TIH , s:eU.ER1SIGIGNATUIlE(!H ~/}brI~4) .,. /"'l ~. __€ SfLLERrSI HO<W_UNGADDRESS TiIJcE~prcsl;StllkmtnISY!;lL't1l PrimedOKlflll2fKl:!1I114'41, RI" III'D r /\111(,1 SOUTH cENTRAL f<lt-E 7175326552 0C/18/02 01142pm p, 003 tl.~, IlU'AltTMFNI (ll t101ISIN(i ANllllltllAN 1I1'VI-l (II'Mt N'I '. SETTLEMENT STATEMENT I'il~' Numocr fl2HYUt\AIUIAM 1'''-Ul2 l. SETTLEMENT CHARGES -- PAID FROM PAID CPOM I 700. TOTAL SALESlBROKER'$ COMMISSION based on prK;e S 32,000.00 t! 6.000 . 1 .20 .00 BORROWER'S SElLER'S DiYiaIondlXllM'liMiorl~7~slollows - FUNDS AT FUNDS AT .- 101 I 960.00 to Ebener , ASs:OC.1.ates -- SETIlEMENT SETIlEMENT '" . 960.00 to Hale Real Eat.ate '" ~ to_ 1 920.00 000. m:MS PAYABLE IN CONNECTION WITH lOAN .n l~""":"'-F" " '" -- " &C3.~Fee to Ox-:r:'stown Ban' .,.sn.OO ... c_--=- '" --=-... to Ox-rstown Bank 200. 00 eotl,"-Fee to Orratown Bank '00.00 "" Floodee.1Fee III Orr-to1fll Bank. 30,00 Ole U::::;::::;;::-Fee 10 Orratawn Bank 200.00 ... ." ." .... ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE - ." _F~ to --;;;- ,.." 1lO2'-~~Pnmi~ klr '" "" HaO'd ~ PnImMn lor to ... '" 1000. RESERVES DEPOSITED W1TH LENDER FOR 1001, Haurdlnwranoe mo---::-S ,~ 10ll2~1lSlftI'ICe _.~~$ ,~ - -- - 'OO3.C;o.,~T.beS ~ . """ 1004.~=T_ rno~s . .63 .~ "" SChOoIT.lrfl mo~.~ 21 " .''"10 "OS s...tt;,"'tment "00. TITLE CHARGES 1101 SeI1IemliIInlor-.....,.. ~ South Cent:r:-.al Home Sattlamanta Inc 300.00 '''' Abitr.ld:orlllle_rt:h 1103 100_ -~ u_ ---.----- - I -.. '"'' TItleII'llt.Ol'lOlb!nder -.. -- -- 110' """'"*" .- ~ A~torn.'. Harold S Irwi.n III 6S0.00 1106 -"'Fns 1\07.-';;;:::::::-tees to w.i=i. and Ass~i..~;';s 300 00 ~lI'ICIude:seboveltemsNo , I "08 Tillektlurerlte .---;-n:Ncles ~ iMns No ) ,,,. L~~ . 2' 000 .00 - '110 """""r_. 32 000. 00 - ',11 1112 1113 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201 Recordi----=-FeesOeel:lS 28.50 ~$36.50 Rcleae$ 6' .00 1202 C 0..,,, 320.00 MorlqaoeS I 320. 00 t 1203 st1IleT=== -. 320.0Q. Mt::>rt1l&Qe$ 320.00 1204. "..--Fees -Ouil Claim 0. to Cuaberland Count R.!c::o~~r ~-.fl.~ 3Q.2Q.. "'" -~- ---- 1300 ADDITIONAL SETTLEMENT CHARGES . 1301 SlINe\I , I "" -- 257 .2;~ - "" 2002 School Tnes to Harry 1t11li.an , "0' j [iili I I ! - - , , , 1400, TOTAL SETILEMENT CHARGES (Mtero"h"e$lCJ':>~lorJ"""_~G:: SecI,onK) I1UDCERfI~Ir.'\TIO"OI IlLOYf<l "t<l' SHLER 1 B65.00 I 3 177 71 I ~"::l~~':='~~~ ~:::~~~~'~";;~~\{I;;r'Ir.;.,~~r.:;1f"""". ,'" ~ ,,""..... oe"",.', .,"'....."'0'.'. '.0....'. .~d d,ot>~"""""""fn8d."'" "'V lttCtlu<1T or ~,m. {Q~~ (J ,~" -<'j??__~_______J. oAP~fr-IS~ Abr31Tl L fiveR I nil<. h, Jh~I' brlllo "fMIlI)' M lo\.d~" / ~~~T:~"Jr:':~"&~~~C:-ZR"'~~'j:;~~~J~~~~rc~~"tlIOt; frr~CJr~~,~=~~~'fOl~ORl)flAUSE[l'TlI ,~ Tilll."t.l"C!;~ Seulc"....nl ~\,,(cm 1'''''1,,<1 U~1lI1110112 <I' ~ 1 ~r '~~Ii"U 1 Sel(.........'S~.." ""oI1r_"~'~ruo<e<1'..~ue..-.dIU<ll"".""""""or'","I'~.,c e, ~V;;;;;;':~;-~l;;;;" RI \ IIll0-1 11 M('I APPRAISAL OF PERSONAL PROPERTY OF THE ESTATE OF MARY M. KELSO, 121 TURNPIKE ROAD, NEWBURG, PA ON MARCH 21, 2002: Maple-finish table & 6 chairs May tag automatic washer May tag dryer Modern oak finish book~ase Eureka upright vacuum cleaner 2-Drawer metal file cabinet Modern 5-drawer chest-of-drawers Tappan microwave Miscellaneous dishware in kitchen cabinets Family Chef toaster Betty Crocker can opener Miscellaneous Pots & Pans Stainless flatware Miscellaneous kitchen utensils Modern kerosene lamp Electric heater Montgomery Ward sewing machine Miscellaneous common baskets Wicker hamper Miscellaneous knick-knacks Miscellaneous Christmas decorations Older style compressor 4 Coleman lanterns @ $7.00 Miscellaneous lawn & garden tools Betty Crocker hand mixer Spindle-back cair (modern) Small wooden table Microwave stand Blue & brown recliners (both damaged) @$ 15.00 Sleeper sofa Entertainment center LXI portable color television Old oak arm rocker (seat re-upholstered) Step-end table Small oak-finished telephone stand Wooden ironing board Metal wardrobe $ 60.00 $ 35.00 $ 25.00 $ 10.00 $ 20.00 $ 10.00 $ 20.00 $ 25.00 $ 20.00 $ 8.00 $ 5.00 $ 15.00 $ 10.00 $ 10.00 $ 8.00 $ 5.00 $ 15.00 $ 3.00 $ 3.00 $ 12.00 $ 5.00 $ 20.00 $ 28.00 $ 10.00 $ 5.00 $ 3.00 $ 5.00 $ 10.00 $ 30.00 $ 150.00 $ 25.00 $ 30.00 $ 75.00 $ 5.00 $ 8.00 $ 8.00 $ 5.00 -2- G.E. refrigerator (older model) Crock pot Metal base cabinet Dust-buster classic Single bed with mattress & box springs (poor cond) 2 Battery kitchen clocks @ $3.00 TOTAL APPRAISED BY: J)-ttUtA:J c5f ~~~= Dennis L. Gotshall, Auctioneer/Prop. Dan Hershey Auctioneering Service PA Lie. #AU-002306-L 3 Brown Road Shippensburg, PA 17257 $ 20.00 $ 8.00 $ 5.00 $ 8.00 $ 15.00 $ 6.00 $ 798.00 L~ ORRSTOWN BANK ORRSTOW!'\. PENr\SYLVANIA 17244 Date 5/07/01 PRIMARY ACCOUNT TAX ID ENCLOSURES Page 1 331449 201-09-8681 WILBUR T KELSO SR MARY M KELSO 121 TURNPIKE RD NEWBURG PA 17240-9328 C H E C KIN G A C C 0 U N T S :OMMUNITY CHECKING ACCOUNT NUMBER PREVIOUS BALANCE 2 DEPOSITS/CREDITS 7 CHECKS/DEBITS SERVICE FEE INTEREST PAID CURRENT BALANCE 331449 459.28 426.77 376.55 .00 .00 509.50 CHECK SAFEKEEPING Statement Dates 4/06/01 thru DAYS IN THE STATEMENT PERIOD AVERAGE LEDGER AVERAGE COLLECTED 5/07/01 32 357.55 357.55 ACTIVITY IN DATE ORDER DATE DESCRIPTION TRACE NO AMOUNT BALANCE 4/06 CHECK 2907 020025840 25.00- 434.28 4/11 CHECK 2909 020054590 81. 00- 353.28 4/11 CHECK 2910 020080300 77.16- 276.12 4/13 DEPOSIT 040131760 180.00 456.12 4/13 CHECK 2912 020051410 41.30- 414.82 4/13 CHECK 2911 020024520 36.64- 378.18 4/16 CHECK 2914 060228200 77.37- 300.81 J1 /1 Q c...'LffiCK '-'0"'" 030135960 38.08- 262.73 ~ I .......... ~--'.J.....J 5/01 CIVIL SERV US TREASURY 312 071200073 246.77 509.50 PPD DATE 4/06 4/11 4/11 4/13 * Denotes CHECK NO 2907 2909* 2910 2911 missing --- CHECK SUMMARY AMOUNT REFERENCE 25.00 020025840 81.00 020054590 77.16 020080300 36.64 020024520 check numbers DATE 4/13 4/18 4/16 CHECK NO 2912 2913 2914 AMOUNT 41.30 38.08 77.37 REFERENCE 020051410 030135960 060228200 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 001522 DUPLICATE IRWIN HAROLD S III 35 EAST HIGH STREET SUITE 201 CARLISLE, PA 17013 ____un fold ESTATE INFORMATION: SSN: 203-' 0-877 3 FILE NUMBER: 2101-0554 DECEDENT NAME: KELSO MARY M DATE OF PAYMENT: 08/14/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 04/19/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $405.32 I I I I I I I I TOTAL AMOUNT PAID: $405.32 REMARKS: HAROLD S IRWIN ESQUIRE CHECK# 5945 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS /b -02.36-~ \, COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX HAROLD S IRWIN STES 201 202 35 E HIGH ST CARLISLE III DATE ESTATE OF DATE OF DEATH F~LE NUMBER CbUNTY ACN 09-30-2002 KELSO 04-19-2001 21 01-0554 CUMBERLAND 101 *' REV-15~7 EX AFP [01-021 MARY M Allount Rellitted PA 17013', 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 -- ifE"v=is4j-EX-AFP--foY:02Y-NoricE--oF-YNHEifiTANCE-rAx-'APPR'AisEifENT-~--AL:rOWANCE-"ifR-------------- --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KELSO MARY M FILE NO. 21 01-0554 ACN 101 DATE 09-30-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) 32.000.00 .00 .00 .00 4.301.88 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 15.791.16 11.619.20 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 36,301.88 (11) (12) (13) (14) 27.410 36 8,891.52 .00 8,891.52 14~ 15 and/or 16~ 17~ 18 and 19 will returns assessed