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HomeMy WebLinkAbout01-0631 Estate of tftti .:.__ L _ 1]':'11':3 also known as mA-1'-III--;J 1.-. tJi<-<-1 $. PETITION FOR PROBATE and GRANT OF LETTERS ;l\- Dl- f.D 3( No. To: Register of Wills for the Deceased. County of CUMBERLAND in the Social Security No. 188-60-:5301 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut r1X in the last will of the above d~cfJdent, dated ~ Jv,.)6- and codicil(s) dated IUj.k named ,~~o, (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumber land County, Pennsylvania, with h er last family or principal residence at 432 W Main Street Mechanicsburg, PA 17055 (list street, number and muncipality) Decendent, then 28 years of age, died at Hershey Medical Center 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: June 14 ,~ 2001 , Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in fleu.nsylvapia I A J. / "- L,. .f"L situated as follows: "2-eI'4. /VD/CTII ~sp/)II' AiL ~. t-/htS.PovJ.NL I FA-- ,..,0,(0 $ 2.(000 $ $ $ ( "ao . c> Co C) WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary theron. (testamentary; administration c.La.; administration d.b.n.c.La.) - '" ~ " u c " ~~ "'~ ,,~ c:C" c -00 c';: """':: _" ~o.. ,,'- 50 ;;; c 00 ii1 \J . t:l1~--/~ tJ~. n ..1 lS OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 1.. ss COUNTY OF Cumberland J The petitioner(s) above-named swear(~) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. C'~~~~~ (A)~' . P' is ~. affirmed and 2ND Ct) c)Q' ::s I::i - s:: ~ ~ No. 21 - 01 - 631 Estate of Marian L Willis , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW JUL Y 5, n 7001. in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, lT IS DECREED that the instrument(s) dated JUNE 6, 2001 described therein be admitted to probate and filed ofrecord as the last will of ~.arian L. Willis and Letters Testamentary are hereby granted to Linda L. Willis MARY CLEWIS FEES $ 235 . 00 $---18...illL $-- $ 6.00 5.00 TOTAL - $----& 64.-00- Filed ........ ~ V P. . ~ ,. .~ QO J. . . . . . . . ... . . . William E. Miller, Jr. ID# 7220 ATTORNEY (Sup. Ct. I.D. No.) 1822 Market Street, Camp Hill, PA 17011 Probate, Letters, Etc. ......... Short Certificates(o) . . . . . . . . . . Renunciation ................ X-Pages JCP ADDRESS 717/737-9210 PHONE Called attorney on 7-5-01 H10\.80S REV 9/86 This is to certifY that the information here given is correctly copied from an original certificate of death duly filed with me as Local R\gistrar. The original certificate will be forwarded to the State Vital Records Office for permanent ~ling. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 No. t~~~~ Local Registrar fI p 7386954 g~ /~ .;2~o ( Date t1105. 143 Ra.. 2187 COMMONWEALTH OF PENNSYLVANIA' OEPARTMENT OF HEALTH' VITAL RECOROS CERTIFICATE OF DEATH TYPEJPRINT IN PERMANENT BLACK WI( ~ fr1 i;l " \5 ~ '" z 2.0()\ NAME OF DECEDENT (for$l Modl:Je, L... B4RTHPLACf (C.Iy..nO SWe 01 fCf8tQll Counl'v) Dauphin Ie. =If't,O RACE. Amencan 1ncHn. ea.o. WhU. Me. '_I White ,.. 28 v.. COUNTY OF DEATH DECEDENT'S USUAl OCCUPATION i~Y:o,,,=:, .~~ :::2,~ "0. Podiatrist "0. DECEDENT'S MAIllNG ADDRESS (SUNt. ClIylbNn. s.-. X~Codt, 432 W. Main st. Mechanicsburg, Pa. 17055 _S DECEDENT EVEA iN us. AAMfOFOACES? ,.. 0 No IXI SURvIVtNQ SPOuSE td....., ~ m.a.oen namel DECEDeNT'S ACTUAL RESIDENCE ISee...........,.,. onOltter$lde1 "0. .....P€,nnc::y 1 v,."ia - '''.Cou Cumberland ""- Pa. " w '" :> '" '" ::; '" LICENSE HUMBER ....011667-L no. ILIE OF DEATH g DATE PRONOuNCED DEAD (MQflIh, Day. Yeafl .4.73 PM H. SLJt-JE 14 I 2001 21. pMff I: EIQt IN diMHH. intutiesor COfTlJ)IicabonI which caused the death, Do noI 'IflleI' the IJlQICM 01 <tting. such.s ca'<$iac Of r.spN'~tory .,r.. shoClt 01' newt faiklf. liafl only one cauM on Ud\ IiM ~~ l: . I , . INTGRST171A L PN&\J/vIONIA DUE 10 lOR Al; A CONSEQUENCE Of), HOD&I</I\J (S L Yf'vI PHOf'..-(A DUE 10 (OR AS A CONSEOUENCE OF): 24. :==-- : anMl and.... I : PART M: 011.- aigtoiftc:lIlI c:oncIiIioM conuibuIing 10". but nal ~ in IhiI UhdMtp'IgcauM given in AUn' I. \I) -.l ...J DUE 1O(OAItS ACClNSEOUENCE Of): z <{ 0-!. <[ ~ WERE" .wlOPSV FINOtNGS A.\tIUlAIk.E PRIOR 10 COMP\.E1lQN 01 CAUSE OF OEAJH? MANNER OF DEATH DATE OF INJURY M(ll1lh.OaV. '4eaf) TIWE Of INJURY tNJURY liS \NORI(? DESCRIBE HOW INJURY OCCURREO. ........ ~ o o Homlf;ide o o o Pt..ACEOFJHJUA'I'AI~.la,m.II'''''tactory.o'' ... building. .-c _ ISpecliv) _. ,.. 0 NoD -- Pendtng In....sligallon _ ~ NoD 2M. ,a CERTIFIER ICfleca. only one) 'CERTlF'VlNG PHYSJClAN (PhwSlClatl Ctlf1ltycng cause ~ t3ea!h wne... anolher ptlVSIC<aO has prOf\Ol.lnce<i dealt! ilnO completed llem 23) To IfM bul 0' my know..... de.th ""&urM.,..... CMlN(S) MId m.p....'.. ...Ied 'UEOICAl EXAMIHER/CORONER On th. be.i, of ...""natlon and/or Inve.Ug.alion,ln my opinion, d.ath occurred at the Ume, date, and place, and due to the c..uae(s) and manneta.alaled _.................._. n. AEG~WR.S SIGNATURE ~D NUM.;/, ,. '11-~-'1 ~ );)eru4i: ~" o1d t4l J4. ,..0 NoD Suic_ CouIQ nor N ~.'1AIMd zt. . PftOHOUHCIHG AM) CaeltrlFYJNG PHySK::tAH jPhySIClOVl bolh o>rOOOl.lncll19 4edth aIId certdYIIl910 cause 01 dedlt1\ To the bft,1 of my knowtedQa. dealh occ:u"ec:I a. IN lime, dat.. and pl.._. and due 10 lba uUM(.) and mann., .. ,.at... LAST WILL AND TESTAMENT OF MARIAN L. WILLIS I, MARIAN L. WILLIS, of the Borough of Mechanicsburg, Cumberland County, Pennsylvania, do hereby make this my Last Will and Testament, revoking any former Wills and Codicils made by me. FIRST: I give my tangible personal property and all of the casualty insurance that I am carrying on said tangible personal property to my brother, CEPHAS S. S. WILLIS, or, if he fails to survive me, in equal shares to my parents, LINDA L. WILLIS, of Mechanicsburg, Pennsylvania, and HAROLD C. WILLIS, of Dillsburg, Pennsylvania, or the survivor of them, to be divided equitably among or between them as they may determine. I have complete confidence that my brother, my parents or my Executor will honor any written instructions that I may leave with regard to said tangible personal property. Any such property not so distributed shall be sold, and the proceeds added to my residuary estate to pass as hereafter described. SECOND: I give, devise and bequeath the rest, residue and remainder of my estate, real and personal, to my brother, CEPHAS S. S. WILLIS, or, if he fails to survive me, to my parents, LINDA L. WILLIS, of Mechanicsburg, Pennsylvania, and HAROLD C. WILLIS, of Dillsburg, Pennsylvania, or the survivor of them. In the event that neither of my parents survives me, then I give of my residuary estate one-half (%) to my mother's heirs-at-Iaw, and one-half (%) to my father's heirs-at-Iaw. THIRD: If any share hereunder becomes distributable to a beneficiary who has not attained the age of twenty-one (21) years, then such share shall immediately vest in such beneficiary, but notwithstanding the provisions herein, my Trustee shall retain possession of such share in trust for such beneficiary until such beneficiary attains the age of twenty-one (21) years, using so much of the net income and principal of such .' ':'';'-'''.. '';; I i~~/i' ~..i2 /' ,::;> f'{~itials Page 1 of 5 share as my Trustee deems necessary to provide for the proper medical care, educa- tion, support and maintenance in reasonable comfort of such beneficiary, taking into consideration to the extent my Trustee deems advisable any other income