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Home My WebLink About01-0640 PETITION FOR PROBATE and GRANT OF LETTERS H ..~' I "".IV }:. Ll1 J;; rs~ ,~ No. 21-01-640 To: Estate of also known as Register of Wills for the . , Deceased. County of c.. v 11'1 Ie 'f'\" 1/JlLdin the Social Security No. I~ 0 .. 0 t::t "" Oc> ~~ 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 (} I?~ in the last will of the above decedent, dated F.;;> h ll'li. fit Y 7 and codicil(s} dated AlP. ;:::",vJf) ".."j-J, 1... vile j,.'Pr- d i.e rL Ii IL 1 iH i 5: /9(;,77 named , 19-+z..- (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in C,~....., b -e v-I ~ "'d- e:.. uJ ~ last family or principal residence at q.!l '( S j y(!)~ k' County, Pennsylvania, with If) $1; f\1~c h'VJwtc.<:>.bt'.l1'f'p4, (list street, number and muncipality) Decendent, th.en , ~~/ at Except as follows, dec ent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for Groba e;. was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ I Lf I> j). 0-0 (If not domiciled in Pa.) Personal property in Pennsylvania $ 3 1 00. r!J 0 (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania . $ : i 000.00 situated as follows: q.1.l.f s. y'" ~ 1<, .$ J; ^1~~t.,1I wJ ic..s"u.~}-o 1 A WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will ~codicil(s) presented herewith and the grant of letters IP ~ r j4 ne w-r po. I^ 'I \. (testamentary;jadministration c.I.a.; administration d.b.n.c.La.) theron. C Po R L L ~ W4>b@ Y" ;l; ~~~/W,:j-);fJ:7?~11 ~~~6 I /-/-luCAGS-r ])l"IIVG. /t{tEcrtl1/V/CS 8UJ< ($-, ~A /70$0 '" '" u c: '" '0 ,-. .- '" "'- "'... p:::'" c: '00 C:'O cU";:: ,-.ll.l ~Il, '" '- ;:;0 ., c: Ol) (Ii c~ rf. ()J~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ S8 COUNTY OF C C.( ""'1- hQ\{'o I ~ lvd J The petitioner(s) above-named swear(s) 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. Sworn to or affirmed and before me this 2nd DL C!.~_ ~ (.LJJ~ .JJca~ D/n47 ~ V'l QQ' ::s l::l - Ii::: ~ ~ No. 21-01-640 Estate of HELEN K WEBER , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW JULY 6 ~200 1 , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated February 7. 1972 described therein be admitted to probate and filed of record as the last will of HELEN K WEBER TESTAMENTARY CARL L WEBER AND PATRICIA A GILL and Letters are hereby granted to 7"Ytf.~,v-/ /bn) Au A-7' Re . ter of Wills FEES Probate, Letters, Etc. ......... x-pages Short Certificates( ).......... Renunciation ................ JCP $ $ $ $ TOTAL _ $ Q4.00 . . . . . . . .JULY. 2,. . 20.Ql. . . . . . . . . . . . . 80.88 J. 6.00 AITORNEY (Sup. Ct. 1.0. No.) 5.00 ADDRESS Filed PHONE ~ WARNING: IT IS ILLEGAL TO ALTER THIS COpy OR TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. COMMONWEALTH OF PENNSYLVANIt', DEPARTMENT OF HEALTH VITAL RECORDS LOCAL REGISTRAR'S CERTIFICATION OF DEATH CEFiT NO. T 4 913 5 3 2 _ji'i-; Ii ,-~:!if~:'~:'_:",~:.;;_ ,;,;'\. ~'u HdlPfA;-",:, <,\\~:.. "4;j'C:~ ",,,,,' ~- ?~' ~.~\ J ~:,ia,: " ~}\ ,.~< " ~ '9;. :/~;;:. ..; '" ;6,' ~~ "y " ^",f '. .,~~ .," ':cec,/4fENi \j\ ~",:,,\, ":~~~';'..L.'J+,!.~t:};.' - ~..-I~n~_,t8,L~QQ1___..... Oa~e cf 1'3";,'(' 01 This Cf'rlit'!~a1!On r,Iarn'3 Cef eden' ,..II,gleIL, 21-01-640 K.. ._____,We be:!' Female . Socia! Security No. 180 - 09 - 6006 Date of Death __~.u.!1~_!~.t_?QQ~_,____ D d e oj 8 d Yl__F e pr1H!!"Y .l!t.t. t21~__ 81 rth p I ace ,PJ!ls1;>1.! rg ..tlO!l~.&.l:1~ rL'}:'g~!ll:l!1..!.Q..t.Y9 r lc_..G(),ll nJ.YL!'~B!lS y 1 va ni a_ Place Df C1E'Ft'h Jt~J:.IJ:.l?lJl,l,r gfI.Ql?E.1 t a t__~__..~a 11 Pl1 i n f(),lll'1!,y.. , u______..____.___. Ha r-r!: l!.~u.~J~ ___..~~. E ~n n syly ani a. I"i,' j\,'; " l'lC;'{-"'-"" 1-"A f.., Viar;taJ ,St,:.~"!_S Occupation _.Ga.rm.ent.WQrkeT Oecedent's Widowed ._ Mailing Address .224.. .. Armed ForcesC? (Yes No) NQ :::~a(>) White South York&.tre.e.t.._ _.,_Me_ch.an:i.cs blIT&__f.A...-.._, 1 (1fo:mant Mr. Car.L.L~.}1eber__... -.. f:une'?,i SCQttJJ.._Bre!l.11~JI!~nJ~D_ , f'j,]n~'e (1nd l.\dc~re:'::.s ot E S lei hi, sh ';'18 ni.cocklin..llunera1Home.. Inc. .3 Q N. Chest nut .Str.eJtt.f.,J1ills.burg,_.PA_.J,1.Ql~_.__._. P?pOi ! in'nl(~dj,J C:ause interval Between Onset and Death C.ardiac ,1\JTe.5.L. A<;\,lL~.J1Y9C.~ rQi al...!n!.Ci!"c~i.on ;'('1 Part I. Other 3'fjrificant Ccnditions M;::l'im~i Of i)F;:.th Descnbe r,ow Injury occurred. f~a tu ra ~ Xxx HOlillclde Pend1nq Investigation Could not be Determined A,ccidE:nt ~)UiC~O~:7 f-lame a:,d Tille of Certfier Kenneth B. Conner, MD ,.. ......._.~-_._---_..---_._------_._.. (M,D" 0.0,. Coroner, ME) Arjd "f: s:c, 207 House ~~~TlE.e_,. Camp Hill, PA 17011 T !~ :~ t certify tha the information h,9r8 given c. rrectly copied from an \'iglnal ceft flcate of:;);:;jh duly filed v\ith me as Local Regist a'. The rlr;Jinai certificate will be forwarded to the Sl;:te Vi a Records Office for permanent !jlin~*~ -r' ~ 67608 --- "" --_.._~------ --~-_.__._--- .u Jij,.ruL.lf4;-i~.OOl. ,. 15~, L()K.<!t1..RoaA, _])1U.~1:)llIg,!..fA 17019_____.__. , ~.. ',',-"" ;~-,., '"Q". -- \,,,.'., 21-01-640 LAST WILL AND TESTA}lliNT OF HELEN K. vffiBER I, HELEN K. vffiBER, of the Township of Upper Allen, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Hill and Testament, hereby re- voking and making void all former \'Tills by me at any time heretofore made. 1. I direct the payment of all my just debts and fune- ral expenses as soon as conveniently may be after my decease. Also, if I have not procured a stone for the lots at the ceme- tery, I direct my Executor hereinafter named, to purchase a suitable stone. 2. All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath to my beloved husband, Kenneth L. t'Jeber, to his own use and benefi t absolutely. 3. In the event, however, that my said husband should predecease me, or, as the result of a disaster common to both of us, should die at about the same time as I do, I give, de- vise and bequeath my Estate to my son, Carl L. Weber and my daughter, Patricia Ann Gill, in equal shares. 4. LASTLY, I nominate, constitute and appoint my said husband, Kenneth L. Weber, to be the Executor of this, my - 1 - Last will and Testament. If he should predecease me or for any other reason fail to qualify as such Executor, I appoint my son, Carl L. Weber, and my daughter, patricia Ann Gill, to be the Executors in his place and stead. I direct that neither of them shall be required to file bond or other se- curity in the office of the Register of Wills for the pur- pose of administering my Estate. IN ~n'rNESS WHEREOF, I have hereun to set my hand and seal this 7f1;; day of February, A. D. 1972. lb., '."'; ~,f: >:t.J. ~?j~~.,. -'~ (SEAL) Signed, sealed, published and declared by the above- named HELEN K. v-JEBER, as and for her Last ~'7ill and 'l'estament, in the presence of us, who have hereunto subscribed our names at her request as witnesses thereto, in the presence of the said Testatrix and of each other. u. /trL ~7 _r ~~A.TA/.1 - 2 - 21-01-640 REGISTER OF WILLS OF c$>l1N~y OATH OF SUBSCRIBING WITN~,~/ / / codicil // (each) a subscribing witness to the will presented here~jth, (each) being duly qualified according to law, depose(s) and say(s) that present and saw the testat , sign the same and that , signed as a witness at the request of testat_ in h presence llnd (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this day of 19_ Register r:-( (Name) (Address) (Name) (Address) REGISTER OF WILLS OF COUNTY OATH OF NON-SUBSCRIBING WITNESS PItTR IC..rA f), bJ..LL (each) a slieseriber Aeret", (p.3cb) being duly qualified according to law, depose(s) and say(s) that r If In familiar with the signature of HIE LE tv k vV f:E,B E ,t-".,_ 1)..... ',I codicil testat..ll.::f::.X of (one of the subscribing witnesses to) the ~ presented herewith and codicil believe' the signature on the ~is in the handwriting of knowledge and belief. ~~a. f) (Name) yf) TNCIfJ' f-j. GIf- L (Address) / H/LLC/1f::.5T D~lf/c:. (Name) /J . ()1lEcH-ffNICS 13 k/?6-1 ,JIJ I /705"'0 that r HELEN 1\. W~t3 E R to the best of iVJ Y Sworn to or affirmed and subscribed before me this 2nd day of ~JULY 1'1<2001 ~~~fw./IkJ.IJ,,::s;:r Reglste ~ (Address) 21-01-640 REGISTER OF WILLS OF _~~TY OATH OF SUBSCRIBING WIT~S ..;,F"~ /",/J ~// /' / /" codicil / (each) a subscribing witness to the will presented h~ewith, (each) being duly qualified according to law, depose(s) and say(s) that ' present and saw the testat , sign the same and that signed as a witness at the request of testat_ in h pres"erice and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this day of 19_ (Name) // (Address) Register (Name) (Address) REGISTER OF WILLS OF eUl11he~j~lVDcOUNTY OATH OF NON-SUBSCRIBING WITNESS f'r}..LC H /J tE L /1, GILL (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that -,: A- W\ familiar with the signature of II fj fA.. J -K. W E:.g f R , codicil em::> presented herewith and codicil believef.the signature on the @is in the handwriting of testat~ of (one of the subscribing witnesses to) the :r: that to the best of }VI f knowledge and belief. {J1I/JJ O.~ Sworn to or affirmed and subscribed before me this 5th day of JULY t~2001 ~y~~,~')A/7i,i;.Jr Register (Name) { fY} I c-l./.It~ Ii - G.; I ,/ (Address) . ) 1I-///Cl'i51 .oe I Vi (Name) /!;1f C/J/tU/c5'1dt4P q fA (7050 (Address) ~ CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Helen K. Weber Date of Death: June 18, 2001 will No. 21-01-0640 Admin. No. To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on August 28, 2001: Name Address Carl L. Weber 25 Walnut Lane Camp Hill, PA 17011 One Hillcrest Drive Mechanicsburg, PA 17050 Patricia Ann Gill Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: August 28, 2001 ,Q Ja es D. One West Ma' street Shiremanstown, PA 17011 (717) 737-8761 Capacity: Personal Representative X Counsel for Personal Representative Register of Wills of CUMBERLAND County, Pennsylvania INVENTORY Estate of Helen K. Weber No. 21-01-0640 also known as Date of Death 06/18/2001 . Deceased Social Security No. 180 - 09 - 6006 Carl L. Weber and Patricia Ann Gill, Personal Representative(s) of the above Estate, deceased. verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death. and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I /We verify that the statements made in this Inventory are true and correct. l!We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Personal Representative Signature: (!ad ~ (jYP~(A,./ C~ 1 L. Weber 0.. . . ~ /1/11,.,., JJ<.li.., Patricia Ann Gill 25 Walnut Lane Name of James D. Bogar Esquire Attorney: I.D. No.: 19475 Address: One West Main Street Shiremanstown, PA 17011 Telephone: 717/737-8761 Signature: Address: Camp Hill, PA 17011 Telephone: 717/737-8279 Dated: 03/13/02 Description Value .........r ... ~ ;", .J' ..... d N (See continuation page(s) attached) :z ;:r:c. :;Q U1 c/) (Attach additional sheets if necessary) Total: 79,539.83 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may. at the election of the personal representative. include the value of each item, but such figures should not be extended into the total of the Inventory. '. .. "'~~--.I..__;.. c..... ^r..,....,..i~til"ln C~r~ IIRW-7 (1<l<l2\ Estate of: Date of Death: County: INVENTORY Helen K. Weber 06/18/2001 Cumberland CASH: Cash on hand 132.84 Commonwealth of Pennsylvania - 2000 Property tax rebate 500.00 Mellon Bank, N.A. - DD Account No. 142-103-6110 1 , 721. 04 Patriot News Co. - Refund 6.55 United American Insurance Company - Refund 66.65 2,427.08 PERSONAL PROPERTY: Contents of home and personal property sold at public sale 8,112.75 8,112.75 REAL ESTATE/PA: All that certain piece or parcel of real estate having erected thereon a dwelling house being known and numbered as 924 South York Street, Mechanicsburg, Pennsylvania. 69,000.00 69,000.00 -1- JAMES D. BOGAR ATTORNEY AT LAW ONE WEST MAIN STREET SHIREMANSTOWN , PENNSYLVANIA 17011 e-mail bogarlaw@ezonline.com TELEPHONE (717) 737-8761 FACSIMILE (717) 737-2086 August 1, 2001 Mary C. Lewis Register of Wills Cumberland County Courthouse Carlisle, PA 17013 RE: The Estate of Helen K. Weber No. 21-01-064 Date of Death: June 18, 2001 Dear Mrs. Lewis: Please be advised that I will be representing the Estate of Helen K. Weber. I would like to note that the Letters Testamentary issued in this matter state that Helen K. Weber was from Mechanicsburg Borough. Please be advised that at her death, Helen K. Weber was late of Upper Allen Township. Your time and consideration in these matters are greatly appreciated. 7r tru ~~.' JDB/leb cc: CarlL. Weber, Co-Executor Patricia Ann Gill, Co-Executor ~ ~ ~ JAMES D. BOGAR ATTORNEY AT LAW ONE WEST MAIN STREET SHIREMANSTOWN , PENNSYLVANIA 17011 e-mail bogarlaw@ezonline.com TELEPHONE (717) 737-8761 FACSIMILE (717) 737-2086 September 14, 2001 via certified Mail/Return Receipt Requested 7000 1530 0001 0192 1596 Mary C. Lewis Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 RE: The Estate of Helen K. Weber No. 21-01-0640 Date of Death: June 18, 2001 Dear Mrs. Lewis: I represent the Estate of Helen K. Weber. Enclosed is a check made payable to the Register of wills in the amount of $2,565.00, same constituting a prepayment at discount on account of Pennsylvania inheritance taxes in the above-captioned estate. The prepayment is determined as follows: $60,000.00 multiplied by 4.5% or $2,700.00, less discount in the amount of 5% or $135.00, resulting in payment of $2,565.00. Please provide me with the appropriate receipt in this matter. Your time and consideration in this matter is greatly appreciated. very. tru~y yours, /1 n...O I . r~D. B AR JDBjjeb Enclosure cc: Carl L. Weber Patricia Ann Gill COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES OEPT, 28060'1 HARRIS8URG, PA 17128.0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BOGAR JAMES 0 1 W MAIN STREET SHIREMANSTOWN, PA 17011 -------- fold ESTATE INFORMATION: SSN: 180-09-6006 FILE NUMBER: 21-2001- 0640 DECEDENT NAME: WEBER HELEN K DATE OF PAYMENT: 09/17/2001 POSTMARK DATE: 09/14/2001 COUNTY: CUMBERLAND DATE OF DEATH: 06/18/2001 NO. CD 000271 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $2,565.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CARL L WEBER C/O JAMES 0 BOGAR ESQUIRE CHECK# 05 SEAL INITIALS: DO RECEIVED BY: $2,565.00 MARY C. LEWIS REGISTER OF WILLS REGISrER OF WILLS REV-1S00 EX +(6-00) CAPB HpRL EplO CRAC KOTK ES C P o 0 R N R 0 E E S N T C o M P T U A T X A T I o N REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT o E C E o E N T COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME(LAST, FIRST, AND MIDDLE INITIAL) Weber Helen K. DATE OF DEATH (MM-DD-YEAR) FILE NUMBER COUNTY CODE r. L/o/ OFFICIAL USE ONLY 21-01-0640 YEAR NUMBER SOCIAL SECURITY NUMBER 180-09-6006 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 3. Remainder Return p~r~i tOj r2e_ait82) S. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch 0) :imllllil~fil>ltlJSlll. NAME James D. Bo ar Es uire FIRM NAME (If Applicable) o o COMPLETE MAILING ADDRESS TELEPHONE NUMBER One West Main Street Shiremanstown, PA 17011 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Sub'eet to Tax (Line 12 minus Line 13) (1) (2) (3) 06/18 2001 02 14/1914 IF APPLICABLE SURVIVING SPOUSE'S NAME LAST, FIRST, AND MIDDLE INITIAL X 1. Original Return 4. Limited Estate X 6. Decedent Died Testate (Attach copy ofWlJI) D 9. litigation Proceeds Received 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy of Trust) 010. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 69,000.00 None None ~r N6p.e 10,5311", t3 , 1,434.95 None 23,039..52 None .0 0 045 .12 .15 OFFICIAL USE ONLY d N 3 ~; ~ Ul (8) CO ~,:) ::x 80,974.78 R E C A P I T U L A T I o N (4) (5) (11) (12) (13) 23.039.52 57,935.26 (6) SEE INSTRUCTIONS ON REVERSE SlOE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116{a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. X 57,935.26 X X X X (14) 57,935.26 (15) (16) (17) (18) (19) 0.00 2,607.09 0.00 0.00 2,607.09 Copyright (c) 2000 form software only The Lackner Group, Inc. FormREV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 924 South York Street CITY I STATE I ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 2,607.09 2,565.00 130.35 Total Credits ( A + B + C) (2) 2,695.35 3. Interest/Penalty if applicable D. Interest E. Penalty TotallnteresVPenalty ( D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line S + SA This is the BALANCE DUE. (5B) Make Check Payablela: REGISTER OF WillS, AGENT 0.00 88.26 0.00 0.00 0.00 i~i!i~~!~!!~~~!~!g!~!~!i~~~!!~~g~~~i!i!i!ii!ii!i Yes No ~~ o o o [B [B [B Under penaltles of perjury, [ declare that [ 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 all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Car 1 L. Weber DATE ___2.~ _!'.":~~~_t._~."_",= uu m ___ hm mum U_'h uu 03/13/02 earn Hill, PA 17011 James D. Bogar Esquire D~E _ __q""__~'=~:t_}~?_i_,, _~:t_r:,=,,:t__ ___ _____ _____ ___ ___ _____ 03/13/02 Shiremanstown PA 17011 Iy 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the .9116(a)(1.1)(;)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to orfor the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116( 1.2} [72 P.S. 9116(aX1}]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(aX1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Copyright (cl 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) ADDITIONAL Personal Representatives Estate of Helen K. Weber SS# 180-09-6006 06/18/2001 *************************************************** Under penalties of perjury, the undersigned declare that they have examined this return, including accompanying schedules and statements, and to the best of their knowledge and belief, it is true, correct and complete. jJ~}-^'kL Signature Name Address Line 1 Address Line 2 City, State, Zip Patricia Ann Gill One Hillcrest Drive Mechanicsburg, PA 17050 Date 03/13/02 REV.1502 EX +(1.97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Helen K. Weber SS# 180-09-6006 06/18/2001 21-01-0640 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 VALUE AT DATE DESCRIPTION NUMBER OF DEATH 1 All that certain piece or parcel of real estate having erected 69,000.00 thereon a dwelling house being known and numbered as - 924 South York Street, Mechanicsburg, Pennsylvania. The property was acquired by Kenneth L. Weber and Helen K. Weber, husband and wife, by Deed dated 01/05/1945 and recorded in the Cumberland County Recorder of Deeds Office, a copy of which is attached hereto and incorporated herein. Kenneth L. Weber died 08/05/1997, whereupon title to the real estate became vested solely in Helen K. Weber, the decedent herein. The above-described real estate was sold pursuant to an Agreement for the Sale of Real Estate, a partial copy of which is attached hereto and incorporated herein. Final settlement took place on 10/31/2001. A copy of the Deed conveying the real estate, along with a copy of the Settlement Statement, are attached hereto and incorporated herein. The sale price of the real estate was $69,000.00. SCHEDULE A REAL ESTATE TOTAL (Also enter on line 1, Recapitulation) $ 69,000.00 (If more space is needed, insert additional sheets of the same size) Copyrlght(c) 1996 form software only CPSystems, (nc. Form REV-1502 EX (Rev. 1-97) No. 25b- W ABBANTY DEED THE RIVERSIDE PREBS, ATHENS, PENNA. ilr4ill Ileeb :Mude the fifth day of January , in the yelll" Nineteen Hundred and forty-five (1945). BlcTWlc~]N CLARENCE E. EPPLEY and ANNA M. EPPLEY, his wife, of the Township of Upper Allen, County of Cumberland and State of Pennsyl- vania, grantors, - and - KENNETH L. WEBER and HELEN K, WEBER, his wife, of the Township or Monaghan, County of York, and State of Pennsylvania, grantee3. WI'l'N~SSErrlI: That in consideration or the sum of One (~~l.OO) Dollar and other good and valuable considerations - D<H.ltl-t'lor ill hand paid, the receipt whereof is hereby acknowledged, the said grantors do hCl'chy grant und convoy to the said grantees all that certain lot of eround s1 tua te in the Township of Upper Allen, in the County of' Cumberland and state of Pennsylvania, bounded and described as follows, to wit:- BEGINNING at a point on the Sheperdstown Road, thence South twenty- four and one-half' (24!) degrees East forty-eie;ht f'eet and four inches (48 f't. 4 in.) along said Road to a stone; thence South sixty-five (65) degrees West along lot of Irvin Alexander four hun- dred and ninety-f'ive (495) f'eet to a point; thence North twenty- four and one-half (24!) degroes West along land formerly of Jolm Brandt forty-eight feet and four inches (48 ft. 4 in.) to a pin; thence by lands of Oscar H. Miller North sixty-five (65) degrees East four hundred and ninety-five (495) feet to the place of Beginnin~; CONTAINING one-half' (1/2) acre, more or less, and having erected thereon a two and one-half' (2~) story frame dwell- ing house and other necessary buildings. BEING the same promises which Jacob E. Weber and Mae O. Weber, his wife, by their deed dated July 22nd, 1944, and recorded in the Recorder's Of'rice in and f'or Cwnberland County, in Deed Boole "VII, Volume 12, Page 483, granted and conveyed unto Clarence E. Eppley and Anna M. Eppley, his wife, the grantors herein. \11 do AND the said grantor 9 hereby warrant generally the property hereby conveyed. IN WITNESS WHEREOF, the suid grantors ha va hereunto set their llUllds und seals the day and year first above written. Signed, Sealed and Delivered in the Presence of _J'1-~<nt'--~~k-- "'" .. ~-~~------ --,--,-,~.........,..--_._-------_._-----_._-_._------- State of Pennsylvania, County of Cwnberland On this rUth ~a,__~t~(r [SenI] f2Mk:JJ.ptGffdff- [SenI] ---______________________________ _______ [Senn _______________________________nm_______________________ [Sen] ) __ ______________mm_m_ [Senn }ss: day of January A. D., ]945 ,hefore me a Notary Public in and for said County, came the ahove IHlIllCd CLARENCE E. EPPLEY and ANNA M. EPPLEY, his wire, and acknowledged the foregoing Deed to be their act and deed, and desired the smne to be recorded as such. WITNESS my hand and no tarial seal the day and year aforesaid. . '-"'<~x'o~\2~r-- ___m___nnn~!_~.~_~.s.~~~~_ ':Xvlr~~ /.1,ll'ch :1 ~, ~ 945 My Commission expires State of PeHnsylvan~a, County of On this mea and acknowledged the foregoing Deed to b(> to be recorded as such. 'VITNESS my hand and }ss: day of A. D.19 . before in and for said County, came the above named act and deed, and desired the same Menl und tho (hty uHd yenr UfOI'Cl:illid. ,. 'I.' My Commission cxpires '-9 "-l (lQ '" ...... State of Pennsylvania, JSS: RECORDED on this sth. day of ~Oi "" ~"'1 A. D. 19 f S in the RClcordor's Office of said County, in Deed Rook "+I Vol. /;1. . Page 1/tJ. Connty ofC u .." b e r ) ~ " J Given unller my Jmnil Dnd the Real of tJw Rllid office, the clnte nbove written. I ])0 HKHlj1BY Clj1Rrrn~Y that the Dated: ~ ~ m , -" ~___() >,1"." ..,,~ ii~ ~ .'" ...... ~.q ..... Po . Po'" 0 '" ~ ..., ..... ...j Po :,(t " , '"'" ~ ..... :':2 0"", ~ .... ..".r/ & ~ '" .:<1 ... ~ ..,... ~ ~ "'.., ~ ....l~ .<11<1 ..., ~'" ~~ "" .,.. P:1 ~/7-'7<:;!J/.', . -----------~-b"-_._/_~Recorder. precise residenee 01 the grantee is . /.9~ I? 10...3 ~~~.::~^" ... ~ E-l Z -< ~ -< ~ .J ~ . ,,'" Ij. '\.". ., ... ........:., I_r;, ~'\ f t ';;iY~1 \::Z,.]~~C~ ,.;".__ ... .Ii Oct 1001 10:24a HELP-U-SELL REAL ESTATE 717-730-6170 STANDARD AGREEMENT FOR TIlE SALE OF REAL ESTATE This rOtn' .ccommcndcd l&IId "i"J'fO~od for, but nllt ,es.rricted I" use by. Ihc fIlCm\>tn ..rthe P.o...yl~.nlaAlOOI;jilllun..f REALTORS_ (PAR) AJS-2K --- I PA LICENSED BROKER SI-.:LLlNG 8ROKER (Company) PA LICENSED BROKER ~::'}~.,:~.~"'~~~- -;.." - ADDRESS ~1'~~~9~~"",( PH ')?>';:, - ~ FAX -'l"'''' - IlESIGNATED AGENT '-OR SEl.LER (if applicable) ADDRESS PH _.~_ __ FAX__.~ DESIGNATED AGENT FOR BUYER {it applicable) J. r~illllgr~C:1d.';"'~"'~ {;>(.j '?r>c> I SJo:LI.ER(S):~ _ K. W Ell. ~~T&~ , is betwe~n BUYER(S), -~ea:r....H""<~...---lii<: 'SledQelle':{Sd 4'.n --r1lJ~.4_1Z. iJ4'KA ft.!. ,clIlled"Buler," ;c 2. PROPERTY (1-98) Seller hereb)' agrees to sdIliud convey to BUYel", who hereb)' IlIrees to purchase: ALq:9it C':,TAIr;,;ot or llit<< of gruund wilb bulldl_Wi lind imprO'l'emcnl$ tbereon erected, if,.,., known lIS: "O~ aI;..__I"Y)El!HA"--)t~~~7~~__~ :n ...___.. __, Inth~ "["""'-"h.""""'~IP of---J..,J:PIJ~./l-JJc:..~, Counlyof~{ A.t~ "_~_ intheCwumo"loI'ellltboCPennsylvania.ZipCude 17"5-:;- ~2 Identification (e.g., Tax ID#; Pan.-el #; Lot, Block; Deed Boo,,". Page, Retordlng Date) 3. TERMS (1-00) ;./;IJ-E.. ~./ (Al Purchase Price ~'5hbV__ ' . _~ ~Dll~AlJD A ~~~I/n Dollan wbkh will be paid to Seller h). BU~'er II.!; rollows: Ca~h or clled, at signing this Agrcllmcm: Cashorched I+ilhin_ days uflhe e"eculion oflhis Agreemcut:__ $ I t:>OO $ : ~~ -~~ Ca~h. cashier's orccnified check altime of settlement: TOTAl. Deposits paid on accouul "f I'lJrCh;l~1l prke to be held by Listing Broker, unless otherwise staled here: Sdkr's ""linen approval to be,,,, 01' hdnre:_ ~J!iPT'"'_L'I-~I._____~__ ScnklHcllt hI be madc on or belnre: --Ot.T.-31,__~_,_., ._____ ._ Con\'eY,1nce twm Sellcr will he by tee simple deed of sJl'Ceial WalTanty unless otherwise staled here: P"ym...nl dlm",t"...r I"",'S .....illl-..: <.livid...d equ;tlly hclwecn BUYlJr and Seller unless olhelwise stalcu here;_ AI lime "r seulcmc01, the followin!! will he adjuSled prn-rala on a daily ba:sis between Bu>'er and Seller, reimbursing wllcre appli;;able: taxI',; relll': inter,"t 'lIIllltlrlgaglJ as,\umptioo,: coodominium fees und hOlnco"..ner as~ociation fees, if an)'; water and/or sewer kes, if any. tOllcth~1 wilhanyothcllienahlenulHicipalsenicc_TIlco;hargcsaretobepro-mled for the period(.<,jcuvercd: Sdler will pay Uplulllldinc!UIJingt n... dahl \,f ~eltknlt:'1l1~ Buyer will pay for all d<lYs /';)l1owing 5elllcmenl, unllJs.~ otberwis<J staled here: 4. ~'IXTtIRI1S & rERSONAL PIUlJ>ElHV (1-60) 11\: INnX'DF\) in tlli' ,,,I,, ;md pUR-h;tsc price an: a!l.'~i"i"f, it"mi pcmllule,llly in,taikd in ,he f'I.op.::ny, flee urlkns. ind,-"hH~ plUlilhillg: b\;Jling: lighting fixtures (inclu<.linll chllndelkrs IInd ceiling fans): water IrCUlmenl S)'slems; ponl and spa equipment; gar..gc dour openers und traU>llIillers: "'Ievi,ion ulllennas;shrubbel1"plml1;tlpand unpolledll'eCS;lIny remaiuingheatingundcoukingfucls slnrcdon lhe Prnpcny ullhe time OfslJlllcm"nl: Willi 10 wall cllrJI'Cling; window covering hardwllfc, shade:" blinds: buill-in aircomJitioncn.; huill-in Ill'p]i- 'IlIe"..: and lhcr;ln~c/o\'cn IInIcSSlllhcrwise..t;dedAI-'l'includcd:__u>t~DOW p.~,-r._______ eEl LEASED ilems (irems nOI owned by Selltlr): (Cl EXCLl'DED fhlUI<:s illld items: ,'; S. SPECIAL CLAUSJo:S (1-00) (AI ~BuYlJr and Seller havlJ received Ihe Consulllf':rNotlcc a.~ ndoptcd by the Slate Rcal E.\Itate Commission u149 Pa. Code !3S.336. (S) JI(I Buyer and Seller have r<;:ceil'cd II SlllllJmcm oflhcir respective eSlimalcd closing costs before sisning thi> Agreemenl. (C) R Buyer hus received lhe Scll~'~ Propel'll" Disclosure Slatcn~m before sisning this Agreemllnl. if required by ]11...... (See NOlicc.lnfnrmaliOfl Rega,dingthe Stlllcr'sPropeny Disc]osureAcl.) (D) J& Buyer has reecil'cd the Depu"il Money NOlice (for cooperative sales when Listing Broker is holding deposit money) before ~igning Ibis Agreement. (E) Th~ following Ute part of this Agreemenl if checked: o Sule & Settlement of Olher Prupel'ly C<.>nlingellC} Addendum (PAR Ponn 130) o Sale & Selllcmelll of Other PropcrJ:)-' CominSc1\C}' Wilh RighI 10 Conlinue Markeling Addendum (PAR "'Qrm ]31) ~2 " ", 5; ,. o Set1lement or Other Property Conlingency Addendum (PAR Forni 13:1) o Tenant-Occupied Property Addendum (PAR I-'orm TOP) 0___ o o :;, " uc \:,1 1]" tl (! IV. &-"P' "' Seller Initials: p.G t...~ f,~ Buyer Inilill15; 4~ ~ AJS-2KPll{:e I 018 m. ~e~t:I~':~aUon of COI'\'IU<JHT PENNSYLVANI" ASSOCIATION 01' REALTIlRS8 t!f9ll ,~, p_2 :.l .'iIl') :j!(1' ~. ..fl\; ',tI' h :'. .," :;~ :J '" 5:; :::t " ,; co f.' ;;? ~;l iit, Oct 10 01 10: 30a HELP-U-S~LL REAL ESTATE 717-730-6170 p.s l8. bROKERS (1-00) nle Busin~ss RdutilNI,Jjip;. ~tween the Broker(~) and Seller und Buyer arc liS fllllow.~, UNLESS II diffcr.:nI rcllltiOflShip is ~hcckedlx:IQw. (,\) The Li~ling Broker is Agenl fur ScHer_ r81 Th~ S~l1ing JJrol~r is Agenl for BUyer. 1(') Wlw.n Il\e L;;<'I;ng Bmker and Selling Broker un: lhc "UI\<:, I~ Bru);.:r 'IS U Du,,1 A~enl. Dtul1 Aseney upplie~ 10 lIJllicen_.I. 'INLESS lhcrc is a lR~illnalcd AgclIl(s) for Seller and il [ksisnuled Agenl(s) for Buyer. If IIlI: same Licensce is dc~ij!:nm.::d foc Seller llnd Buyer, rhe Ucensce is 01 Dual Agcnl. A Ylu~illess Nel,lIIiilnship exisls that is dlfferenl rrUII. above, as I"ollow.\: !)( lh:ScllillgBrokerislh<:Agel1l/SlIh~gen'f(lrSeltcr_ o The- Selling Broke-I' is a 1'ran.~aCli{Jfl Licensee, o Th~ I.i,!i,,!! Bmler is II TransaCtion Li..;enscl' 11)1 Brokl'rls) may p.::rf0I111 s.:rvk'c.' 1(lI1Mi~1 unrcp,,-,scmed pMti.::s in l:omplyiJlJ!, with Ihe ~rm.' 01" Ihi., AJ;ll'emenl. 29. I\.UWI.-\TlON (7-96) 9j NOT AVAILABLE pi- WAIVED_ Buy.:r and &:l1er U1uJer'iand thai IIi.:y nUl}' choose 10 medimt; at a laler dale. should a dtlpule arise. bUllhm ther.: will be no ohli. galion 01\ (he pan ~,f "ny p;o.rl~' 1000 <,\l, o ELECTED (!\) llu}.:f ,mil Seller williI)' I<J rcs\olve allY dispule or claim thatllla)' arise frum thi~ Agreemmllhrough nledi,llion. in accordalJ(:e wilh tl", Rules ;u',,\ I'roceduf\l~ of Ihe Home Sellers/Home Buye" Di.,pute Rc~nllJlion System. Any :lgrecment read1ed through il medialion eOflrcrcnce and ~i!!lI<::d by lhe J)<lnies will Ix: bindinJ,:. Hl) Buyer l10d S.:l~r al'kl\l>"'l~g" Ihll.t they Im\'.:: reC<.':ived, re;uJ, anll ul1defSl~nd the Rules nod Proccdo.-.:.s of rlie Home SellenJHome Buyers Di.~putc Re.,ululion Spl.::m. (SL'C Mediation Nutice) leI Thi, agretlment 10 mediale di,p"tc..' "rising I"rom litis Agreement will survive selllement. .;;~ 8uyer Ilnd Seiler acknowledge th:>1 th..y- have read and undenlaod tbe nolices and explanalf>ry Infonnation set fcwlh 111 this Aitneemenl. ;c" lluyer acll.nowlcdgL"S rect.'h'lllg a Cf>JIy of tlUs Agremlellt al ttw time (if signing. ';:i NOTICE TO I'ARTlES: WflEN SIGNlm. THIS AGItEEME~T IS ,", BINDING CONTRACT. Rcturn by r:u::r;lmlle tralLimissioo (FAX) of this u". A',i,reement,:!o1Hl all *,"I>rn!;l, \)t\\r;nj; the~ignl),1ur6l)f 1111 partics, n>nstltulC.'i Ilccephance 01 th~~ A.grurnent. Parlles 10 lhis trlllDaclioQ lire lld\'~d .'" ~:, '""'""," """""",,,b"M.,ign'"gilthe)' desire legal lldvicc. ~~~ ' lJ'.' "nNF.s..'i . 1I11YI!:R _~~__ _._ DATE~\. ti~;, auycrNllll"'(plIl\l)__~ 1-4.-t'" T"..(: 7.. ~ ss*--1!C~Slt>;r_1,__ -= ,;21 liL:: ~hilinllAddlcs~ ~~_ N_~_~,:),~'\\H"""r..~~to,}f..> ~.'m'!,'n\'j _ _. ~2~ 6~" Ph"ne Its..J30.::_"'1.Y.~l FAX # e-Mail "" CE#- '17'1 - InS" ' .. /,/., . 63' WITNESS.. IJUYERY:, ,~C.:; ~ K W DA.TE~ J#fflt.l! 63Z Bu}"crN"me(Priol.~.\~.'1__\l::-\~.. ___.. - ,'_.--,---ISS#_-----2i;'S:.s~- m_~.~'(------- 6:l~ 633 MallingAddles~ ,_I I \'''-J,t,.~~~~'\\'(t Vt. leI _ &Jl 63~ \'h(llre./fs~__'~__-:1""lD-----__..__I'i\Xn_____.'_ e-Mail___~_______ &34 '" '" '" .~ '" "'" ." ." ." ... ." 'co; "~~ ~:m 5'0', 63, BL:YER DATE 636 WITNI<:SS 6)1 UllyerNilrne(prinl) G3B MailingAddress__ 639 Phone #~ 640 ." ~, 6H sS# f<:AX# EMild SelJerhereby approves th" above eonlr.lClthi~ (dllCe) :SEPt .!lL>. .9C2:)'-_.__ and llleonsider:llion oflheserviee~ remkred in procuring Ihe Buyer. Sellcrngrel<slfJ pay lllcnamed Li~ting BuJlc.ccll-f"""<Jf ~ of/l'romtlrehcreins!",,,:ilicdsalepricc.llIlhcevtllllluyerddallllshercunder. any lIIonies paid on nccounlwill be divided ~H Seller. 0 __ , Lisling Bro cr. but in no CVC:III will Ihe sum paid to lite Listing Brokc:r be in C,l(te~~ of the above sp<:dfied Broker's l"et. fj.15 ~. 6-1ti WIT:"IES:;'-~;;; 6.;1 Sellc:r Nume (pri.lll 6-;6 M>l.ilingA~ss 6~9 PhullC ./fs ~:O ." tiS] 65;) SELLE aJ,ld~.Jdk...- -o.-~ _._._____. __ S5"__ PATE'2..?O"'>/':.._" fi46 5.11 li4~ '" ~5g Q"':1O-o1 651 5~~ wnNF's' SellerNlUIle(prilll) MailingA.tdrc's PhotlClf$~____ FAX II __.. ' SE~ EMnil DATE SS# t~2 t~1 FAXlt E.Mail 6:.; tibii WIT~ESS_ 057 ScllerN,lI\le(plilll)~_ Mailin!!Address I-'llOuc'it,,_ SFJ..LE.1t DAU:___ f,~b 5:'0 65;; SSIt_ 557 oS~ ." .;GO G5~ FAX II E-Mail__ ..______ b.~ [;(;a ".,1 8mkers'/Ucensees' Cerlifieatlons (check all that are IIpplicllble): ,'i' W,> 0 kti,lardlng Lead-Bused Painl Hazarlls Disc:lu~ure: Required il Pntpe.-ty Wil-~ built before 1978: TIle undersign"d Li~"Cnsccs involved in ;:l 6": Ihi.' 1l1lnSaLliu",un [lehalfof themselves and Ihcir brol;.ers, ce<tif ythalllleirslalCrrlCnlSllretruetothebeslofll>cirknowledgeandbelid, ,:,,,:,, ,6.' Ackllo\\'Jed~t'menl: The Liceu>ces involved in this lt1lmmetion have illfollnetl Seller of Selh:r's oblig:uiulIs undc( The Re_identiaJ Lcud (>-.rim ;;j~ ,~, IJill.ard ReJucti,," Al:t, 42 U_S_C 48.52tdl, (uld are aware oflheir respon.~ibilil}" 10 ensure compliance. 0' ,._.1; "" 0 Rl'garding FH_~ Morlgages: The undcrsigned Lil:cnsees involved in IhislrJ.l\sauion. on bcl\a.I.f of 1II':\I,,,,,tve,", "m] tlwir bmll."-Th. <:""1if, 11m! tile lenllS "I' lhj~ <:Ollhal,1 fur pllrdl,1hC ,lie Ill"" 10 Thc best oj their kn",,"",ll:c aud helief, ,1"oJ Ih~t allY tllher I1WCcmClll clllco:d IIllO by "n~ oj ll,~ .,. Iltese panics inCUJ\lleCliOl\Wllhthi~lfansaeliooisaltachcIlIOlhisAgrecmelll. lif,!' e.') ~)~ o Re~al"dinG Mediation: The undersigned 0 Li.lrin,g Broker 0 Scllin~ 8ro);er "gre<: 10 submit 10 medi....ion in ~cconlancc wilh pal"- [,11 bll grJph 29 oflhis Agrccmenl. til2 :;n ~n 675 67.; LISTING BROKER (Cumpany Name) ACCEPTED BY 0;_ DATE :n \:o-~~ C/~ d~ SELLlNG BROKER (Company :-lam:l ACCEPTED BY .___DATE~--. [if,; 6'1& f;;1 r.1~ 6~~ AIS-2KPage8or8 6!C SELLER'S COpy NOV. -01' Ol!THUj 11: 29 M S A / R & A TEL:7!7 763 1907 P 006 Tax Parcel No. 42-25-0032-059 THIS INDENTURE, MADE THE 7/~ C"'-' . ~, day ofJ-k...-~ two thousand one (2001) BETWEEN CARL L. WEBER and PATRICIA ANN GILL, Co- Executors of the Last will and Tast~ent of Helen K. Weber, late of Mechanicsburg, Penn- sylvania, parties of the first part, a.nd ALBERT .1. HYKES, JR. and TRICIA R. In'KES, husband and wife, of Shiremanstown, Pennsylvania, parties of the second part: WKBREAS, the said Helen K. Weber by her Last Will and Testament, duly proved and recorded in the Cumberland County Register of wills Office, Pennsylvania, in Docket Book 21-01-0640, Letters Testamentary being issued on July 6, 2001, provided, in pertinent part, as follows: 2. All the rest, residue and remainder of my Estate, real, personal and ~ixed, whatsoever and wheresoever situate, I give, devise and bequeath to my beloved husband, Kenneth L. Weber, to his own use and benefit absolutely. 3. In the event, however, that my said husband should predecease me, or, as the result of a disaster COmmon to both of us, should die at about the same time as I do, I give, devise and bequeath my Estate to my son, carl L. Weber and my daughter, Patricia Ann Gill, in equal shares. 4. Lastly, I nominate, constitute and appoint my said husband, Xenneth L. Weber, to be the Executor of this, my Last Will and Test~ent_ If he should predecease me or for any other reason fail to qualify as such 5xecu- tor, I appoint my son, Carl L. Weber, and my daughter, Patricia Ann Gill, to be the Executors in his place and stead... . NOV. -01'01 (THU) II: 29 M S A / R & A TEL:717 763 1907 p, 007 NOW THIS IND~ttRE WITNBSSETR, that the said parties of the first part, by virtue of the power and authority aforesaid, in said Will contained, and in consideration of the Slm of Sixty-Nine Thousand Dollars ($69,000.00) to them paid by the said parties of the second part, at and before the ensealing and delivery of these presents, the receipt whereof is hereby acknowledged, have granted, bargained, sold and conveyed, and do hereby grant, bargain, sell and convey to the said parties of the second parties, their heirs and assigns forever: ALL THAT CERTAIN lot of ground situate in Upper Allen Township, Cumberland county, Pennsylvania, bounded and described as follows, to wit: BEGINNING at a point on the Sheperdstown Road, thence South twenty-four and one-half (24 1/2) degrees East forty-eight feet and four inches (48 feet 4 inches) along said Road to a stone; thence South sixty-five (65) degrees West along lot now or formerly of Irvin Alexander tour hundred ninety-five (495) feet to a point; thence North twentY-four and one-half (24 1/2) degrees West along land formerly of John Brandt forty-eight feet and four inches (48 feet 4 inches) to a pin: thence by lands now or formerly of Oscar H. Millar North sixty-five (65) degrees East four hundred and ninety-five (495) feet to the place of BEGINNING. CONTAINING one-half (1/2) acre, more or less, and having erected thereon a two and one-half (2 1/2) story frame dwelling house and other necessary buildings. BEING the same premises which Clarence E. Eppley and Anna M. Eppley, husband and wife by deed dated January 5, 1945 and recorded January 5, 1945 in the cumberland County Recorder of Deeds ottice in Deed Book "w", VolUlne 12, Page 410, granted and conveyed unto Kenneth L. Weber and Helen K. Weber, hUSband and wife. The said Kenneth L. Weber died August 5, 1997 whereupon full and complete title to the within described real estate became vested solely in Helen K. Weber. The said Helen K. weber died June 18, 2001. TOGETHER with all and singular the rights, liberties, privileges, hereditaments and appurtenances whatsoever thereunto belonging or in anywise appertaining, and the reversions and remainder~, rents, issues and profits thereof, and all the estate, right, title, interest, property, claim and demand whatsoever of the said Helen K. Weber at and immediately before tae time of her decease, in law or equity or otherwise howsoever, of, in, to or out of the same: NOV, -01' olITHU) 11:30 M SA / R & A TEL:7li 763 190i p, 008 TO DV!l AND TO HOLD the said granted pl:"emises to the said parties of the second part, their heirs and assi~s forever. AND the said parties of the first part, do covenant, promise, grant and agree, to and with the said parties of the second part, their heirs and assigns, by these presents, that the said parties of the first part, have not done, committed, or knowingly or Willingly suffered to be done, any act, matter or thing what- soever, ..whereby the premises aforesaid, or any part thereof, is, are, shall or may be charged or encumbered, in title, charge or estate, or otherwise howsoever. IN WITNESS WHEREOF, the said parties of the first part have hereunto set their hands and seals the day and year above writ- ten. S1rned. Scaled and Zd in th. P....<Qloe of - u.L-. LL . - (!~ ~ w..d.u-- (SEAL) Carl L. Weber, Co-Executor of the Estate of Helent.F. Weber t4zu..- t2wr,~ (SEAL) Patricia Ann Gill, Co-Executor of the Estate of Helen K. Weber COMMONWEALTH OF PENNSYLVANIA : COUNTY OF Cuf'\b.vICl.J'\J. : 55. On this, the 3 pt day ot OUub~ ,2001, bafora me, the undersigned officer, personally appeared CARL L. WEBER and PATRICIA ANN GILL, Co-Executors of the Estate of Hellin K. Weber, known to me (or satisfactorily proven) to be the persons de- scribed in the foregoing instrument, and acknowledged that they executed the same in the capacity therein stated and tor the purposes therein contained. IN WITNESS WHEREOF, I seal. hereunt~~t MSY han~~offiCia1 ~ CL- (SEAL) ~tcomml~I~~EXPires: NotarIalSiW Jannilor S. Kuhns. NoIaIy Public Camp HII Boro Cu~1b4~and CoWlIV My CommiS$lM 5""'.... Sop!. 11. 20l}4 I r~/8;'~';''";:i''""'':-~:, ", "::T''':~~i\..o:.ri,!-~ t NOV:-OI'01ITHUll1:30 M S A / R & A TEL:i!7 763 1907 P. 009 CERTIPICATE OP RESIDENCB I do hereby certify that the precise residence and complete post office address of the within named graznt.. 's . C/ ;;-'1 5. i,:"'u~ s:e-. , _." . ~.JI /l>1<-";;0{ - t, ,fA {1Qs:s I:J-----. -~ AttorneY/l\.~CJ.l for ~~ COMMoNWEALTH OF P~NNSYLVANIA : SS. COUNTY OF CUMBERLAND RECORDED on this day of , 200 -' in the Recorder's Office of the said County, in Deed Book , Page Given under my hand and the seal of the said office, the date above written. , Recorder. OMB NO 2502 0265 A'o. . ''1' A. U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT '.oFHA 2.DFmHA 3.nCONV. UNINS. 4. OVA 5. DCONV. INS. SETTLEMENT STATEMENT HYKES I" 1581647305 8. MORT~ INS CASE NUMBER: 5'k~ MORTGA.GE INS CASE NUMBER: 6.875%\F\439 C. NOTE: This fo"" is furnished to give you a statamtmt of ac;tual satt/amant costs. Amounts paid to and by the sattlement agent ara shown. Items marked 7POCr ware paid outside the closing; they are shown here for Informational purposes and are not /flc/uded In the iotals. ,.. "" (H\'I<....pld/HYKESl121 u. N}lM~ ANU ADuR~t:>::; UI"" B E. . NAM. AND ~ I..~NDER: ALBERT J, HYKES, JR, "d ESTATE OF HELEN K. WEBER CHASE MANHATTAN MORTGAGE TRICIA R. HYKES 924 S. YORK STREET MECHANICSBURG, PA 17055 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 23-2114426 I. SETTLEMENT DATE: 924 S. YORK STREET Mldstate Abstract CompOlny MECHANICSBURG. PA 17055 Oclober 31, 2001 CUMBERLAND County, Pennsylvania PLACE OF SETTLEMENT 2331 Market Streel Camp HIli, PI. 17011 100. GR N . M ., ~ ER: ontractSa es rice ee' 0<> ersona roperty erson9 roperty ettemen argesla orrower "" 14. ~O5. e , "' 0' em, s s una snce ~usmens 0' sm, s, y ancs ~usmans y ,~ ~, axes 0 , - axes 10 ~ 1 ounty axes 10 " axes 10 00 axes 00 axes ~ we' <0 atloo ~ ~SewefF'rcfRal on 10 120. GROSS AMOUNT DUE FROM BORROWER 73,522.42 420. GROSS AMOUNT DUE TO SELLER 69,518.78 200. AM UN PAID B . , ~REDUlmON~ EL , eposll or earnest money . xcess pas ee ns ru on' ~ nnclpa mount 0 ew oans . , ",go. xlstlng oan s la ensu act to ~llngOans ensu lec . ayo 0 rs Mortgage ., ..000 gage ~ ."'" s .8sprocee s Adjus men s or ems npal y . , us men s .m' ops y . , , - axes ~n axes 0 ouny axes 0 ,,"n~ axes 0 000 axes to 000 axes 0 216. 1 1519. 220. TOTAL PAID BY/FOR BORROWER 67.900.00 520. TOTA/... REDUCTION AMOUNT DUE SELLER 3,654.66 ~ Gross mount us rom orrower ne , mounRfue ~ , """ 0 ... ne . ess mount a y or OTlower (line 220) e" ., 00' "" . ., ,. 303. CASH ( X FROM) ( TO) BORROWER 5,622.42 603. CASH ( X TO)( FROM) SELLER 65,864.12 ceipt of a completed copy of pages 1 &2 of this statement & any allachments referred to herein. The "d"'''9''0 hem" oo"1",,;e Borrower ~ s.".. Q~~~~ ,oa:<<< C' - t:;..~ C-.0 ~e i<._<-ec'.c;<<-.~-..... D.T I ase on co VIsIOn 0 mmlSSlOn me S ws: '"'. , '.000.00 '0 Nt,e- L. SETTLEMENT CHARGES @l % 2,000.00 Onutll$SlOll al a "1". 0.1 A oan nglna on ee 0 oan seaun ppralsall ee ax eae ervlce ee n eMn Ing ee ortgage ro er ae lIU'. lela;,prea remlum- essenge~ etvery ervlce eeMlrIa\Ol"\- I\\\a e ca lon- Ie 1:111. t-'rocessmg ee D.IT RID 901.lntarestFrom 10/31101 10 11101/01 o gage nsurance remlum Of moo 903. Hazard Insu(ance pram urn or years PAlOfJIDM BORROWER'S FUNOSAT SETTLEMENT ID 0 0 0 0 0 0 0 0 0 0 A @ . 12.60OQOO/day ( 1 days %) 12.60 ""0. 1000. RE:;;EKVE:;; ut:P 1 1.Hazardlnsurance ol1gage Insurance ty own axes 1 olmty axes 11UUt). ~CJ1001Iaxas e ITeE "HAg 111)1. SetUement Of Closlng Fee strac or a ear . Title Examination Ite nsurance mer acumen repara on os ng serv ce Let ar Itorneys ees mcu ese v9/emnum ers: e nsurance mcu es a ove Ilem nl1m e an 13 s overage na s ovemga n Dfsamen cary ee " .. ewer I 00 men , ""'" , months moo , ""'" , moo , moo , moo , to 0 0 0 0 0 , , to 0 ~ 0 " . '" ompany , " 0 0 Isae '" pany Ire ae I' "0. UOu. Guvt:.KNMEN I R R I 1201. Recording Faes; Deed $ \y ouny a"JI amps. e late ax mps: avanue D R A 26.50; Mortgage $ 1 9 par ma per man per month pe< moo per mon po' men per mon per man ,m", 51.50; Releases $ Q" ; orlgage 1 OO.AD IT AL L 1301. Survey 135 nspec on r er aIVlca ee 1~U4. lax Kecalpls 1 reament 10.TOA E E E to o o to to nleron ys<gmngpagoloflnisstat"",,,,,t.lhesignalotiesacoowlatlge'OCfl4pt nas 03. act on an 2, Section a cDmpJelodcopyo page2 thslwopagBstatomBflI Certified to be a true copy. Mklstate AOstract L;ompany // Settlement Agent 4,w3.u.q //J- "'"' PAlO FROM SELLER'S FlJNDSAT SEHLEUE.NT 51.2 78.00 '''.00 ~,6tl4.6 (HYKESIHYKESll~ ) REV-1508 EX +(1~97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Helen K. Weber SS# 180-09-6006 06/18/2001 21-01-0640 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 Cash on hand DESCRIPTION VALUE AT DATE OF DEATH 132.84 2 Commonwealth of Pennsylvania - 2000 Property tax rebate 500.00 3 Mellon Bank, N.A. - DD Account No. 142-103-6110 1,721.04 4 Patriot News Co. - Refund 6.55 5 United American Insurance Company - Refund 66.65 6 Contents of home and personal property sold at public sale 8,112.75 TOTAL (Also enter on line 5, Recapitulation) S 10,539.83 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-150a EX (Rev. 1-97) @ P.O. Box 7899 Philadelphia, PA 19101-7899 Mellon Bank August 30,2001 James D Bogar Attorney at Law One West Main Street Shiremanstown, Pennsylvania 17011 Estate Of Helen K Weber Date of Death: 06/18/2001 SSN 180-09-6006 Dear Sir/Madarn: In accordance with your request, the attached infonnation sheet has been provided in the above decedents name as of hislher date of death. For IL or LC accounts, contact our Loan Department at 1-800-537-5591. For all other inquiries, please call (215) 553-1585. sinfCffr.: EmJ;JgU~to Mellon Bank, N.A. Deposit Support Services 199-5355 Page 1 of 2 @ Mellon Bank Thursday, August 30, 2001 Account Number AccountTitie 142-103-6110 Kenneth L Weber Helen K Weber Date Opened: 03/10/1971 Principal Sal Int from Last as of DOD Posting to DOD $1,721.04 $0.00 Account Type: DD Account Sal YTD Int to as of DOD DOD $1,721.04 $0.00 Page 2 of 2 REV-1509 EX + (1 -97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen K. Weber SCHEDULE F JOINTLY-OWNED PROPERTY SSfI 180-09-6006 06/18/2001 FILE NUMBER 21-01-0640 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. A. SURVIVING JOINT TENANT(S) NAME Carl L. Weber ADDRESS RELATIONSHIP TO DECEDENT 25 Walnut Lane Camp Hill, PA 17011 Son B. c. JOINTLY-OWNED PROPERTY, LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial Institution and bank DATE OF DEATH DECO'S VALUE OF account number or similar Identifying number. NUMBER TENANT JOINT Attach deed for jolntly- held real estate. VALUE OF ASSET INTEREST DECEDENT'SINTERES 1 A 09/01/97 First Union National Bank - 2,869.89 50.00% 1,434.95 Savings Account No. 3014187797737, date of death balance $2,868.48, accrued interest $1. 41 TOTAL (Also enter on line 6, Recapitulation) $ 1,434.95 T (If more space is needed insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1509 EX (Aev.1-97) F~N' Reference ID: 196315 First Union National Bank Attn: Account Verifications POBox 40028 Roanoke VA 24022-7313 September 17, 2001 JAMES D. BOGAR ATTORNEY AT LAW ONE WEST MAIN STREET SHlREMANSTOWN, PA 17011 SUBJECT: Verification / Confirmation of Account and Balance Information provided for: HELEN K WEBER (SSN# 180-09-6006) Date of Death: June 18,2001 Deoosit Account loformation Account Type Account Number Date of Death Balance Average Balance'" Date Opened Maturity Interest Accrued YTD Date Date Rate Interest Interest Paid Closed SA VINGS 3014187797737 $2,868.48 91111997 $1.41 $12.80 7/31/2001 LEGAL TITLE: HELEN K WEBER C\RL L WEBER '" Due to system limitations, we can only provide a twelve month average balance on depository accounts. No Safe Deposit Box found for customer. '" Date of death balance does not include accrued interest. >I< If date of death occurrs on a weekend OT a holiday, date of death balance does not include any transactions that were made during that time period. September 17, 2001 Date Drema Rubinoff Depository Representative Servicenter Associate Title (540)563-7323 Phone Number sss;ses 001022 REV-1511 EX + (1 -97) COMMONWEALTH OF PENNSYLVANIA INHERfTANCETAX RETURN RES10ENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Helen K. Weber SSiF 180-09-6006 06/18/2001 FILE NUMBER 21-01-0640 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES, 1 Baughman Memorial Works Inc. - Memorial 1,788.00 2 Cocklin Funeral Home, Inc. - Funeral bill 9,148.38 B. ADMINISTRATIVE COSTS, 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip - Year(s) Commission Paid: 2. Attorney's Fees James D. Bogar Esquire 3,850.00 3. 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. Probate Fees Register of Wills 94.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Al Hykes - Window repair 125.00 2 Boyd E. Diller, Inc. - Refuse disposal 32.50 3 Chuck Bricker, Auctioneer - Corrunission re sale of personal 2,427.75 property 4 Comcast - Final bill 21.67 5 Corrunerce Bank - Check printing charge 23.75 6 Help-U-Sell Real Estate Professionals - Commission re sale of 2,000.00 Total of Continuation Schedule(s) 3,527.97 TOTAL (Also enter on line 9, Recapitulation) $ 23,039.52 (If more space is needed, insert additional sheets of the same size) copyright (c) 1996 form software only CPSystems, Inc, Form REV-1511 EX (Rev. 1-97) Estate of: Helen K. Weber Soc Sec #: 180-09-6006 Date of Death: 06/18/2001 Item # Continuation of Schedule H-B7 (Other Administrative Costs) Description Amount real estate 7 Help-U-Sell Real Estate Professionals - Real estate tax receipts 5.00 8 Home Paramount - Pest treatment to real estate 859.66 9 Marlin Yohn, Sr., Treasurer - School real estate tax bill 644.33 10 Merovich & Sons Construction - Ceiling repair 130.00 11 PPL - Electric bill 72.65 12 Recorder of Deeds - Realty transfer tax 690.00 13 RESERVES: Costs to conclude administration of Estate including filing fee for PA Inheritance Tax Return, Inventory and First & Final Account; preparation of Fiduciary Income Tax Returns 650.00 14 U.S. Postal Service - Certified mail 3.94 15 United Water Co. - Water bill 75.11 16 Upper Allen Township - Sewer bill 305.53 17 Verizon - Telephone bill 61.99 18 Waste Management - Refuse bill 29.76 3,527 .97 REV- 1513 EX t (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Helen K. Weber SS# 180-09-6006 06/18/2001 NUMBER I. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (Include outright spousal distributions, and transfers under Sec. 91 16{a)(1.2)1 Patricia Ann Gill One Hillcrest Drive Mechanicsburg, PA 17050 1 2 Carl L. Weber 25 Walnut Lane Camp Hill, PA 17011 3 Kenneth L. Weber FILE NUMBER 21-01-0640 R.LATIONSH,IP TO DEqDENT AMOUNT OR SHARE Do NotList Trustee(s) OF EST ATE Daughter One-half (1/2) of rest, residue and remainder of Estate Son Husband One-half (1/2) of rest, residue and remainder of Estate Predeceased decedent, having died 08/05/1997 ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE. ON REV 1500 COVER SHEET II. NON- TAXABLE DISTRIBUTIONS, A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 0.00 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00) .. " '::.:. ';i~. _ \ ; , .. '~ .' 1 '\." ~ . - - -- LAS'f WILL AND TESTM1ENT OF HELEN K. WEBER I, HELEN K. WEBER, of the Township of Upper Allen, County of Cumberland and State of Pennsylvania. being of sound and di~posing mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby re- voking and making void all former Wills by me at any time here to fore made. 1- I direct the payment of all my ;ust debts and fune- ral expenses as soon as conveniently may be after my decease. Also, if I have not procured a stone for the lots at the ceme- tery, I direct my Executor hereinafter named. to purchase a suitable stone. 2. All the rest, residue and remainder of my Estate, real, personal and mixe.d, whatsoever and wheresoever situate, I give, devise and beC]ueath to my beloved husband, Kenneth L. to1eber, to his own use and benefi t absolutely. 3. In the event, however, that my said husband should predecease me, or, as the result of a disaster common to both of us, should die at about the !;ame time as I do, I give, de- vise and bequeath my Estate to my son, Carl L. Neber and my daughter, Patricia Ann Gill, in equal shares~ 4. LASTLY, r nominate, constitute and appoint my said husband, Kenneth L. Weber, to be the Executor of this, my - 1 - Last Will and Testament. If he should predecease me or for any other reason fail to qualify as such Executor, I appoint my son, Carl L. Weber, and my daughter, Patricia Ann Gill, to be the Executors in his place and stead. I direct that neither of them shall be required to file bond or other se- curity in the office of the Register of Wills for the pur- pose of administering my Estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 7 It( day of February, A. D. 1972. '11, _-f?/).?/l..k'~_ (SEALI Signed, sealed, published and declared by the above- named HELEN K. WEBER, as and for her Last Will and Testament, in the presence of us, who have hereunto subscribed our names at her request as witnesses thereto, in the presence of the said Testatrix and of each other. -~(5 1M l.lL 47 r ~L.:._..... /z -c;;2"/,9.- ~3 ~, BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRIS8URG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX '02 HaY -3 ...--..i,. fi) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-29-2002 WEBER 06-18-2001 21 01-0640 CUMBERLAND 101 JAMES D BOGAR ESQ ONE WEST MAIN ST SHIREMANSTOWN '* REV-1S47 EX AFP 101-02) HElEN K PA \11011 Cl i Ie Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~ REv=is4j-Ex-AFP--coY=02Y-NoYicE--oF-INHEifiTAirci-Y,i;c-APPR1risEMENT~--AL1-owAirci-oi----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WEBER HElEN K FILE NO. 21 01-0640 ACN 101 DATE 04-29-2002 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 U} (2) (3) (4) (5) (6) (n 69,000.00 .00 .00 .00 10,539.95 1, 434.95 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14" Net Value of Estate Subject to Tax (9) UO} 23,039.52 .00 UlJ (2) (3) Cl4} NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 80,974.78 23.039.52 57,935.26 .00 57,935.26 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 16. Allount of Line 14 taxable at Lineal/Class A rate 17. Allount of Line 14 at Sibling rate 18. Allount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due US) .00 X 00 = .00 U6} 57,935.26 X 045 = 2,607.09 (7) .00 X 12 = .00 U8} .00 X 15 = .00 Cl9}= 2,607.09 TAX CREDITS: ..' ... Kt.I;t..Lr'1 l+J AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 09-14-2001 CDOO0271 130.35 2,565.00 04-22-2002 REFUND .00 88.26- TOTAL TAX CREDIT 2,607.09 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A D~~lwn ~FF REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS.) ~/b -~-1/ ~2- -3 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REY-1607 EX AFP [01-021 JAMES D BOGAR ESQ ONE WEST MAIN ST SHIREMANSTOWN '02 V!J\Y 2~ DATE ESTATE OF DATE OF DEATH FILE NUMBER :c(1OUNTY ACN 05-06-2002 WEBER 06-18-2001 21 01-0640 CUMBERLAND 101 HELEN K Allount Rellitted PA 170U.) ~ Cw r, 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 ~ REV=i6'ifj-ix-AFP-("OY:02Y------...--iNHEiiifA'NcE"-iAX--STAyEHE-tii-oF'-Accoutif--.-..------------------ --- ESTATE OF WEBER HELEN K FILE NO. 21 01-0640 ACN 101 DATE 05-06-2002 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: 04-22-2002 PR I NCI PAL TAX DUE: ........................................................................................................................................................................................................................... 2,607.09 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 09-14-2001 CDOO0271 130.35 2,565.00 04-22-2002 REFUND .00 88.26- TOTAL TAX CREDIT 2,607.09 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 If SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "'CREDIT"' (CRJ, ..-.. 'u" De nile A D....IINO.. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J c" ~ STATUS REPORT UNDER RULE 6.12 Name of Decedent: Helen K. Weber Date of Oeath: June 18, 2001 Will No. 21-01-0640 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes x No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No x b. The separate Orphans' Court No. (if any) for the personal representative's account is: 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 Cerk of the Orphans' Court and may be attached to this report. James D. B , Esquire Name (Please, type or print) One West Maln St. Shiremanstown, PA 17011 Address Date: 07/19/02 (717) 737-8761 Te 1. No, Capacity: Personal Representative x Counsel for personal representative (MAH:rmf/AM3)