to date. NOTE: I~ an assessment was issued previously~ lines re~lect ~igures that include the total o~ ALL ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: .00 X 00 = 8.891.52 X 045= .00 X 12 = .00 X 15 = (19)= .00 400.11 .00 .00 400.11 n",..",...r. (+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-14-2002 CDOO1522 5.21- 405.32 BALANCE OF UNPAID INTEREST/PENALTY AS OF 08-15-2002 TOTAL TAX CREDIT 400.11 BALANCE OF TAX DUE .00 INTEREST AND PEN. 8.37 TOTAL DUE 8.37 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates Df decedents dying Dn Dr befDre December 12, 1982 -- if any future interest in the estate is transferred in pDssessiDn Dr enjDyment tD Class B (cDllateral) beneficiaries Df the decedent after the expiratiDn Df any estate fDr life Dr fDr years, the CDmmDnwealth hereby expressly reserves the right tD appraise and assess transfer Inheritance Taxes at the lawful Class B (cDllateral) rate Dn any such future interest. PURPOSE OF NOTICE: TD fulfill the requirements Df SectiDn 2140 Df the Inheritance and Estate Tax Act, Act 23 Df 2000. (72 P.S. SectiDn 9140). PAVMENT: Detach the tDP pDrtiDn Df this NDtice and submit with YDUr payment tD the Register Df Wills printed Dn the reverse side. --Make check Dr mDney Drder payable tD: REGISTER OF KILLS. AGENT REFUND (CR): A refund Df a tax credit, which was nDt requested Dn the Tax Return, may be requested by cDmpleting an "ApplicatiDn fDr Refund Df PennsYlvania Inheritance and Estate Tax" (REV-1313). ApplicatiDns are available at the Office Df the Register Df Wills, any Df the 23 Revenue District Offices, Dr by calling the special 24-hDur answering service fDr fDrms Drdering: 1-800-362-2050; services fDr taxpayers with special hearing and I Dr speaking needs: 1-800-447-3020 (TT Dnly). OBJECTIONS: Any party in interest nDt satisfied with the appraisement, allDwance, Dr disallDwance Df deductiDns, Dr assessment Df tax (including discDunt Dr interest) as shDwn Dn this NDtice must Dbject within sixty (60) days Df receipt Df this NDtice by: --written prDtest tD the PA Department Df Revenue, BDard Df Appeals, Oept. 281021, Harrisburg, PA 17128-1021, OR --electiDn tD have the matter determined at audit Df the accDunt Df the persDnal representative, OR --appeal tD the Orphans' CDurt. AOMIN- ISTRATIVE CORRECTIONS: Factual errDrs discDvered Dn this assessment shDuld be addressed in writing tD: PA Department Df Revenue, Bureau Df Individual Taxes, ATTN: PDSt Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 PhDne (717) 787-6505. See page 5 Df the bDDklet "InstructiDns fDr Inheritance Tax Return fDr a Resident Decedent" (REV-1501) fDr an explanatiDn Df administratively cDrrectable errDrs. DISCOUNT: If any tax due is paid within three (3) calendar mDnths after the decedent's death, a five percent (5%) discDunt Df the tax paid is allDwed. PENAL TV: The 15% tax amnesty nDn-participatiDn penalty is cDmputed Dn the tDtal Df the tax and interest assessed, and nDt paid befDre January 18, 1996, the first day after the end Df the tax amnesty periDd. This nDn-participatiDn penalty is appealable in the same manner and in the the same time periDd as YDU WDuld appeal the tax and interest that has been assessed as indicated Dn this nDtice. INTEREST: Interest is charged beginning with first day Df delinquency, Dr nine (9) mDnths and Dne (1) day frDm the date Df death, tD the date Df payment. Taxes which became delinquent befDre January 1, 1982 bear interest at the rate Df six (6%) percent per annum calculated at a daily rate Df .000164. All taxes which became delinquent Dn and after January 1, 1982 will bear interest at a rate which will vary frDm calendar year tD calendar year