or resources of such beneficiary or his or her parents known to my Trustee. Any income not so paid or applied shall be accumulated and added to principal. Such beneficiary's share shall be paid over and distributed to such beneficiary upon attaining the age of twenty-one (25) years, or if he or she shall sooner die, to his or her executors or administrators. FOURTH: If any beneficiary and I should die under such circumstances as would render it doubtful whether the beneficiary or I died first, then it shall be conclu- sively presumed for the purposes of this my Will that said beneficiary predeceased me. FIFTH: (1) I name as my Executrix, my mother, LINDA L. WILLIS, or, if she is unable or unwilling to serve, I name as my Executor, my father, HAROLD C. WILLIS. If both my mother and my father are unable or unwilling to serve, then I name WILLIAM E. MILLER, JR., as my Executor. I direct that my Executor, herein referred to as my Executor regardless of number or gender, serve without bond in any jurisdiction in which called upon to act. (2) I name WILLIAM E. MILLER, JR., as my Trustee, and I direct that he serve without bond in any jurisdiction in which called upon to act. SIXTH: I give to any Executor and to any Trustee named in this Will or any Codicil hereto or to any successor or substitute Executor or Trustee all of the powers now applicable by law to fiduciaries in the Commonwealth of Pennsylvania and in particular through the Pennsylvania Probate, Estates and Fiduciaries Code, as effective and as in effect on the date hereof, during the administration and until the completion of the distribution of my estate, and until the termination of all trusts created in this Will or any Codicil hereto and until the completion of the distribution of the assets of such trusts. ......r--~ ~.X \ ,. . .' .'. -.) '--t;> . / "-/ ; Initials Page 2 of 5 IN WITNESS WHEREOF, I have set my hand and seal on this my Last Will and Testament this (c.-fh. day Ofr- ,2001. /~ ..~ c:..,~< . ..C C / .1.1 C .C. . {&iA~/ :-. ~L1JS:./ ;/ (SEAL) Page 3 of 5 21 - 01 - 631 GISTER OF WILLS OF CLVBEPLAND COUNTY OATH OF SUBSCRIBING WIT ESS (each) a subscribing witness to law, depose(s) and say(s) that Marian Lee Willis the testat rix , sign the same and that request of testat rix in h er other subscribing witness(es)). ewith, (each) being duly qualified according to present and saw signed as a witness at the in the presence of each other) (in the presence of the Sworn to or affirmed and subs me this ibed before day of 19 L da L. Willis s~~~rgr, Mechanicsburg, PA 17055 Register REGISTE.R OF WILLS OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS William E. Miller, Jr. {J.,Jo t..J /<./Pn- '- . WI l (.. IS' (each) a subscriber hereto, (each) being duly qualified according to law. depose(s) and say(s) that he is familiar with the signature of Marian Lee Willis codicil will that he presented herewith and codicil believes the signature on the will is in the handwriting of test at rlX of (one of the subscribing witnesses to) the Marian Lee Willis to the best of his knowledge and belief. ______ ~ Sworn to 0' affirmed and sub",ibed before . Willi,!," E. ~~ me this 2ND day of (Name) JULY 01 1822 ~1arket Street, ~~~ ~tJPI)- 1-. ,JIL<-, Camp Bill, PA 17011 W~. y?~ l;J,4r (Name) /YJ1h~ ..-r~L~r M~;(/hI1 c..S /J//,ec (//r ' 1'0.)".1 (Address) C/ ' '~-'" CERTIFICA TION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Marian L. Willis Date of Death: 14 June 2001 Will No. 2001-00631 PA Admin. No. 21-01-0631 To the Register: I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned Estate on 20 July 2001. Name Address Cephas S. S. Willis 432 West Main Street Mechanicsburg, PA 17055 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: N/A William E. Miller, Jr., Es Miller & Associates, 1822 Market Str Camp Hill, P 7011 717/737-9210 ..~ Date: 23 July 2001 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND l J 55: LINDA L. WILLIS being duly sworn ~~ according to law, deposes and says thats he 1S the ExecutI~~__ _ _____~~_u____ of the Estate of Marian L. Willis late of __. M~ch<:l!l~<:sbuI'g _ n______~___, Cumberland County, Pa., deceased and that the within is an inventory made by Li_Il~-"-- Wi~li?__~_~ __~ __ __, the said Executrix___ of the entire estate of said decedent, consisting of all the personal prop~rty and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. ~rVf. rch " '\ and subscribed before me, l '/ - d' - ~:~___4Ld,J r;f ~- / 6< /d~1 )( ___ Executor. Administrator Sworn Linda L. Willis, Executrix 432 W ~1ain Street, Mechanicsburg, PA 17055 Address Date of Death 14 June 2000 Day Month Year INSTRUCTIONS I. 2. 3. 4. An inventory must be filed within three months after appointment of personal representative. A supplement inventory must be filed within thirty days of discovery of additional assets. Additional sheets may be attached as to personalty or realty See Article IV, Fiduciaries Act of 1949. "..-. r' ... J ~.. ,.. - :j ;r":'" c::i N i.,' -;,;" ...-- A! ~ ::::::::.. \:f1 0', >- -0 H Q) I- w '" ~ >- a:: I- '1J rl W <( <ll t'l 0:: Cl.. I- b.() 0 H \0 0 VI U) H <ll CD Q) 0 Cl t7\ >-- (J) W a:: W H ;::J 'll r-< <ll (J) ~ I Cl.. .....:1 ..0 Cl.. rl c I Z I- ...J U. .....:1 tf) '1J .rl '- I, rl -<( 0 H U Cl.. 2 0 U. ...J :t: 0 w -<( w ~.- .rl 0 ~. >.. -<( II 0 > a:: ~ N Z (Ij -+- Wi Z 0 c Cl .....:l ..c: ::J 'I VI Z u 0 ~ [, 0 a:: -<( ~ Q) U 4oI't- @ I z w '=' .rl I' ~ I Cl.. H -0 rl \, ~ c rl '1J I '+- '- .rl II '""-< 0 (lJ 3: .D -0 -'" <ll E -+- Q) 0 '" ::J 0 -' U U. a:l I William E. Miller, Jr. Anthony E. Marrone LAW OFFICES OF MILLER & ASSOCIATES, PC 1822 MARKET STREET · CAMP HILL, PA 17011 TEL: (717) 737-9210. FAX: (717) 737-9215 13 March 2002 Direct Dial Number: 737-9213 CERTIFIED MAIL - RETURN RECEIPT REQUESTED Mary C. Lewis, Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 Re: Estate of Marian L. Willis No. 2001-00631 Dear Mrs. Lewis: Enclosed herewith for filing are two (2) copies of the Pennsylvania Inheritance Tax Return Resident Decedent, Form REV-1500 for Ms. Marian L. Willis who died on June 14t'.... 2001. I am also enclosing a check from the Estate payable to you, as Agent, in the amount of $6,845.00, representing payment in full of the Pennsylvania Inheritance Tax due. Finally, I am enclosing an original and one (1) copy of the Estate Inventory and our firm's check payable to you in the amount of $13.00 to cover the filing fee for the Inventory. Please acknowledge receipt of this letter and its enclosures by time-stamping the enclosed copy of this letter and inventory returning them to me in the envelope provided. If you have any questions, please call me at the direct-dial number shown above. Thank you for your assistance with this matter. ~~~;~ Michelle E. Miller Imem Enclosures COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 28060 'I HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MILLER & ASSOCIATES 210 WALNUT STREET PO BOX 11963 HARRISBURG, PA 17108 -------- fold ESTATE INFORMATION: SSN: 188-60-3307 FILE NUMBER: 2101-0631 DECEDENT NAME: WILLIS MARIAN L DATE OF PAYMENT: 03/14/2002 POSTMARK DATE: 03/11/2002 COUNTY: CUMBERLAND DATE OF DEATH: 06/14/2001 NO. CD 000952 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $6,845.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: MILLER & ASSOCIATES CHECK# 1056 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $6,845.00 MARY C. LEWIS REGISTER OF WILLS c.. REV-1500EX+ (6-00) OFFICIAL USE ONLY . COMMONWEALTH OF PENNSYLVANIA REV-1500 /6 - c:2 5// - /0 DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21-01-0631 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Willis Marian L 188-60-3307 DECE- DATE OF DEATH (MM-DD- YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 06/14/2001 09/25/1972 WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER N/A - - 3. Remainder Return CHECK ~ 1. Original Return ~' Supplemental Return 8 (date of death prior to 12-13-82) APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required ~ateof dealhafler 12-12-82) PRIATE 6. Decedent Died Testate 7. ecedent Maintained a living Trust 0 B. Total Number of Safe Deposit Boxes (Attach copy of Will) (Atlach a copy of Tru:;;t) BLOCKS 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death between 0 11. Election to ta~ under Sec. 9113(A) 12-31-91and 1-1-95) (Attach 8ch 0) fHjSs~btlbNMustjjebQMj:>!W!$t~Q:AlWbQRR~SPONQg.jGe&.GONfioeNtiAUf1\XINrbRMJ>.tioosf.!ol)i@$eJolii'l!i.CTeQTQ! NAME COMPLETE MAILING ADDRESS COR- William E. Miller, Jr. 1822 Market Street RE- FIRM NAME (If Applicable) Camp Hill, PA 17011 SPON DENT Miller & Associates, PC TELEPHONE NUMBER 717-737-9210 155.;llIfG OFFICIAL USE ONLY 1. Real Estate (Schedule A) (1) c::i "Jl 2. Stocks and Bonds (Schedule B) (2) 12,j.1'> N " 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) , 0 4. Mongages & Notes Receivable (Schedule 0) (4) 0 -~., ;::::..t ;;'::J 5. Cash, Bank Deposits & Miscellaneous Personal ~ Property (Schedule E) (5) 16,530 -.-'" 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested (6) 1,490 --' -.--. RECA- " PITULA- 7. Inter - Vivos Transfers & Miscellaneous ()';, TION Non-Probate Property (Schedule G or L) (7) 0 8. Total Gross Assets (total Lines 1-7) (B) 185,199 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 34,000 10. Debts of Decedent, Mortgage Liabilities, & liens (Schedule I) (10) 94,157 11. Total Deductions (total Lines 9 & 10) (11) 128,156 12. Net Value of Estate (Line 8 minus Line 11) (12) 57,042 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax (13) 0 has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 57,042 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of line 14 taKable at the spousal taK rale, or transfers under Sec. S116 (a)(1.2) 0 X 0 00 (15) 0 TAX 16. Amount of Line 14 taKable at lineal rate 0 X.O 0.045 (16) 0 - COMPU- 17. Amount of line 14 taxable at sibling rate 57,042 X .12 (17) 6,845 TATION 18. Amount of Line 14 taxable at collateral rate 0 X .15 (lB) 0 19. Tax Due (19) 6,845 20. 0 1Gi!l$CKBe!'lWji'!You,M\$i'\$q\.l!$$:\,INtiAll!$i'!QNOPI!Mti:@'eRiiAYMeNtl o PA 15001 NTF 29755 ~>aE SUI'lE TO ANSWEflALL QUESTIONS ON PAQE a ANO RECHECK MATH<< Copyrisht 2000 Greatland/Nelco LP - Forms Software Only PA REV -1500 EX (6-00) o d C I Page 2 ece ent s omplete ress: STREET ADDRESS 432 W Main Street Cumberland County CITY I STATE I ZIP Mechanicsburg PA 17011 Add Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 6,845 o o o Total Credits (A + 6 + C) (2) o 3. InteresVPenalty if applicable D. Interest E. Penalty o o Total InteresVPenaJty (0 + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 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. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check to' REGISTER OF AGENT (3) 0 (4) 0 (5) 6,845 (SA) 0 (56) 6,845 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; b. retain the right to designate who shall use the property transferred or its income; c. retain a reversionary interest; or. . d. receive the promise for life of either payments, benefits or care? If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Yes No ~ ~ B ~ 2. o ~ 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 the personal representative is based on information of which oreoarer has any knowledqe. SIGNATUR OF PERSON RESPONSI6LE FOR FILING RETURN <..,,01'<>- U:U..,.., 4e ADDRESS 432 West Main Street, Mech., PA 17055 SIGNATURE ()F PRFPA'3fR OTHER THAN REPRESENT TIVE ....------ ~ C::-...:- ADDRESS 1822 Market Street, -, DATE 3 -/3 -O.;;l. Hill, PA 17011 spouse [72 P.S. 19116 (a) (1. 11 (i)]. For dates of dealh onorafter January 1, 1995, the tax rate is imposed on the net value oltranslers to or lor the use of the surviving spouse is 0% [72 P.S. Ii 9116 (a)(1.1)(li)). The statute dnA;; nnl AI/Rmn! a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are stilt applicable even if the surviving spouse is the only beneficiary. For daies of death on or after July 1,2000: The tax rate Imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child Is 0% /72 P.S.1i91 16(aX1.2)). The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is4.5%, except as noted in 72.P.S.li 9116(1.2) [72 P.S. 69"6(a)(1)]. The tax rate imposed on the net value 01 transfers to or for the use of the decedent's siblings is 12% [72 P.S. li9116(a)(1.3)]. A sibling is defined, under Section9102, asan individual who has at least one parent in common with the decedent, whether by blood or adoption. o PA 15002 NTF 29756 Copyright 2000 Greatland/Nelco LP - Forms Software Only I, " " \ , ,'" " , j.' " , . ,". , .\ \ " I, \ , . i ') . : . .' '., ~ .' \ .. <' .~.' ,"- \\' . " ....\ " ," ", ,,"""' WHEREAS, dated June on the 5th 2nd 2001 Register of Wills of CUMBERLAND County, Pennsylvania Certificate of Grant of Letters No, 2001-00631 PA No. 21-01-0631 ESTATE OF WILLIS MARIAN L lLA~l, tlK0l, M1UULb) Late of MECHANICSBURG BOROUGH CU1VIl:$.t;KLAl\lU CUUN'l Y 1 Deceased Social Security No. 188-60-3307 day of July 2001 an instrument was admitted to probate as the last will of WILLIS MARIAN L (LA01 , tlK01, M1UULb) late of MECHANICSBURG BOROUGH CUMBERLAND County, who died on the 14th day of June 2001 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS , Register of wills in and for the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to WILLIS LINDA L who has duly qualified as Executor (rix) and has agreed to administer the estate according to law, all of which fully appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, of my Office the 5th day I have hereunto set my hand and affixed the seal of July 2001. lf4 @.~. ~a%~ << eJ~JfJ: l s . **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) LAST WILL AND TESTAMENT OF MARIAN L. WILLIS I, MARIAN L WILLIS, of the Borough of Mechanicsburg, Cumberland County, Pennsylvania, do hereby make this my Last Will and Testament, revoking any former Wills and Codicils made by me. FIRST: I give my tangible personal property and all of the casualty insurance that I am carrying on said tangible personal property to my brother, CEPHAS S. S. WILLIS, or, if he fails to survive me, in equal shares to my parents, LINDA L WILLIS, of Mechanicsburg, Pennsylvania, and HAROLD C. WILLIS, of Dillsburg, Pennsylvania, or the survivor of them, to be divided equitably among or between them as they may determine. I have complete confidence that my brother, my parents or my Executor will honor any written instructions that I may leave with regard to said tangible personal property. Any such property not so distributed shall be sold, and the proceeds added to my residuary estate to pass as hereafter described. SECOND: I give, devise and bequeath the rest, residue and remainder of my estate, real and personal, to my brother, CEPHAS S. S WILLIS, or, if he fails to survive me, to my parents, LINDA L WILLIS, of Mechanicsburg, Pennsylvania, and