with that rate annDunced by the PA Oepartment Df Revenue. The applicable interest rates fDr 1982 thrDugh 2002 are: Vear Interest Rate Daily Interest FactDr Vear Interest Rate Oaily Interest FactDr 1982 20% .000548 1992 9% .000247 1983 16% .000438 1993-1994 7% .000192 1984 11% .000301 1995-1998 9% .000247 1985 13% .000356 1999 7% .000192 1986 10% .000274 2000 8% .000219 1987 9% .000247 2001 9% .000247 1988-1991 llZ .000301 2002 6Z .000164 --Interest is calculated as fDllDws: INTEREST = BALANCE OF TAX UNPAID X NUftBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any NDtice issued after the tax becDmes delinquent will reflect an interest calculatiDn tD fifteen (15) days beYDnd the date Df the assessment. If payment is made after the interest cDmputatiDn date shDwn Dn the NDtice, additiDnal interest must be calculated. BUREAU OF INDIVIDUAL TAXES . INHERI1'ANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX HAROLD S IRWIN STES 201 202 35 E HIGH ST CARLISLE III DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-30-2002 KELSO 04-19-2001 21 01-0554 CUMBERLAND 101 '* REY-1547 EX AFP 101-02) MARY M Anount Renitted PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV:: i5'4j-Ex-AFP-foY:ozY-NciT"icE--oF-YNHEiiiiAi.rcri"-A'x-APPRAisEifENT-,--AL.rOWAHcE-oR"------------ - - --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KELSO MARY M FILE NO. 21 01-0554 ACN 101 DATE 09-30-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED 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 E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) 32,000.00 .00 .00 .00 4,301.88 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adn. 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 (9) (10) 15,791.16 11.619.20 (1lJ (12) (13) (14) NOTE: To insure proper credit to your account, subnit the upper portion of this forn with your tax paynent. 36,301.88 27.410 36 8,891.52 .00 8,891.52 NOTEi 14: 15 and/or 16, 17~ 18 and 19 will returns assessed to date. If an assessment wa; issued previou51y~ lines reflect figures that include the total of ALL ASSESSMENT OF TAX: 15. Anount of Line 14 at Spousal rate 16. Anount of Line 14 taxable at Lineal/Class A rate 17. Anount of Line 14 at Sibling rate 18. Anount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: (15) (16) (17) (18) .00 X 00 = 8,891.52 X 045 = .00 X 12 = .00 X 15 = (19)= .00 400.11 .00 .00 400.11 ~". ,~_. . l+J AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 08-14-2002 CDOO1522 5.21- 405.32 BALANCE OF UNPAID INTEREST/PENALTY AS OF 08-15-2002 TOTAL TAX CREDIT 400.11 BALANCE OF TAX DUE .00 INTEREST AND PEN. 8.37 TOTAL DUE 8.37 . 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.) RESERVATION: Estates of decedents dying on or before December lZ, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z3 of ZOOO. (7Z P.S. Section 9140), PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGISTER OF MILLS. AGENT REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of PennsYlvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the Z3 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: 1-800-36Z-Z050i services for taxpayers with special hearing and I or speaking needs: 1-800-447-30Z0 (TT only). OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 171Z8-10Z1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: Thp 15;( tAX ~P.lnQsty nOr!-perticipation penalt~ is computed cn the total of thili tax. and interest aSSBSSQU, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOZ are: Year Interest Rate Daily Interest Factor Vear Interest Rate Daily Interest Factor 198Z ZO% .000548 199Z 9% .000Z47 1983 16% .000438 1993-1994 7% .00019Z 1984 11% .000301 1995-1998 9% .000Z47 1985 13% .000356 1999 7% .00019Z 1986 10% .000Z74 ZOOO 8% .000Z19 1987 9% .000Z47 ZOOI 9% .000Z47 1988-1991 11% .000301 ZOOZ 6% .