HAROLD C. WILLIS, of Dillsburg, Pennsylvania, or the survivor of them In the event that neither of my parents survives me, then I give of my residuary estate one-half ('h) to my mother's heirs-at-Iaw, and one-half ('h) to my father's heirs-at-Iaw. THIRD: If any share hereunder becomes distributable to a beneficiary who has not attained the age of twenty-one (21) years, then such share shall immediately vest in such beneficiary, but notwithstanding the provisions herein, my Trustee shall retain possession of such share in trust for such beneficiary until such beneficiary attains the age of twenty-one (21) years, using so much of the net income and principal of such ~~'" .F .Y. "0' ,. qnitials Page 1 of 5 share as my Trustee deems necessary to provide for the proper medical care, educa- tion, support and maintenance in reasonable comfort of such beneficiary, taking into consideration to the extent my Trustee deems advisable any other income or resources of such beneficiary or his or her parents known to my Trustee. Any income not so paid or applied shall be accumulated and added to principal. Such beneficiary's share shall be paid over and distributed to such beneficiary upon attaining the age of twenty-one (25) years, or if he or she shall sooner die, to his or her executors or administrators. FOURTH: If any beneficiary and I should die under such circumstances as would render it doubtful whether the beneficiary or I died first, then it shall be conclu- sively presumed for the purposes of this my Will that said beneficiary predeceased me. FIFTH: (1) I name as my Executrix, my mother, LINDA L. WilLIS, or, if she is unable or unwilling to serve, I name as my Executor, my father, HAROLD C WilLIS. If both my mother and my father are unable or unwilling to serve, then I name WilLIAM E MillER, JR, as my Executor. I direct that my Executor, herein referred to as my Executor regardless of number or gender, serve without bond in any jurisdiction in which called upon to act. (2) I name WilLIAM E MillER, JR, as my Trustee, and I direct that he serve without bond in any jurisdiction in which called upon to act. SIXTH: I give to any Executor and to any Trustee named in this Wilt or any Codicil hereto or to any successor or substitute Executor or Trustee all of the powers now applicable by law to fiduciaries in the Commonwealth of Pennsylvania and in particular through the Pennsylvania Probate, Estates and Fiduciaries Code, as effective and as in effect on the date hereof, during the administration and until the completion of the distribution of my estate, and until the termination of all trusts created in this Will or any Codicil hereto and until the completion of the distribution of the assets of such trusts. /#){ \ Initials Page 2 of 5 IN WITNESS WHEREOF, I have set my hand and seal on this my Last Will and Testament this (.''''dayofc~' . ,2001. I t" /. . MA~~'dVJ~LiIS ' ( (SEAL) Page 3 of 5 REV-1502 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Marian L. Willis SCHEDULE A REAL ESTATE FILE NUMBER 21-D1-D631 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value 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. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 1. 282 N Lansdowne Avenue, Lansdowne, PA - Real property owned by decedent and sold on 12/7/D1. (See HUD-1 Settlement Statement attached. ) 155,DDO TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 155,000 9 PA15021 NTF 1087' Copyright 1999 Greatland/Nelco LP - Forms Software Only A. Settlement Statement 8. Type of Loan U.S. Department of Housing and Urban Development OMB No. 2502.0265 1.0FHA 2. OFmHA J. Deanv. Unins. I 6. Fill Number 17. Loan Number I 8. Mortgage Insurance Case Number 4. OVA 5. Deany, Ins, T19326 4387297Tl1X C. Note: ,~~~_T~r":l_.~!}I1,m.. 0 glV' VOU..8 emen 0 Be ua '~~~.me[l!.CO'~~.AP.10U~~_P' 0 an y ." emen .~e~}..8r. ~!l~wn. Items merked nlp.a.c.)" were plld ouUld, th, clolln~: they .r. .hown her. for lnformetlon r~~;~~' end Ir. not Ine uded In the tot,I.. WARr'fG: 11 }',"~ crime, ~..,kno~inllIY make f.I"c~~'~~~,~~..,:. ~:,..u~~',~ S<;ltat.. on this or en Oth.:'~ ~:n!tT!. form. P_nalti.. upon D. NAME OF BORROWER: John T. Waite and Terease S. Waite ADDRESS: 282 N. Lansdowne Avenue, Lansdowne, PA 19050 E. NAME OF SELLER: Linda Willis, Executrix of Estate of f/lA.-Ui!VL.c;(, W~ ADDRESS: F. NAME OF LENDER: Wells Fargo Home Mortgage, Inc. ADDRESS: Final Documents, 3601 Minnesota Drive, Bloamington, MJ 55434-5284 G. PROPERTY ADDRESS: 282 N. Lansdowne Avenue, Lansdowne, PA 19050 Boro. of Lansdowne o Principal Residence o Other RBlI Estate H. SmLEMENT AGENT: American Land Transfe~:ssociates, Telephone: 610-543-8000 Fax: 610- PLACE OF SETTLEMENT: 816 W. springfield Road, ringfield, PA 19064 l. SETTLEMENT DATE: 12/07/2001 J. SUMMARY OF BORROWER S TRANSACTION: K. SUMMARY OF SElLER'S TRANSACTION: 100. GROSS AMOUNT OUE FROM RORROWER 400. GROSS AMOUNT OUE TO SELLER: 101. Contraclsaluprice 155,000100 401. Contract saJas price 155,000.00 lOt PersonllProperty 40t PaflonalProparty 103. Settlemenl charges 10 borrower nine 1400) 8,31.2.23 403. 104. 404. 105. . 405. Adjustments for items paid by seller in advanliB Adiustments for items paid by seller in advance 10S. City/lawn lue, 12/07/01to12/31/01 61.50 406. City/town laus 12/07/011012/31/01 61.50 107. CountylaX8S 12/07/011012/31/01 34~,52 401. Counlyluu 12/07/01to 12/31/01 34.52 108. School Taxes 12/07/011006/30/02 1,856.52 ~,08. SchoolTues 12/07/011006/30/02 1,856.52 109. 409. 110, Sewer lees 12/07/01to12/31/01 6.36 410. Sewer fees 12/07/011012/31/01 6.36 111. Refuse feu 12/07/011012/31/01 24.65 411. Refuse lees 12/07/011012/31/01 24.65 112. 412. 120. GROSS AMOUNT OUE FROM BORROWER 165,295.78 420. GROSS AMOUNT OUE TO SELLER; 156,983.55 200. AMOUNTS PAlO BY OR ON BEHALF OF BORROWER 500. REOUCTIONS IN AMOUNT OUE TO SELLER 201- Deposit orelrnesl rooney 15,500.00 501. ExceuOepo.!it(seoinstructionsl lOt PrincipII eroounl of new loens 139,500.00 502. Settlement charga, to sell81 Oine 14001 12,591. 00 203. Existing !oanlsl taken subject to 503. Exlstingloanlsllakensubjaclto 204. Fundt brought 10 closing.Buyel 12,1.12.75 504. Plyoff:910001765 76,501.73 - RElM], I::nc. 205. Good Faith Credit 340.00 505. Payoff of Second Mortgage Loan Wells Fargo Bane __, """ 206. 506. 207. Credilasagreed 500.00 507, Creditesagread 500.00 208. 508. 209. 509. Adjustments for items unpaid by saller Adjustments for items unnaid by seller 210. City/lown tam 510. City/town texes 211. Counlytaxes 511- County taxes 21t SchoaJTaxat 51t ScholllTaxes 213- 513. 214. 514. m. 515. 216. 516. 217. 517. 218, 518. 219. 519. 220. TOTAL PAlO BY/FOR BORROWER 167,952.75 520. TOTAL REOUCTION AMOUNT OUE SELLER 89,592.73 300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER 301. Grots amount due from bOlrower Uine 120) 165,295.78 601. Gross amounl due to seller Olne 4201 156,983.55 302. Lass amounts paid byltor borrawer Uina 2201 167 ,952. 75 602. leu leduclian emounl due seller (line 5201 89,592.73 303. CASH TO BORROWER 2,656.97 603. CASH TO SELLER 67,390.82 SUBSTlTUTE FORM 1099 SELLER STATEMENT: Th, information contained her.ln I. Important tax InformatIon and I. being fuml.hed to th. Internal Revenue :~d~~e. l~fS Y3~"~~lri:~u~r;~1 ff h':: ~o~'~~~n ~.;~~~~:nc'\~'B~~7r.~~ ~~:~ 'pa,rcC;IoI..~b:: ~'::~fn':d48f :~~v~ ~~~.~fu're~' theeq~~~~.t~r~~::S:~1dthf' trantaction. ~aElCL~;~~~S~~Uo~~~~~~.~fc:I~I~.