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. 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 HAROLD S IRWIN III ESQUIRE 35 EAST HIGH STREET SUITE 201 CARLISLE, PA 17013 u______ fold ESTATE INFORMATION: SSN: 203-10-8773 FILE NUMBER: 2101-0554 DECEDENT NAME: KELSO MARY M DATE OF PAYMENT: 10/22/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 04/19/2001 NO. CD 001756 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $8.37 I I I I I I I I TOTAL AMOUNT PAID: $8.37 REMARKS: HAROLD S IRWIN III ESQUIRE CHECK# 6408 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS T /b-cZ36 -c:Y ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-1U7 EX AFP IDl-DZl HAROLD S IRWIN STES 201 202 35 E HIGH ST CARLISLE III DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-04-2002 KELSO 04-19-2001 21 01-0554 CUMBERLAND 101 MARY M 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 forll with your tax paYllent. CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~ ifiv =i6'ifj-ix-AFP-foY=02y------...--iNHERiTANC'E-TAX-STATEH'E-NT-cfF'-AccouiiT--.-..---------------- - - --- ESTATE OF KELSO MARY M FILE NO.21 01-0554 ACN 101 DATE 11-04-2002 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-30-2002 P R I NC I PAL T AX DUE: ....................................................................................................................................................................................................................... 400.11 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-14-2002 CDOO1522 5.21- 405.32 10-22-2002 CDOO1756 8.37- 8.37 TOTAL TAX CREDIT 400.11 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 II IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) PAVMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. If RESIDENT DECEDENT make check or money order payable to: REGISTER OF WILLS, AGENT. If NON-RESIDENT DECEDENT make check or money order payable to: COHHONWEAL TH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of PennsYlvania Inheritance and Estate Tax" (REV-13l3). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices or from the Department's 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and I or speaking needs: 1-800-447-3020 (TT only). REPLV TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTV: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are: Vear Interest Rate Daily Interest Factor Vear Interest Rate Daily Interest Factor 1982 20% .000548 1992 9% .000247 1983 16% .000438 1993-1994 7% .000192 1984 11% .000301 1995-1998 9% .000247 1985 13% .000356 1999 7% .000192 1986 10% .000274 2000 8% .000219 1987 9% .000247 2001 9% .000247 1988-1991 11% .000301 2002 6% .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. , " l,/ C Oh STATUS REPORT UNDER RULE 6.12 Name of Decedent: MARY M. KELSO Date of Death: APRIL 19, 2001 Will No. 21- 01 - 0554 Admin No. 2101 - 0554 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 A 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 ~ 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 thi report. Harold S. Irwin, III Attorney for Estate March 22, 2003 35 East High Street Carlisle, PA 17013 717 -243-6090 I Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 phone: (717) 240-6345 Date: 3/10/2003 BAER SHARON L POBOX 204 NEWBURG, PA 17240 RE: Estate of KELSO MARY M File Number: 2001-00554 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 4/19/2003 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, DONNA M. OTTO DEPUTY REGISTER OF WILLS cc: /File Counsel Judge