~e~~~~~:~: ;~. a~~~J~:bt~e~~e~ld~~~. J~;/.oro'r~1~l52s:~df':r Elg~:S~: 'll (~~~Pf~~l~ldence, for any gaIn. with your Income You..a required by law to provlda the Settlament Agent with your correct taxp.yer Id.ntlflcatlon numbar. If you do not provlda your correct taxpayer ~~d:~fi~:~:RI:;,~r';.rfU~. rr~~~lfv '~~;c:h:o n~~b:: :~o~a~~ath'~tl:~a::'::~;1. ~~':cirrect taxpayar IdentIfication number. TIN: SELlER(Sl SIGNATURE(S): SELLERlS} NEW MAILING ADDRESS: TitleExpress Settlement System Printed 121071200t at 15:26 REV. HUD.1 {J/861 U.S. DEPARTMENT Of HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT File Number: 119326 PAGE 2 L. SETTLEMENT CHARGES PAID FROM PAlO FROM JOO.TDTAL SALES/BROKER'S COMMISSION based on nrlee $155,000.00 @ 6.000 = 9,300.00 BORROWER'S SEllER'S DMMl\o.lco.lM'iuilm{liI\t7DD\&$lo.lklwt: FUNDS AT fUNDS AT 7Dl. I 4,650.00 to c-21 Al.lia:nce SETTlEMENT SETTlEMENT 70~ I 4,650.00 to weichert Realtars 703. Coll'fTliuionpaidRtSettlemenl 9,300.00 704. Reimburse for certs to Weichert Realtors 35.00 800.lTEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Origination fee 1.000 "Wells Fargo Hans M:::Art:g8ge, Inc. 1,395.00 '" ll)lnOlstounl , 803. Appraisal fee to value .It 325.00 804. Credit Rt'part to""'" 15.00 805. lel\der'slnspeclianfBa 806. Mortgage Applicatian fee 807. Anu""tionfeR 808. Dacumltllt Prep 809. Tax Slll'Vice faa to wells Fargo Real Estate Tax Service Co. 100.00 810. flaodcBttificatian to' Wella Fe.rgo J'1ood Service 16.00 611.I'tl)tlls5ir091ee to' Welle Farg6 HanllI M::lrtgage, Inc. 350.0Q 900.lTEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. tnterRst from 12/07/2001to. 01/01/2002 @I 24.840G "" 2S Doys 621.00 902. Mortglge Insurance Premium for to 903. HlZlrd Insurance p'emlum far 1-~-to Nat:icnwid8 Insu:nnoe (P.o.c.l 1,634.00 Buyer 904. 905. 10DO.RESERVES DEPOSITED WITH LENDER FOR , lOOt Halardklsullnct 4 mo.@ * 150.00 /.. 600.00 tOOl. MortgJlJIlnSW'alItII mo.' $ 'm. l1J03. City Property Tlus 12 mo.@ $ 112.57 /m' 1,350.84 , 1004. County P,operty Taxu 12 mo. @ $ 42~OO ,.. 504.00 , , 1005. Schaal Teus 7 mo.. @ $ 274.12 .,. 1,918.84 1009. Agglegate Anelysis Adjustmenl to Wells Fazgo H:ma M:xrtg.!lge, ~. 1.998.33 nOO.TlTLE CHARGES 111)l.SIlttlementorclasingfea 11!l2.Abstrectortltleselrcb 111)3. Title examination 1104. Titlt insurance. hinder 1105. Oacument Preparation 1106. Nalaryfees 26.00 1107. Altorney'sfees (Includes abave items No: , 11OB. TitlRklsullnce to 1ttIm'ican Land Transfer A88Ccl.ates 993.38 finctudu abnveltems No.: IDc1udes lender prEmium of $921.38 I 1111Q. Lend'M'~ CIlYMagt $' 139,500.00 - 1110. Ownel's Coverlge. $ 155,000.00 . 993.38 lIlt Endl0IJ,End3DO,End900 to 1\1rElrlcan I&'ld Transfer :MsocUtes 150.00 1112, UPS Deed & Prnceeds 10 1Imerlcan Land Transfer ASsociates 31.00 1113. CSL to 1mBrlcan Land T.ransfer 1\SSC:IC:UteB 35.00 1200.GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording fees Ooed$ 50.00 ; Mortgege $ 100.00 ; ReJeue t 150. 00 12ll2, Tlenstl1lTu Deed $ 1,550.00 ; Mortgage $ 1,550.00 1203. State Transfer Tu Deed $ 1,550.00 : Mortglge $ 1 550.00 1204. UPS\layo.ll tll llln'erican Latld '1'ratl8fer IIa8CCiates 15.00 1205. UPS Mortgelle plplrs to Atr8rlcan land Transfer Asaociates 15.50 1300.ADOITIONAL SETTLEMENT CHARGES 1301. Survey 1302.. Pest Inspection 1303. SeUlemenfServices 10 Wtrlcbert R8aJ.tars 90.00 1304. Reirrburse for U & 0 . to John Caxpenter 50.00 ''''. Stlue\Ul&\CIlI\ to GmCcl'1tract:c:lrs 55.00 1306. Concrelerepliu to D. L:l.berati 1,465.00 1307. 9rokersservices to C.21 Al.lianoe ~9S. 00 1400.TDTAL SETTlEMENT CHARGES (enllronfinesl03,SectianJlnd502,SectianKJ 8,31.2.23 :12.,591.00 \:r- .1 have eaund Or will CllU,. fund. tcbe ditburtlld ete 9 lie ~~~~t~~' i~'\n~~~~~ ~~n:~n~~~~:~~~eF~~"~~~11~t...~, t.t~leU,~e~. S~~t~~dc:.n i~~~f~~ '~br~~~ ~~~~1~nf01r8',-o~enett~s upon TitleExpress Settlement System Printed 12/0712001 at 15:26 REV. HUO.l (3/86) REV-1503EX+ (1-97) COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT _ESTATE OF Marian L. Willis SCHEDULE B STOCKS & BONDS FI LE NUMBER 21-D1-0631 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. 11. DESCRIPTION VALUE AT DATE OF DEATH 300 Shares ACNB Corporation CUSIP: 000868108 5,154 2 25 Shares Pennsylvania state Bank Stock CUSIP: 709142103 244 3 100 Shares PNC Financial Services Group, Inc. CUSIP: 693475105 6,781 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 12,179 9 PA15031 NTF10872 Copyright 1999 Greatland/Nelco LP - Forms Software Only REV -1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Marian L. Willis SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FI LE NUMBER 21-01-0631 Include proceeds of litigation & dale proceeds were received by the estate All prop. jointly-owned with right of survivorship must be disclosed on Sch. F. ITEM NO. 11. OESCRIPTION 1999 Subaru 4 Door Sedan sold on 10/13/01 VALUE AT DATE OF DEATH 16,000 2 Miscellaneous tangible personal property including furniture, household goods, etc. 530 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 16,S30 9 PA15081 NTF 10875 Copyrighl1999 Greatland/Nelco LP - Forms Software Only BILL OF SALE Seller: Linda L. Willis, Executrix Estate of Marian L. Willis 432 West Main Street Mechanicsburg, PA 17055 Purchaser: Jill S. Pearsall 88 Beard Drive New Milford, CT 06776 Vehic1e Description: 1999 Subaru 4 door sedan VIN: 4S38D685XX724 I 193 Odometer Reading: 23,763 Selling Price: $16,000 Date of Sale: October 13, 2001 /C J ' ,--/' ,. '} . .tL....A~ . L(j ::"'_&_k..~~'1 ignature of Seller Ey: (C,Jrl Y ~ # !IJ,()P(/I. I(il& le/ISJa i ~nature of Purchaser' .. REV-1509 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Marian L. Willis SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 21-D1-0631 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME A. Linda L. Willis ADDRESS 432 W Main Street, Mechanicsburg, PA 17055 RELATIONSHIP TO DECEDENT Mother B. C. JOINTLY-OWNED PROPERTY, LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR MADE Include name of financial institution and bank DATE OF DEATH DECD'S VALUE OF JOINT account number or similar identifying number. NO. TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 11. A A. 04/10/2000 Mellon Bank Checking Account 1,772 50.000 886 2 A 04/10/2000 Mellon Bank Checking Account 1,208 50.000 604 TOTAL (Also enter on tine 6, Recapitulation) $ 1,490 9 PA 15091 NTF 10676 (If more space is needed, insert additional sheets of the same size) Copyright 1999 GreallandlNelco LP ~ Forms Software Only @ Mellon Bank Thursday, November 29,2001 Account Number Account Title 000-602-2701 Marian L Willis Or Linda L Willis ------- ..-._,--~ Date Opened: 05/08/1998 Account Type: DD Principal Bal Int from Last Account Bal YTD Int to as of DOD Posting to DOD as of DOD DOD $1,20787 $0.00 $1,20787 $19.01 Date Opened: 07/27/1998 Account Type: DD Principal Bal Int from Last Account Bal YTD Int to as of DOD Posting to DOD as of DOD DOD $1,772.13 $0.00 $1,77213 $0.00 000-619-9285 Marian L Willis DPM Or Linda L Willis Page 2 of 2 REV-1511EX+ (1-97) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Marian L. Willis FILE NUMBER 21-D1-0631 Debts of decedent must be reported on Schedule I. ITEM NO. A. 1. 1 DESCRIPTION AMOUNT FUNERAL EXPENSES: Malpezzi Funeral Home - Funeral 8,048 2 Rolling Green Cemetary 1,035 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN No. of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. 3. Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4,DOO 4. Probate Fees 264 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Delaware County Treasurer - 2001 County Real Estate tax on decedent's home 520 2 American Land Transfer Associates - Overnight fees re: settlement on home 46 3 AT&T 38 Total from continuation paqes 20,049 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 34,000 9 PA15111 NTF 10878 Copyright 1999 GfeallandlNelco LP - Forms Software Only Schedule H part 2 (Page 2) Estate of: Marian L. Willis item No. Description Amount 4 Bradley Tree Service - Removal of dead trees in preparation of sale of decedent's home 5 Century 21jWeichert Realtors - Real estate commission from sale of home 6 eMS Contractors - Repair railings at home in preparation for sale 7 Comcast Cable 8 Cumberland Valley Motors - Maintenance/repairs to decedent's car in preparation for sale 9 D. Liberti - Concrete repairs for sale of home 10 George E. Heinly Jr. - 2001 Boro & School real estate taxes for decedent's home less credit received at settlement 11 Empowered Painters - Painting of decedent's home in preparation for sale 12 Enbridge Co. - Plumbing repairs to decedent's home 13 First Union Checking Account 14 GMB Contractors - Structural certificate needed for sale of home 15 Greenawalt & Co., PC - Preparation of decedent's final income tax return 16 John & Terease Waite - Closing cost credit re: purchase of home Total (Carry forward to main schedule) 400 9,300 300 82 80 1,465 2,857 740 706 12 55 250 500 16,747 Schedule H part 2 (Page 3) Estate of: Marian L. Willis Item No. Description Amount 17 John Carpenter - U&O Permit 18 Lansdowne Police Department - False alarm fee 19 Miller & Associates, PC - Misc. administrative expenses 20 Old Guard Insurance - Homeowners insurance on decedent's home less credit for overpayment 21 PECO - Electric bills for house 22 Penn National Insurance - Insurance on decedent's car less refund of overpayment 23 Delaware County Recorder of Deeds - Transfer tax on sale of home 24 PSW - Water bill at decedent's home 25 Verizon 26 Weichert Realtors - Fee for settlement services 27 WT Galbraith - Fuel for decedent's home Total (Carry forward to main schedule) 50 10 234 39 232 231 1,550 64 163 125 604 3,302 REV-1512EX+ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Marian L. Willis Include unreimbursed medical expenses ITEM NO. DESCRIPTION SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS FILE NUMBER 21-01-0631 AMOUNT 1. 1 Citibank Credit Card - Personal credit card 215 2 Discover Card - Personal credit card 2,688 3 First Union Bank - Car Loan 9,303 4 MBNA Credit Card - Personal credit card 829 5 Medical expenses 1,065 6 REMG, Inc. - Mortgage payments made on decedent's home from 7/1 through 12/1 and final payoff of mortgage at settlement 80,057 9 PA15121 NTF 10874 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 94,157 Copyright 1999 GreallandlNelco LP - Forms Software Only /6 -c:JLj/- /LJ ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF T~X '02 DATE ESTATE OF DATE OF DEATH FILE NUMBER ::4COUNTY ACN 05-06-2002 WILLIS 06-14-2001 21 01-0631 CUMBERLAND 101 l'iJiY 10 WILLIAM E MILLER JR MILLER & ASSOCS 1822 MARKET ST CAMP HILL '* REV-1547 EX AFP 101-D21 MARIAN L Allount Rellitted C PA 170(i;lln;:, 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 =iS47-EX-iFP-foY=02Y-NOYicE--OF-YtiHEifiTANCE-YAX-APPRAisEir€NT-,--iLi-owANcE-oi-------------- --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WILLIS MARIAN L FILE NO. 21 01-0631 ACN 101 DATE 05-06-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 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 = .00 .00 X 045 = .00 57,042.00 X 12 = 6,845.00 .00 X 15 = .00 (19)= 6,845.00 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) 155.000.00 12.179.00 .00 .00 16.530.00 1.490.00 .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) 34,000.00 94.157.00 (1lJ (12) (13) (14) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 185,199.00 128.156 00 57,042.00 .00 57,042.00 . l+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-11-2002 CDOO0952 .00 6,845.00 TOTAL TAX CREDIT 6,845.00 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 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.) IN THE MATTER OF THE ESTATE OF MARIAN L. WilLIS, DECEASED IN THE ORPHANS' COURT DIVISION OF THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 2001-00631 ESTATE SETTLEMENT AGREEMENT THIS AGREEMENT, made as of thisalrd day of October 2002, WITNESSETH: THE CIRCUMSTANCES leading to the execution of this Agreement are as follows: 1. Marian L. Willis (the"Decedent"), died testate on 14 June 2001 at 28 years of age, and Linda L. Willis duly qualified with the Register of Wills of Cumberland County, Pennsylvania, as Executrix (the "Executrix") of the Decedent's probate estate (the "Es- tate"). 2. Decedent's Last Will and Testament (the "Will"), which was admitted to probate, was executed by Decedent on 6 June 2001. 3. Article FIRST of the Decedent's Will provides for the distribution of the Decedent's tangible personal property, as follows: FIRST: I give my tangible personal property and all of the casualty insurance that I am carrying on said tangible personal property to my brother, CEPHAS S. S. WILLIS, or, if he fails to survive me, in equal shares to my parents, LINDA L. WILLIS, of Mechanicsburg, Pennsylvania, and HAROLD C. WILLIS, of Dillsburg, Pennsylvania, or the survivor of them, to be divided equitably among or between them as they may determine. I have complete confidence that my brother, my parents or my Executor will honor any written instructions that I may leave with regard to said tangible personal property. Any such property not so distributed shall be sold, and the proceeds added to my residuary estate to pass as hereafter described. 4. Article SECOND of the Decedent's Will provided for distribution of the remainder of her estate as follows: SECOND: I give, devise and bequeath the rest, residue and remainder of my estate, real and personal, to my brother, CEPHAS S. S. WILLIS, or, if he fails to survive me, to my par- ents, LINDA L. WILLIS, of Mechanicsburg, Pennsylvania, and HAROLD C. WILLIS, of Dillsburg, Pennsylvania, or the survivor of them. In the event that neither of my parents survives me, then I give my residuary estate one (%) to my mother's heirs-at- law and one-half (%) to my father's heirs-at-law. 5. Cephas S. S. Willis (the "Beneficiary") survived the Decedent. 6. The Beneficiary desires to forever settle and compromise any and all claims and rights which he may possess, now or hereafter, in the Estate and to confirm his acceptance of the Informal Account (the "Account"), attached hereto as Exhibit "A" and incorporated herein by this reference, and the Schedule of Proposed Distribution (the "Schedule"), attached hereto as Exhibit "B" and incorporated herein by this reference. The Beneficiary desires that the distributions to the Beneficiary, as set forth in Exhibit "B", be in full satisfaction of his rights in the Estate. 7. The Beneficiary wishes to release the Executrix and to indemnify her against any and all claims that may be asserted against the Estate or the Executrix after the date hereof. The Beneficiary also desires to release the Executrix with respect to the waiver of a right to a formal adjudication of a First and Final Account of the Estate. -2- 8. The Executrix is willing to settle the Estate informally in consideration of the indemnifications hereinafter provided by the Beneficiary. NOW THEREFORE, in consideration of the foregoing and intending to be legally bound, the Beneficiary, for himself, his heirs, personal representatives, successors and assigns: 1. Represents and warrants that he has read and understood this Agreement and confirm that the facts set forth above are true and correct to the best of his knowledge, information and belief. 2. Declare that he has sufficient information to make an informed waiver of his right to a formal accounting with the Court, and he does hereby waive the filing and auditing of the same. 3. Acknowledges that the distributive share or amount set forth on the Schedule shall be in full satisfaction of the Beneficiary's entitlements under the Will. 4. Releases, remises, quitclaims and forever discharges the Executrix, her heirs, personal representatives, successors and assigns, from and against all claims that he may, as a legatee of the Estate, and in connection with the Estate, have, had, now has or may in the future have in connection with the Estate. 5. Agrees to refund, on demand, all or any part of any aforesaid distribution, which has been determined by the Executrix, or by the Court of Common Pleas of Cumberland County (the "Court"), or by any court of competent jurisdiction, to have been improperly made. 6. Agrees to indemnify and hold harmless the Executrix, her heirs, personal representatives, successors and assigns, from and against any and all claims, loss, liability or damage (whether or not related to the negligence of the Executrix) that may hereafter be asserted against the Estate or against the Executrix. 7. Agrees to execute such other or additional documents as may be necessary to effectuate the agreements set forth herein. -3- 8. Acknowledges that this Agreement shall be governed by and construed in accordance with the laws of the Commonwealth of Pennsylvania. 9. Consents to the Court exercising personal jurisdiction over the Beneficiary in any suit or action arising out of the enforcement of this Agreement. IN WITNESS WHEREOF, the Executrix and the Beneficiary have placed their hands and seals on the attached Consents to Estate Settlement Agreement. -4- CONSENT TO ESTATE SETTLEMENT AGREEMENT AND RECEIPT OF DISTRIBUTION I, CEPHAS S. S. WilLIS, hereby acknowledge receipt of the assets of the Estate of Marian L. Willis, and I hereby consent to and join in the Estate Settlement Agreement, including Exhibits, which has been provided to me. WITNESS: -- , ~. ~ t /' /' ~.., ./,. '_') ~7.. .' /;~~//'.~// <'>/ t/ / " ..,..-.~ ..... --- , '" L 1../'_ CEPHAS S. S. WilLIS COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND ~""") On this, the E day of October 2002, before me, the undersigned officer, personally appeared CEPHAS S. S. WilLIS, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same in the capacities and for the purposes therein contained. IN WITNESS WHEREOF, I hereunder set my hand and official seal. ~~ ~~~ Notary 4bliC NOT ARIAL SEAL . ROY EARLE COOK. Notary Public Mechanicsburg Bora:. CumberlaRd C~ ." Ml""Q~I}1!"isslOn Ex Ires Au . 22. 200 -5- CONSENT TO ESTATE SETTLEMENT AGREEMENT I, LINDA L. WILLIS, Executrix of the Estate of Marian L. Willis, hereby consent to and join in the Estate Settlement Agreement, including Exhibits, which has been provided to me on behalf of the Estate of Marian L. Willis. (;r~~ ti~~j Ct~UJt,f'y" .f LINDA L. WILLIS, Executrix COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND On this, the ~3 ~~ day of October 2002, before me, the undersigned officer, personally appeared LINDA L. WILLIS, Executrix of the Estate of Marian L. Willis, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same in the capacities and for the purposes therein contained. IN WITNESS WHEREOF, I hereunder set my hand and official seal. ~:~~ -6- EXHIBIT A INFORMAL ACCOUNT OF THE EXECUTRIX Date of Death: June 14, 2001 Accounting for Period: June 14, 2001 through September 30, 2002 Marian L. Willis Receipts of Principal Inventory Value Cash and Cash Equivalents 06/14/2001 Mellon Bank Checking Account - Held jointly w/ mother $ 1,772.13 Mellon Bank Checking Account - Held jointly w/ mother 1,207.87 Total Cash and Cash Equivalents $ 2,980.00 No. of Shares Stocks 300 ACNB Corporation $ 5,154.00 25 Pennsylvania State Bank Stock 243.75 100 PNC Financial Services Group, Inc. 6,781.00 Total Stocks 12,178.75 Tangible Personal Property 1999 Subaru 4 Door Sedan sold on 10/13/01 $ 16,000.00 Miscellaneous tangible personal property including furniture, household goods, etc. 530.00 Total Tangible Personal Property 16,530.00 Real Property 282 N Lansdowne Avenue, Lansdowne, PA - Real property owned by decedent and sold on 12/7/01. (See HUD-l Settlement Statement attached. ) $ 155,000.00 Total Real Property 155,000.00 Total Receipts of Principal $ 186,688.75 Page 1 (2) Date Paid 06/26/2001 07/17/2001 07/30/2001 07/30/2001 07/30/2001 07/30/2001 07/30/2001 08/01/2001 08/14/2001 08/14/2001 08/24/2001 09/04/2001 09/04/2001 09/20/2001 09/27/2001 Page 1 Marian L. Willis Disbursements of Principal Debts of Decedent First Union Bank - Car Loan $ 344.35 First Union Bank - Car Loan 353.86 Citibank Credit Card - Personal credit card 214.82 MBNA Credit Card - Personal credit card Credit card payoff less credit received from overpayment of interest 828.92 Medical expenses Haverford MRI - less $72 refund received in December 49.51 Medical expenses Hershey Medical Center 100.00 Medical expenses MSHMC Physicians 15.00 First Union Bank - Car Loan 346.93 Medical expenses Drexel Anesthesia 32.00 Medical expenses Const. in Med. Onc & Hemo 734.93 First Union Bank - Car Loan 8,257.75 Discover Card - Personal credit card Payment of credit card balance owed at date of death 200.00 Medical expenses MSHMC Physicians Group 10.00 Medical expenses MS Hershey Medical Center 72.00 REMG, Inc. - Mortgage payments made on decedent's home from 7/1 through 12/1 and final payoff of mortgage at settlement 732.90 (3) Amount Paid Date Paid 09/30/2001 10/10/2001 10/28/2001 10/31/2001 11/07/2001 11/29/2001 12/07/2001 07/01/2001 07/30/2001 Disbursements of Principal (Continued) Debts of Decedent Discover Card - Personal credit card $ REMG, Inc. - Mortgage payments made on decedent's home from 7/1 through 12/1 and final payoff of mortgage at settlement REMG, Inc. - Mortgage payments made on decedent's home from 7/1 through 12/1 and final payoff of mortgage at settlement Discover Card - Personal credit card REMG, Inc. - Mortgage payments made on decedent's home from 7/1 through 12/1 and final payoff of mortgage at settlement Medical expenses Kramer Medical REMG, Inc. - Mortgage payments made on decedent's home from 7/1 through 12/1 and final payoff of mortgage at settlement Total Debts of Decedent Funeral Expenses Rolling Green Cemetery Fee for interment, opening crypt, crypt plate, etc. $ Malpezzi Funeral Horne - Funeral Total Funeral Expenses Federal and State Taxes 2,000.00 732.90 1,433.68 487.53 656.10 51.59 75,845.63 $ 1,035.00 8,048.00 $ Amount Paid 93,500.40 9,083.00 Date Paid 03/13/2002 06/26/2001 06/26/2001 06/26/2001 06/26/2001 07/16/2001 07/21/2001 07/30/2001 07/30/2001 07/30/2001 07/30/2001 08/08/2001 08/14/2001 Disbursements of Principal (Continued) Federal and State Taxes Cumberland County Register of Wills, Agent $ $ 6,845.00 Total Federal and State Taxes Administration Expenses Comcast Cable $ PECO - Electric bills for house Verizon WT Golbraith - Fuel for decedent's home Fuel oil for decedent's home Penn National Insurance - Insurance on decedent's car less refund of overpayment Insurance on decedent's car First Union Checking Account Service fee charged to decedent's checking account Comcast Cable Lansdowne Police Department - False alarm fee False alarm call PECO - Electric bills for house Verizon Cumberland Valley Motors - Maintenance/repairs to decedent's car in preparation for sale Maintenance on car in preparation of sale AT&T Phone bill from decedent's home 6,845.00 39.92 35.26 35.29 184.93 142.00 12.00 42.10 10.00 61.29 38.62 79.95 9.41 Amount Paid Date Paid 08/17/2001 08/23/2001 08/25/2001 08/25/2001 09/01/2001 09/04/2001 09/20/2001 09/20/2001 09/20/2001 09/27/2001 10/01/2001 10/23/2001 Disbursements of Principal (Continued) Administration Expenses Bradley Tree Service - Removal of dead trees in preparation of sale of decedent's home Removal of dead trees at decedent's real property in preparation of sale $ Verizon PECD - Electric bills for house Penn National Insurance - Insurance on decedent's car less refund of overpayment Final car insurance payment less refund for early cancellation Enbridge Co. - Plumbing repairs to decedent's home Plumbing repairs to decedent's home PSW - Water bill at decedent's home Water bill at decedent's home Delaware County Treasurer - 2001 County Real Estate tax on decedent's home George E. Heinly Jr. - 2001 Boro & School real estate taxes for decedent's home less credit received at settlement Verizon PECD - Electric bills for house WT Golbraith - Fuel for decedent's home PECD - Electric bills for house 400.00 24.22 34.36 89.00 705.55 31.18 519.91 2,857.42 27.84 35.90 418.86 19.80 Amount Paid Date Paid 11/07/2001 11/19/2001 11/20/2001 11/23/2001 11/23/2001 11/23/2001 12/01/2001 12/07/2001 12/07/2001 12/07/2001 12/07/2001 12/07/2001 12/07/2001 Disbursements of Principal (Continued) Administration Expenses Empowered Painters - Painting of decedent's home in preparation for sale Paint exterior of decedent's home in preparation of sale $ AT&T PSW - Water bill at decedent's home Old Guard Insurance - Homeowners insurance on decedent's home less credit for overpayment Home insurance premiums (less refund received on 12/20 for cancellation of policy) PECO - Electric bills for house Verizon CMB Contractors - Repair railings at home in preparation for sale Repair railings at decedent's home in preparation for sale American Land Transfer Associates - Overnight fees re: settlement on home Century 21/Weichert Realtors - Real estate commission from sale of home D. Liberti - Concrete repairs for sale of home GMB Contractors - Structural certificate needed for sale of home John & Terease Waite - Closing cost credit re: purchase of home John Carpenter - U&O Permit 740.00 28.40 24.97 39.00 22.10 36.68 300.00 46.00 9,300.00 1,465.00 55.00 500.00 50.00 Amount Paid Date Paid 12/07/2001 12/07/2001 12/20/2001 12/26/2001 01/07/2002 02/28/2002 03/13/2002 03/13/2002 03/13/2002 03/13/2002 03/13/2002 03/13/2002 Disbursements of Principal (Continued) Administration Expenses Delaware County Recorder of Deeds - Transfer tax on sale of home $ Weichert Realtors - Fee for settlement services PECO - Electric bills for house PSW - Water bill at decedent's home WT Golbraith - Fuel for decedent's home Miller & Associates, PC - Misc. administrative expenses Certified/insured expense to mail stock certificates Miller & Associates, PC - Misc. administrative expenses Estate advertisement in The Sentinel Miller & Associates, PC - Misc. administrative expenses Estate advertisement in the Cumberland Law Journal Miller & Associates, PC - Misc. administrative expenses Probate fees paid to Cumberland Co. Register of Wills Miller & Associates, PC - Misc. administrative expenses Short certificates Miller & Associates, PC - Misc. administrative expenses Stock transfer fee Miller & Associates, PC - Misc. administrative expenses Attorney fees to administer estate 1,550.00 125.00 23.28 8.11 98.96 19.60 80.87 75.00 264.00 9.00 20.00 4,000.00 Amount Paid Date Paid 03/13/2002 Disbursements of Principal (Continued) Administration Expenses Miller & Associates, PC - Misc. administrative expenses Inventory Filing Fee $ $ 134,177.18 Total Administration Expenses Total Disbursements of Principal 13.00 $ Amount Paid 24,748.78 Marian L. Willis Distributions of Principal to Beneficiaries Cephas S. S. Willis 02125/2002 300 Shares ACNB Corporation $ 02125/2002 100 Shares PNC Financial Services Group, Inc. 02125/2002 25 Shares Pennsylvania State Bank Stock 04/29/2002 Cash Distribution Value 5,154.00 6,781.00 243.75 40,000.00 Total Distributions of Principal Page 1 (10) $ $ 52,178.75 52,178.75 Marian L. Willis Receipts of Income Income Collected 282 N Lansdowne Avenue, Lansdowne, P A - Real property owned by decedent and sold on 12n101. (See HUD-1 Settlement Statement attached.) 01/08/2002 Deposit forfeited by purchasers $ 1,000.00 ACNB Corporation 12/31/2001 Dividend on 300 Shares $ 33.60 Pennsylvania State Bank Stock 04/09/2002 Dividend on 0 Shares 07/03/2002 Dividend on 0 Shares $ 12.00 5.00 PNC Financial Services Group, Inc. 01/25/2002 Dividend on 100 Shares $ 12.00 Total Income Received Page 1 (12) $ 1,000.00 33.60 17.00 12.00 $ 1,062.60 Date Paid 04/06/2002 08/26/2002 Page 1 Marian L. Willis Disbursements of Income Administration Expenses Greenawalt & Co., PC - Preparation of decedent's final income tax return $ 200.00 Greenawalt & Co., PC - Preparation of decedent's final income tax return 250.00 Total Administration Expenses $ 450.00 Total Disbursements of Income $ (13) Amount Paid 450.00 Marian L. Willis Summary of Account Principal Receipts Net Loss on Sales or Other Dispositions Balance Before Distributions Less Distributions to Beneficiaries $ $ $ 93,500.40 9,083.00 20,484.78 6,845.00 4,264.00 $ 186,688.75 (155,530.00) 31,158.75 Less Disbursements: Debts of Decedent Funeral Expenses Administrative Expenses Federal & State Taxes Fees & Commissions Principal Balance On Hand $ 134,177.18 (103,018.43) 52,178.75 332.82 Unrealized Gains and Losses Income Receipts $ 1,062.60 Net Loss on Sales or Other Dispositions 0.00 $ 1,062.60 Less Disbursements: Administrative Expenses $ 450.00 450.00 Balance Before Distributions $ 612.60 Less Distributions to Beneficiaries 0.00 Income Balance on Hand S 612.60 Unrealized Gains and Losses Combined Balance on Hand $ (154,584.58) Page 1 (1) EXHIBIT B SCHEDULE OF PROPOSED DISTRIBUTIONS REMAINING ASSETS OF THE ESTA TE: Balance in Estate Checking Account $ 945.42 TOTAL ASSETS REMAINING $ 945.42 PROPOSED DISTRIBUTIONS: Final Distribution to Beneficiary: Cephas S. S. Willis Total Final Distributions $ 945.42 $ 945.42 TOTAL PROPOSED DISTRIBUTIONS $ 945.42 -------- " 0~ STATUS REPORT UNDER RULE 6.12 Name of Decedent: M~rian L. Willis Date of Death: 14 Jillle 2001 will No. 2001-00631 Admin. No. 2101-0631 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above- captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to NO.1 is Yes, state the following: a. court? Yes Did the. personal representative file a final account with the No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: ~~~ Signature William E. Name (Please type or print) 1822 ~~rket Street, Camp Hill, PA 17011 Address 717/737-9210 . Tel. No. X Personal Representative Counsel for personal representative Capacity: