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Home My WebLink About01-0705 PETITION FOR PROBATE and GRANT OF LETTERS Social Security No. 171 - 28 - 4539 21-01-705 Register of Wills County of Cumberland in the Commonwealth of Pennsylvania Estate of VERA M. PURNELL No. also known as , Deceased. To: The petition of the undersigned respectfully represents that: Your petitioner, who is 18 years of age or older, is the personal representative named in the last will of the above decedent, dated June 29, 2001. Decedent was domiciled at death in CARLISLE BOROUGH, Cumberland County, Pennsylvania, with his last family or principal residence at 570 West Louther Street, Carlisle, Cumberland County, Pennsylvania 17013. Decedent, then 65 years of age, died July 20, 2001, at Harrisburg Hospital, Harrisburg, Dauphin County, Pennsylvania. Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent. Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: TOTAL $ 60,000.00 $ $ $ 60,000.00 $/,).0 (JC)OJQO / WHEREFORE, petitioner respectfully requests the probate of the last will presented herewith and the grant of letters testamentary thereon. . ~ J; kf m. KY) atLIl- SHIRLEY M. KN RR 412 Limestone Road, Carlisle, PA 17013 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND The petitioner above-named swears that the statements in the foregoing petition are true and correct to the best of the knowledge of petitioner and that as personal representative of the above decedent petitioner will well and truly administer the estate according to law. Sworn 10 and subscribed C) 1 LA' J ~ //). ~ a.!l fL, before me this ~ day of SHIRLEY M. KN RR JULY, 2001. >r~~Y~DJ t.:~~) -d/UL~..tf R glster / b-;2~ ~ -/l:3 Estate of VERA M. PURNELL, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW, JULY 31, 2001 , 2001, in consideration of the petition attached hereto, satisfactory proof having been presented before me, IT IS DECREED that the instrument dated June 29, 2001, described therein, be admitted to probate and filed of record as the last will of VERA M. PURNELL Letters Testamentary are hereby granted to SHIRLEY M. KNARR. ~:~ ~'~-fu,J~$].~'--r Rister fWI s FEES Probate, Letters, Etc. Short Certificates ReF.tM~iation JCP TOTAL Filed: $ 235.00 $ 24.00 $ b . uu $ 5.00 $ 270.00 JULY 30. 20001 HAROLD S. IRWIN III (ID NO 29920) 35 East High Street Carlisle, PA 17013 717-243-6090 r2~~ ~ , I ~:: ~".; '::'''":'.'' 'This is to certify that the information here given is correctly copied fro~ an original certificate of death dlll~ filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filmg. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. &:- ~~c~;:;,:~~ Fee for this certificate, $2.00 p 7578075 JUl 2 0 2001 Date 21-01-705 ?- '''05.'4.3 Rev 2/87 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH .T ~~ I. AGE (La.. Bot1rIcIaYl Vera M. Purnell UNDER' YEAR __ 0.,. SEX 2. Female STATE "LE "UMBER SOCIAl SECURITY HUMBER ). 171 - 28 DATE OF DEATH 1M""",, 0.,. '_, 2001 IT < NAME Of DECEDENT l~~" Mo<l<Ie. L"I IIlRTl-tPLAce (Coly aneJ SUI'. Of FC,el(jl1 COUMYJ s. 65 "'rs. COUNTY OF DEATH Carlisle, PA :="YIO RACE .A__"._. _.. etC. (SpeeIr) '" FRHVl'S NAME (F.... hlo<l<le. LaSl) lB. Mullen Kuhn INFORMANT'S NAME (T Yl*f'rinll 2Oa. Deborah J. Irwin lo1ETHOO OF DISPOSITION O _, ~ 0.",...".0 00Ntian 0IIlef . ".. ''''. Cou Old - ... in I CUmberland lDwnIIlip? 17d.(8 :n.. -=-'::01 IolOTHER'S NAME ,F.... hl.-. M_Suo_) !t. Edna Neidi h INFORMAHrS MAIUHG AOOflESS (SIr.... Clly~. S\aI.. LOP Code) 73 West Main Street, Plainfield, Pa. 17081 PU\CE OF DISPOSITION. _ aI c-te<y. 0..n.1Ory LOCATION. Cily/Towrl. StaI.. r'l' Coo. or 01,,", "'- Westminster Memorial Gdns ,'e. MAAfTAl STATUS.__ N_M_...._. 0N0n:ecl ~ I.. Divorced He.D _.__11> White SURVIVIHO SPOUSE In_.~"-''''''''' ...... 570 West Louther Street Carlisle, Pa. 17013 Carlisle cityI'bon>. DATE Of DISPOSITION (Month. o.y. -I o July 25, 2001 lICENSE NUMBER 010343L NAMe AllOAESS OF FM:Illl'l' 0 ~.2l9 North Hanover LICENSE NUMBER OATE PROtlOUNCEDOE~IM"""'. Day. ......r) ,.. M. H. Jul Y 20, 2001 21. HJfT I: EnUH'the disea.... tniurieS Of c;ompIiClliOn1 wf'Mctl caused 1he death. 00 not enter ,he mode of dYing. such IS cardiac or ,e5C)iratDtY arrest, Jhoctr; Of Mitt failu,. LiIC onfy one ca... on ..en tine. 23b. 23c. WIIS CASE REFERRED TO MEDICAL ElCAMINERlCOROHER? ......0 ~ I :. L. WERE AU10PSY FINOINGS ~lAlllE PRIOA TO COMPlETION OF CAUSE OF DEATH? H. I Approximat. ;inCfttVIIf~n ,--- , : PART ", Ol'* .iQtlillcanc ....-.~lOdllttI.lluI .... ,.....'10\9 III 'Ile undI<lyWlg CI<* 9'"" in """" I. DUE 10 (OR AS A CONSEOlJEHCE OF): MAHHEflI OF DEATH DATE OF INJURY {Monlll. Day. _, TIME OF INJURY INJUflIY AT WORK7 DESCRIBE HOW INJlJRY OCCURRED. - ~ o Hom;c;ae o o o PlACE OF INJURy. .... home. '.rm. SIr.... tactO<y. orne. ...-.g. etc. rSpecoIvl :lee. _ 0 NoD -..... P.1\ding 1IWIsItga11O" ~.~~~~ l("~\ Id\.\ ,01 SIGN _ O...p! _ 0 __ 2eII. ","IFIEflICl>ct< only onel '","N'YING PHVSlCIAH (Physoo.... c...~ cause of _ _ at'<lI~.. ""......... ~.. IlOonounce<IdI.'" anocOlT1lllelI<l n.... 23) T...._ol...,.~..__....._......c....oe(.'.l\dm..........t.,ed.................................................... . NoD Su;ciOe CoulcI "'" be del.""1MCI 29. o '1'fIONOUNCIHG AHO CERTIfYING PHYSICIAN IPhysoo_ boIh ;>rOf"OU(lCong death _ ce<1I'Y"'9 10 cau.. 0/ dee'''' To the beet of my kno~.. dea'" occurred at .. dine. dete, and p'ace. and d\M: to the C.""(I) and manner'l ".leeI.. 'MEDlCAl EXAMINER/CORONER on _ baail 01 ..aminatlon and/or '"vulillatiot>. i" my opi"io", de.th cx:eurr.d at the 11m., d.,., and pIle., IncI dUlto tll8 CaUse(I\lncI 3t.~aftnlf U .tatM.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " . . . . . . . . . . . . . . . REGISTRAR'S SIGNATURE ANO NU E o 21-01-705 LAST WILL AND TESTAMENT I, VERA M. PURNELL, of Carlisle, Cumberland County, Pennsylvania, do hereby make, publish and declare this to be my last will and testament, hereby revoking all wills heretofore made by me. 1 . I direct my personal representative to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. I direct that all inheritance taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property, whether or not such property passes under this Will, shall be paid by my personal representative out of my estate. 2 I authorize and empower my personal representative to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or biiis or sale therefore, in fee simple, as I cOliiJ c'v ;~ :i'ving. My iepresentative is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said representative. 3. I give, devise and bequeatn all OT my estate of whatever nature and wherever situate to my three children, share and share alike, the child or children of any deceased child taking the share their parent would have taken if living. 4. I nominate and appoint S to be the personal representative of my estate, to serve without bond. If he or she cannot or does not serve, then I appoint NO CJ1}I sf( personal representative, also without bond. to be the substitute 5. I suggest that my personal representative retain the services of Harold S. Irwin, III, Carlisle, Pennsylvania in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 29th day of June, 2001. 7Jp,/1AU Jr1, fu N}f #/ ~ VERA M. PURNELL (SEAL) Signed, sealed, published and declared by the above-named person as and for a last will and testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as subscribing witnesses. ~d~) tf~ & 11h- c4- &-..~ ACKNOWLEDGMENT AND AFFIDA VIT WE, VERA M. PURNELL, RHONDA S. IRWIN and HEATHER A. BARBOUR, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her last will and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. V~'/'Y1 ( f~ VE~. PURNELLO ""G) ~ ~gLJ-')j~ RHONDA S. IRWIN . Cf"ltfb/ b 4~ A,. 10. HEATHER A. BARBOUR COMMONWEALTH OF PENNSYLVANIA :55: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by VERA M. PURNELL the testatrix herein, and subscribed and sworn to before me by RHONDA S. IRWIN and HEATHER A. BARBOUR, witnesses, this 29th d of June, 2001. I Notarial Seal Harold S. Irwin !II, Notary Public Carlisle Bora, Cumberland County My Commission Expires Sept. 23, 2002 M~lmber, Pe:lnsylvanla i\ssociation at Notaries ~ ---- CERTIFICATE OF NOTICE UNDER RULE 5.6(!!} Name of Decedent: VERA M. PURNELL. Date of Death: JULY 20, 2001 Will No. 2001-00705 Admin. No. 21-01-0705 To the Register: I certify that notice of beneficial interest or estate administration required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on July 16, 2001. Name DEBORAH J. IRWIN Address P. O. BOX 163 PLAINFIELD PA 17081 DENNIS L. PURNELL 570 WEST LOUTHER STREET ARLlSLE PA 17013 DUANE C. PURNELL 570 WEST LOUTHER STREET CARLISLE PA 17013 Notice has now been given to all persons entitl d thereto under Rule 5.6(a) except: None HAROLD S. IRWIN, I, ES UIRE 35 East High Street, uit 201 Carlisle, PA 17013 717-243-6090 Attorney for Estate of Vera NJ. Purnell August 3, 2001 I' Supplemental Inventory of the Real and Personal Estate of VERA M. PURNELL, deceased 1. HOUSE AND LOT AT 570 WEST LOUTHER STREET, CARLISLE, PA 17013 58,000. 00 2. MEMBERS FIRST FEDERAL CREDIT UNION - Account No. 57795 (Value based on bank statement attached at Exhibit "C") Suffix:OO - Savings $ 105.56 Suffix:02 - Holiday Club 793.74 Suffix:15 -IRA 30 Mo. Cert. 20,498.06 Suffix:17 -IRA 18 Mo. Cert. 2,185.00 Suffix: 18 -IRA 30 Mo. Cert. 528.93 TOTAL Members 1 st $24,111.29 24,111 29 3. M & T BANK (Value based on bank statement attached at Exhibit "D") Account No. 15004201140388 $ 656.80 Account No. 1307924 2,016.95 TOTALM&T $2,673.75 2,673. 75 4. COMCAST - Cable Refund 5. 91 5. I.R.S. - Income Tax refund 300. 00 6. AMERICAN CENTURY - Retirement Account (Value based on statement attached at Exhibit "E") 1 ,389. 59 7. GROSS PROCEEDS OF PUBLIC SALE OF PERSONAL PROPERTY 12,410. 25 8. MEMBERS FIRST FEDERAL CREDIT UNION - Insurance Refund 25. 00 9. TAX PRO-RATION ON SALE OF REAL ESTATE 365. 87 10. DONEGAL MUTUAl- Car Insurance RefJ,lnd 50. 50 11. M & T BANK - Safety Deposit Box Refund 7. 50 ........ ,... :.l ~ ~ ~ =: (: -< r;" \ ~ ::0 X; ::.~ ) :1 ..v TOTAL $99,339 66 COMMONWEALTH OF PENNSYLVANIA: :SS: COUNTY OF CUMBERLAND SHIRLEY M. KNARR, being duly sworn according to law, deposes and says that she is the executrix of the estate of VERA M. PURNELL, late of Carlisle, Cumberland County, Pennsylvania, deceased, and that the within supplemental inventory made by her, the said executrix of the entire estate of said decedent, consisting of all of the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the inventory represent its fair value as of the date of decedent's death. Sworn to and subscribed before me r-~A ^ \ , A" ~ \~~a ^-^- e"1'1 day of April, 2002. SHIRLEY M. KNARR Executrix Notarial Seal Harald S. Irwin III, Notary Public Carlsfe Boro. Cumberland County My CommIssipn Expl . 23. 2002 Date M'rma~ania Association of Notaries Day -JULY 2001 Month Year INSTRUCTIONS 1. An inventory must be filed within three months after appointment of personal representative. 2. A supplemental inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty. 4. See Article IV, Fiduciaries Act of 1949. I nventory of the real and personal estate of VERA M. PURNELL, deceased 1. HOUSE AND LOT AT 570 WEST LOUTHER STREET, CARLISLE, PA 17013 2. MEMBERS FIRST FEDERAL CREDIT UNION - Account No. 57795 Suffix:OO - Savings $ 105.56 Suffix:02 - Holiday Club 793.74 Suffix: 1 0 -IRA Savings 23,585.22 Suffix:15 - IRA 30 Mo. Cert. 20,498.06 Suffix:17 -IRA 18 Mo. Cert. 2,185.00 Suffix:18 -IRA 30 Mo. Cert. 528.93 TOTAL Members 1st $47,696.51 3. M&TBANK' Account No. 15004201140388 $ 656.80 Account No. 1307924 2,016.95 TOTAL M & T $2,673.75 4. COMCAST - Cable Refund 5. I.R.S. - Income Tax refund 6. AMERICAN CENTURY - Retirement Account 7. GROSS PROCEEDS OF PUBLIC SALE OF PERSONAL PROPERTY 8. MEMBERS FIRST FEDERAL CREDIT UNION - Insurance Refund 9. TAX PRO-RATION ON SALE OF REAL ESTATE 10. DONEGAL MUTUAL - Car Insurance Refund 11. M & T BANK - Safety Deposit Box Refund 58,000. 00 47,696 51 2,673. 75 5. 91 300. 00 1,389. 59 12,410. 25 25. 00 365. 87 50. 50 ......,.... 7. 50 ...J\."; - "'. :;;,; (I) ~ ~ ~- ;; ;::;::> VJ .Fe;. ()>, TOTAL $122,924. 88 v COMMONWEALTH OF PENNSYLVANIA: :55: COUNTY OF CUMBERLAND SHIRLEY M. KNARR, being duly sworn according to law, deposes and says that she is the executrix of the estate of VERA M. PURNELL, late of Carlisle, Cumberland County, Pennsylvania, deceased, and that the within inventory made by her, the said executrix of the entire estate of said decedent, consisting of all of the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the inventory represent its fair value as of the date of decedent's death. Sworn to and subscribed before me PI day of March, 2002. c' 1'. . \ J Q~^A{ ~ m. l'"W1aA 1\ SHIRLEY M. KNARR Executrix Notartal Seal Ha~d S. Irwin III, Notary P Ie Cartlsle Bol"O, Cumber1and CoU My COmmIssion Expires sept. 23, 2002 Member, Pennsylvarlli1 ASSOCi~ of Notaries Date of Death: JULY 2001 Day Month Year INSTRUCTIONS 1. An inventory must be filed within three months after appointment of personal representative. 2. A supplemental inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty. 4. See Article IV, Fiduciaries Act of 1949. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT IRWIN HAROLD S III 35 EAST HIGH STREET SUITE 201 CARLISLE, PA 17013 ____un fold ESTATE INFORMATION: SSN: 171-28-4539 FILE NUMBER: 2101-0705 DECEDENT NAME: PURNELL VERA M DATE OF PAYMENT: 03/15/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 07/20/2001 NO. CD 000958 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $3,936.44 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: HAROLD IRWIN III CHECK# 5327 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS $3,936.44 MARY C. LEWIS REGISTER OF WILLS 'v /6' -c2~6 ,- ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG1 PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE HAROLD S IRWIN III STE 201 202 35 E HIGH ST CARLISLE '02 IljiW -3 DATE ESTATE OF DATE OF DEATH FILE NUMBER :,,:; (J:OUNTY ACN 04-29-2002 PURNELL 07-20-2001 21 01-0705 CUMBERLAND 101 *' REY-1547 EX iFP (01-02) VERA M Allount Relli tted t~,:: PA 170:(31,mc~ MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=is4j-Ex--AFP--rol-':ozT-NoY-iCEoF-'rNHERiTANci-,.-"x-APPRA-isiifENy-,--Aii-owiNCi-oi----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF PURNELL VERA M FILE NO. 21 01-0705 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. ~ointly Owned PrOPerty (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) 58,000.00 .00 .00 .00 64,924.88 .00 .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 Bequestsj Non-elected 9113 Trusts (Schedule ~) 14. Net Value of Estate Subject to Tax (9) (10) 25,095.03 10.353.34 (11) (12) (13) (14) NOTE: To insure proper credit to your account, subllit the upper portion of this fOnD with your tax paYllent. 122,924.88 35.448 37 87,476.51 .00 87,476.51 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate 16. Allount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Allount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due (15) .00 X 00 = .00 (16) 87,476.51 X 045 = 3,936.44 (17) .00 X 12 = .00 (18) .00 X 15 = .00 (19)= 3,936.44 TAX CREDITS: ........n. IU:\;I:~r" I (+) AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 03-15-2002 CDOO0958 .00 3,936.44 TOTAL TAX CREDIT 3,936.44 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT.. (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) /b'-c:2Y6- /-3 " BUREAU OF INDIVIDUAL TAXES '" INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 11128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-ln7 EX AFP CUl-02l '02 16 DATE ESTATE OF DATE OF DEATH . -FILE NUMBER :\ (COUNTY ACN 08-19-2002 PURNELL 07-20-2001 21 01-0705 CUMBERLAND 101 VERA M HAROLD S IRWIN III STES 201 & 202 35 E HIGH ST CARLISLE PA 170 ~ Allount R_itted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE~ PA 17013 NOTE: To insure proper credit to your account~ submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=i6o7-ix-AFP--coi-:ozi------...--XNHERITANCi--YAX-STA-fEMfriY-O"F-Accouiif--...--------------------- ESTATE OF PURNELL VERA M FILE NO. 21 01-0705 ACN 101 DATE 08-19-2002 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: 07-19-2002 PR I NCI PAL TAX DUE: ........................................................................................................................................................................................................................... 2~875.10 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-15-2002 CDOO0958 .00 3~936.44 07-29-2002 REFUND .00 1~061.34- TOTAL TAX CREDIT 2~875.10 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE~ SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1~ NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) /6 -c:2~6- tZ:3 \. BUREAU Of INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 t ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT 'll~ --2 I -~ ", U DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-22-2002 PURNELL 07-20-2001 21 01-0705 CUMBERLAND 101 HAROLD 5 IRWIN III STE5 201 & 202 35 E HIGH 5T ~. CARLISLE PA 1~013 Allount Rellltted * REV-1593 EX AFP U2-00> VERA M 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 ~ RE-y:is9-i-i3fiifrp--fiz-:ooi------il.-iN-HERI-fANC-i-yiri-RE-CORD--ADJ1iSTiiENT-ii.----------------------------- ESTATE OF PURNELL VERA M FILE NO. 21 01-0705 ACN 101 AD~USTMENT BASED ON: VALUE OF ESTATE: PROTEST BOARD DECISION 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule CJ 4. Mortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. ~ointly Owned Property (Schedule f) 7. Transfers (Schedule GJ 8. Total Assets DEDUCTIONS AND EXEMPTIONS: (1J (2) (3) (4) (5) (6) (7) 58,000.00 .00 .00 .00 41,339.66 .00 .00 (8) 9. Funeral Expenses/Adllinistrative Costs/ Miscellaneous Expenses (Schedule HJ Debts/Mortgage Liabilities/Liens (Schedule IJ Total Deductions Net Value of Tax Return Charitable/Govern.ental Bequests; Non-elected 9113 Trusts Net Value of Estate Subject to Tax 10. 11. 12. 13. 14. TAX: 15. Allount of Line 14 at Spousal rate 16. AIIount of Line 14 taxable at Lineal/Class A rate 17. AMOunt of Line 14 at Sibling rate 18. Allount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: (9) (10) 25,095.03 10}353.34 (11) (2) U3J (14J (Schedule ~) .OOX 00 63,891.29X 045= .OOX 12 = .OOX 15 = (9) US) (16) (17) U8J DATE 07-22-2002 99}339.66 35,448.37 63,891.29 .00 63,891.29 .00 2,875.11 .00 .00 2,875.10 t"AT"I:NT K~l;~~"1 l+ J AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 03-15-2002 CDOO0958 .00 3,936.44 TOTAL TAX CREDIT 3,936.44 BALANCE OF TAX DUE 1}061.34CR INTEREST AND PEN. .00 TOTAL DUE 1,061.34CR · IF PAID AFTER DATE INDICATED} SEE REVERSE (IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE Of THIS FORM FOR INSTRUCTIONS.) BOARD OF APPEALS DEPT. 281021 HARRISBURG, PA 17128-1021 ~ .r. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE HAROLD S IRWIN III ESO 35 E HIGH ST STES 201 202 CARLISLE PA 17013 IN RE ESTATE OF: VERA M PURNELL DOCKET NO. : 0213003 TAX TYPE: INHERITANCE APPEAL TYPE PROTEST FILE NUMBER: 21 01-0705 ACN: 101 APPRAISEMENT: APRIL 29, 2002 PETITION FILED: JUNE 7,2002 EXAMINER: WILLIAM J. ZDRADZINSKI Direct Dial: (717) 787-5761 Fax: (717 787-7270 Email: wzdradzins@state.pa.us MAILING DATE: DECISION AND ORDER JUL 1 1 2002 On April 29, 2002, the Department issued an appraisement and assessment that accepted the original inheritance tax return as filed. Petitioner has now established that Members First Federal Credit Union Account #57795-10, reported as item 1-c on Schedule E at $23,585.22, was actually created after decedent's death from Members First Federal Credit Union Accounts #57795-15, #57795-17 and #57795-18 which were reported as items 1-d, 1-e and 1-f respectively. Accordingly, it is hereby, Ordered that the protest is sustained. The Department is directed to issue an amended appraisement and assessment deleting item 1-c on Schedule E. It is further Ordered that a refund be issued for any resulting overpayment, plus appropriate interest. FOR THE BOARD OF APPEALS ~e~ Jo ph R. leek, Member Page 1 of 2 \..- I {., - ~~ 6 -;<:3 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT ....#, . ~ .. DATE ESTATE OF DATE OF DEATH FILE NUMBER .cOUNTY u ACN HAROLD S IRWIN III STES 201 & 202 35 E HIGH ST CARLISLE 'UZ JUL -CI L PA 1701(3t 06-19-2002 PURNELL 07-20-2001 21 01-0705 CUMBERLAND 101 Allount Rellitted *' REV-1595 EX AFP U2-00) VERA M 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 ~ RE-"=is93"-i3f-AFP--fi'2-:oo.r-----..-iiftiER.rfANC-i-YAX-RE-CORD-AD-:.iusi'HiNY--..----------------------------- ESTATE OF PURNELL VERA M FILE NO. 21 01-0705 ACN 101 DATE 06-19-2002 ADJUSTMENT BASED ON: VALUE OF ESTATE: ADMINISTRATIVE CORRECTION 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule f) 7. Transfers (Schedule G) 8. Total Assets DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adllinistrative Costs/ Miscellaneous Expenses (Schedule H) Debts/Mortgage Liabilities/Liens (Schedule I) Total Deductions Net Value of Tax Return Charitable/Governllental Bequests; Non-elected 9113 Trusts Net Value of Estate Subject to Tax 10. 11. 12. 13. 14. TAX: IS. Allount of Line 14 at Spousal rate 16. Allount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. AlIOunt of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: U) (2) (3) (4) (S) (6) (7) 58,000.00 .00 .00 .00 41,339.66 .00 .00 (8) 99,339.66 35,448.37 63,891.29 .00 63,891.29 .00 2J875.11 .00 .00 2J875.10 rAY"~NT K~l,;~.1f'r l+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-15-2002 CDOO0958 .00 3,936.44 TOTAL TAX CREDIT 3,936.44 BALANCE OF TAX DUE 1.061.34CR INTEREST AND PEN. .00 TOTAL DUE 1,061.34CR (9) UO) 25,095.03 10,353.34 Ul) (2) (13) (4) · If PAID AFTER DATE INDICATED, SEE REVERSE (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. fOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) (Schedule J) US) (16) (7) (8) .00 X 00 63.891.29X 045= .OOX 12 = .OOX 15 = (19) REV.1470 EX (6-88) '* INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEALTH OI=..P.Ef'Jb!f,YLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME FILE NUMBER REVIEWED BY ACN 2101-0705 101 VERA PURNELL SCOTT ELLISON ITEM SCHEDULE NO. EXPLANATION OF CHANGES THE DUPLICATED ASSETS HAVE BEEN REMOVED FROM THE ABOVE ESTATE. ROW PaQe 1 /6.,.e21/6-~ ~BUREAU OF INDIVIDUAL TAXES INHERIT/NeE TAX DIVISION DEPT. 2.01 ~~R1S8URGI PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE * NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX REY-1547 EX AFP (01-021 HAROLD S IRWIN III STES 201 S 202 35 E HIGH ST CARLISLE ~02 JU!J 1 [} DATE ESTATE OF DATE OF DEATH FILE NUMBER ;~ 'r' 7COUNTY I L) . ) , ACN 06-04-2002 PURNELL 07-20-2001 21 01-0705 CUMBERLAND 101 AlIOunt Rellitted VERA M L PA 170OC:$~'~';' MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~ R'E-y=is4,-ix--AFP--loi-:02i--NoTIci--oF-'rtiHiiiifAifci-TAi-A-PPRAisiifENT~--Ai.i-owAifcE-oR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF PURNELL VERA M FILE NO. 21 01-0705 ACN 101 DATE 06-04-2002 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN NO. 01 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Hortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) (S) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets . 00 NOTE: To insure proper . 00 credi t to your account, . 00 sublli t the upper portion .00 of this forll with your . 00 tax paYllent. .00 .00 (8) . 00 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) (9) 10. Debts/Hortgage Liabilities/Liens (Schedule I) (10) 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 .00 .00 Ull (2) (3) (4) 00 .00 .00 87,476.51 I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect ~igures that include the total of abb returns assessed to date. ASSESSMENT OF TAX: 15. A_ount of Line 14 at Spousal rate (IS) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. AIIount of Line 14 at Sibling rate (17) 18. A_ount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due NOTE: .00 X 00 = 87,476.51 X 045= .00 X 12 = .00 X 15 = (9)= .00 3,936.44 .00 .00 3,936.44 TAX CREDITS: I n I 'Ion I n__.._. . II l+ J AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 03-15-2002 CDOO0958 .00 3,936.44 TOTAL TAX CREDIT 3,936.44 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT-- (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) REV-1470 EX (6-88) ... . INHERITANCE TAX N- EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 DECEDENrS NAME FILE NUMBER Vera M. Purnell 2101-0705 REVIEWED BY ACN Sheila Megonnell 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES E Forwarded to Post Assessment Review Unit in reference to the reduction to Schedule "Ell. ROW Page 1 REV-1500 EX '(6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT, 280601 HARRISBURG, PA 17128-0601 .I REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY /6 - ,{2~b ~ /3 FILE NUMBER 21 COUNTY CODE 01 YEAR 0705 NUMBER DECEDENT'S NAME (LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER PURNELL, VERA M. 171 - 28 - 4539 DATE OF DEATH DATE OF BIRTH JULY 20, 2001 SEPTEMBER 5, 1935 (IF APPUCABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER l 1. Original Return 4. Limited Estate _ 2. Supplemental Return 3. Remainder Return (dates of death poorto 12-13-82) 5. Federal Estate Tax Return Req 8. Total No. of Safe Deposit Boxes ..lL 6. Decedent Died Testate (Attach copy of Will) EX. A _ 9. Litigation Proceeds Received _ 4a. Future Interest Compromise (for dates of death after 12-12-82) _ 7. Oecedent Maintained a Living Trust (Attach copy of Trust) _ 10. Spousal Poverty Credit (date of death between 12-31-91 and H-95) 11, Election to tax (See, 9113(A)) (Attach Sch 0) . ,~;!~,It!I.crtONkM jlM. . NAME HAROLD S. IRWIN, III TELEPHONE NUMBER 717-243-6090 1. Real Estate (Schedule A) 2, Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages and Notes Receivable (Schedule 0) 5. Cash, Bank Oep & Mise Personal Property (Schad E) 6, Jointly Owned Property (Schedule F) 7. Transfers I Misc. Property(Schedule G) (Schedule L) 8. Total Gross Assets (total Lines 1.7) 9. Funeral Expenses & Administrative Costs (Sched H) 10. Debts, Mortgage liabilities & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests (schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 15. Amount of Line 14 taxable at the spousal rate 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax due COMPLETE MAILING ADDRESS 35 EAST HIGH STREET, SUITES 201/202 CARLISLE, PA 17013 (1) , , OFFICIAL US..pNL Y 58,000.00 8 -".,~~. (2) C 0.00 3: (3) = ;0:, 0.00 -~ (4) en 0,00 (5) 64,924.88 (6) ~,~, 0.00 --J (7) 0.00 (8) 122,924,88 (9) 25,095.03 (10) 10,353.34 (11) 35,448.37 (12) 87,476.51 (13) 0,00 (14) 87,476.51 x, - (15) 0,00 $87,476,51 x .045 ~ (16) 3,936.44 x .12 (17) 0.00 x .15 = (18) 0.00 (19) 3,936.44 Decedent's Complete Address: STREET ADDRESS 570 WEST lOUTHER STREET CITY I STATE I ZIP CARLISLE PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 18) 2. Credits I payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) $ 3.936.33 Total Credits (A+B+C) (2) 3. Interest I Penalty if applicable O. Interest E. Penalty TotallnteresUPenalty (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. A. Enter the interest on the tax due. (5A) (5) B. Enter the total of Line 5+5A. This is the BALANCE DUE. (5B)$ 3,936.44 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use of income of the property transferred; ................................... b. retain the right to designate who shall use the property transferred or its income; ........ C. retain a reversionary interest; or ........................................................................... d. receive the promise for life of either payments, benefits or care? ............................... 2. If death occurred on or before December 123. 1982, did decedent within two years preceding death transfer property without receiving adequate consideration? If death occurred after December 12.1982, did decedent transfer property within one year of death without receiving adequate consideration? ...... ...... ...... ......... ......... ...... ...... ......... ........... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ...... ...... ............ ..... .... ....... .............. ........................ ......... ...... ...... ... 4. Did decedent own an individual retirement account, annuity, or other non-probate property? ...... No -1L -1L -1L -1L N/A -1L -L IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than personal representative is based on all information of which preparer has any knowledge. SIGNATUI1E OF PERSON RESPONSIBLE FOR FILING RETURN .' \, ,L:..-y rn. .J.. {)n.) /1 ADDRESS 412 LIMESTONE ROAD, CARLISLE, PA 17013 SIGNATURE OF PRE PARER OTHER THAN PERSONAL REPRESENTATIVE DATE March , 2002 ADDRESS DATE 35 EAST HIGH STREET, CARLISLE, PA 17013 March ,2002 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. Section 9116 (a)(1.1)(i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. Section 9116 (a)(1.1 )(ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. Section 9116 (a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%. except as noted in 72 P .5. Section 9116 (1.2)[72 P.S. Section 9116 (a)[1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. Section 9116 (a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX + (12-85) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER VERA M. PURNELL 2101 - 0705 (Property jointly-owned with Right of Survivorship must be disclosed on Schedule F) All real estate should be reported at fair market value which is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. ITEM DESCRIPTION NUMBER 1. VALUE AT DATE OF DEATH HOUSE AND LOT AT 570 WEST LOUTHER STREET, CARLISLE, PA 17013 (Value based on sale price. See HUD-1 settlement statement attached as Exhibit "B") . $ 58,000.00 TOTAL (Also enler on Line 1. Recapitulation) $ 58,000.00 (If more space is needed, insert additional sheets of same size.) REV-1503 EX + (4-86) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF VERA M. PURNELL (All property jolntly-owned with Right of Survivorship must be disclosed on Schedule F.) ITEM DESCRIPTION NUMBER SCHEDULE B STOCKS AND BONDS FILE NUMBER 2101 - 0705 VALUE AT DATE OF DEATH NONE TOTAL (Also enter on Line 2, Recapitulation) NONE (If more space is needed, insert additional sheets of same size.) REV-1504 EX + (3-92j COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY HELD STOCK PARTNERSHIP AND PROPRIETORSHIP ESTATE OF VERA M. PURNELL FILE NUMBER 2101 - 0705 ITEM NUMBER NONE TOTAL (Also enter on Line 3. Recapitulation) (If more space is needed, insert additional sheets of same size.) VALUE AT DATE OF DEATH NONE REV-1507 EX + (6-86) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES AND NOTES RECEIVABLE ESTATE OF VERA M. PURNELL (All property jointly-owned with Right of Survivorship must be disclosed on Schedule F.) ITEM DESCRIPTION NUMBER FILE NUMBER 2101 - 0705 VALUE AT DATE OF DEATH NONE TOTAL (Also enter on Line 4, Recapitulation) NONE (If more space is needed, insert additional sheets of same size.) REV-1508 EX + (2-87) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY ESTATE OF VERA M. PURNELL (All property jointly..owned with Right of Survivorship must be disclosed on Schedule F.) ITEM DESCRIPTION NUMBER FILE NUMBER 2101 - 0705 VALUE AT DATE OF DEATH 1. MEMBERS FIRST FEDERAL CREDIT UNION - Account No. 57795 (Value based on bank statement attached at Exhibit "C") Sufflx:OO - Savings $ 105.56 Sufflx:02 - Holiday Club 793.74 Suffix:l0 -IRA Savings 23,585.22 Suffix:15 -IRA 30 Mo. Cert. 20,498.06 Suffix:17 -IRA 18 Mo. Cert. 2,185.00 Suffix:18 -IRA 30 Mo. Cert. 528.93 TOTAL Members 1st $47,696.51 $ 47,696.51 2. M & T BANK (Value based on bank statement attached at Exhibit "0") Account No. 15004201140388 $ 656.80 Account No. 1307924 2.016.95 TOTAL M & T $2,673.75 2,673.75 3. COM CAST - Cable Refund 5.91 4. I.R.S. - Income Tax refund 300.00 5. AMERICAN CENTURY - Retirement Account (Value based on statement attached at Exhibit "E") 6. GROSS PROCEEDS OF PUBLIC SALE OF PERSONAL PROPERTY 1,389.59 12,410.25 25.00 7. MEMBERS FIRST FEDERAL CREDIT UNION -Insurance Refund 8. TAX PRO-RATION ON SALE OF REAL ESTATE 365.87 9. DONEGAL MUTUAL - Car Insurance Refund 50.50 10. M & T BANK - Safety Deposit Box Refund 7.50 TOTAL (Also enter on Line 5. Recapitulation) $ 64,924.88 (If more space is needed, insert additional sheets of same size.) REV-1509 EX. (12-88) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF VERA M. PURNELL SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 2101 - 0705 Joint tenentes): NAME ADDRESS RELATIONSHIP TO DECEDENT A. NONE B. c. Jointly-owned property" ITEM LETTER DATE DESCRIPTION OF PROPERTY TOTAL DECD'S DOLLAR NO. FOR MADE VALUE % INT. VALUE OF JOINT JOINT OF ASSET DECEDENT'S TENANT INTEREST TOTAL (Also enter on Line 6. Recapitulation) NONE (If more space is needed, insert additional sheets of same size.) REV-1510 EX + (2-87) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER VERA M. PURNELL 2101 .0705 THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OF THE COVER SHEET IS YES. SCHEDULE G TRANSFERS ITEM DESCRIPTION OF PROPERTY EXCLUSION TOTAL DECD:S DOLLAR NUMBER Indude name o( the transferee, their relatiOnship to decedent. date of transfer VALUE % OF INT. VALUE OF OF ASSET DECEDENT'S INTEREST NONE TOTAL (Also enter on Line 7, Recapitulation) NONE (If more space is needed, insert additional sheets of same size.) REV-1511 EX + (7-BBi COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES ESTATE OF VERA M. PURNELL FILE NUMBER 2101 . 0705 ITEM DESCRIPTION AMOUNT NUMBER A. Funeral Expenses: 1. HOFFMAN - ROTH FUNERAL HOME, INC. $ 6,674.00 2. GEORGE'S FLOWERS - Reimbursement for Funeral Flowers 202.40 3. CUMBERLAND VALLEY MEMORIAL GARDENS 815.00 4. B. Administrative Costs: 1. Personal Representative Commissions: SHIRLEY M. KNARR 6,666.99 Social Security Number of Personal Representative:: Year Commissions Paid: 2001 2. Attorney Fees: HAROLD S. IRWIN, III 6,666.99 3. Family Exemption: Claimant Relationship Address of Claimant at decedent's death: Street Address City State Zip Code 4. Probate Fees: 270.00 C. Miscellaneous Expenses: 1. REGISTER OF WILLS - File Inventory and Inheritance Tax Return 25.00 2. HAROLD S. IRWIN, III - Notary Fees 10.00 3. DONEGAL MUTUAL INSURANCE COMPANY - Car Insurance 92.50 4. SOLLENBERGER'S - Car Registration Renewal 16.90 5. ROWE'S AUCTION SERVICE - Public Sale Expenses 1,595.25 6. LINE & LINE - Repairs to Grandfather Clock for Public Sale 212.00 7. TRANSFER TAXES ON SALE OF REAL ESTATE 580.00 B. HAROLD S. IRWIN, 11I- Attorney Fee on Sale of Real Estate 250.00 9. S & S MAINTENANCE SERVICE - Cleaning of Real Estate Prior to Settlement 300.00 10. TERMINEX - Termite Treatment of Real Estate 530.00 11. DARLENE MOYER - Real Estate Taxes 188.00 12. 13. 14. 15. 16. 17. TOTAL (Also enter on Line 9. Recapitulation) $ 35,095.03 (If more space is needed, insert additional sheets of same size.) REV-1512 EX + (1-93j COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF VERA M. PURNELL ITEM NUMBER SCHEDULE I DEBTS OF DECEDENT, MORTGAGES, LIABILITIES AND LIENS FILE NUMBER 2101 - 0705 DESCRIPTION AMOUNT $ 150.76 119.81 83.72 84.24 91.68 7,035.11 1. SPRINT - Phone Bills 2. PP&L - Electric Bills 3. BOROUGH OF CARLISLE - Water I Sewer Bills 4. AGWAY - Fuel Oil Bills 5. FASHION BUG - Credit Card Account Payoff 6. PNC BANK - Mortgage Balance 7. MEDICAL BILLS: Belvedere Medical Center Blue Mountain Anesthesia Carlisle Imaging Community Lifeteam, Inc. Cumberland-Goodwill Fire EMS Cary Cummings, III, MD Peter Giessmein, MD Lancaster HMA Physician Management Masland Associates, Inc. Pinnacle Health Hospitals Nita Rastogi, MD RWC Corporation SCCI Hospital of Harrisburg Sedlack Surgery Susquehanna Surgeons. L TD Vascular Associates Women's Health Associates 39.55 40.19 9.55 794.00 24.17 37.95 30.34 107.82 2.05 146.45 208.89 12.45 792.00 343.20 28.61 162.67 8.13 TOTAL (Also enter on Line 10, Recapitulation) $ 10,353.34 (If more space is needed, insert additional sheets of same size.) REV-1513 EX + (2-87) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF VERA M. PURNELL SCHEDULE .J BENEFICIARIES FILE NUMBER 2101 - 0705 ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR NUMBER SHARE OF ESTATE A. Taxable Bequests: 1. DEBORAH J. IRWIN DAUGHTER 1/3 RESIDUE P.O. BOX 162 PLAINFIELD, PA 17081 2. DENNIS L. PURNELL SON 1/3 RESIDUE 570 WEST LOUTHER STREET CARLISLE, PA 17013 3. DUANE C. PURNELL SON 1/3 RESIDUE 1918 RESERVOIR DRIVE CARLISLE, PA 17013 ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE B. Charitable and Governmental Bequests: NONE TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on Line 13. Recapitulation) NONE (If more space is needed, insert additional sheets of same size.) " LAST WILL AND TESTAMENT I, VERA M. PURNELL, of Carlisle, Cumberland County, Pennsylvania, do hereby make, publish and declare this to be my 1251 will and testament, hereby revoking all wills heretofore made by me, 1 , I direct my personal representative to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. I direct that all inheritance taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property, whether or not such property passes under this Will, shall be paid by my personal representative out of my estate. 2 I authorize and empower my personal representative to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or oiils of Sale tilerefure, in fee simple, as I cOulJ Co''; ;~ :;'.;ng. My .-ep.-esentative is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said representative. 3. I give, devise and bequeatn all or my es,ate ot whatever nature and wherever situate to my three children, share and share alike. the child or children of any deceased child taking the share their parent would have taken if living. 4. I nominate and appoint 5 representative of my estate, to serve without bond. to be the personal If he or she cannot or does not serve, then I appoint NO t:J1}f f;P. personal representative, also without bond. to be the substitute 5. I suggest that my personal representative retain the services of Harold S. Irwin, III, Carlisle, Pennsylvania in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 29th day of June, 2001. 7JP'/1~ rYI. ~h/'f1P/1 VERA M. PURNELL (SEAL) Signed, sealed, published and declared by the above-named person as and for a last will and testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as subscribing witnesses. ~d~) L{ t/Lllh- 0/ ~~ ACKNOWLEDGMENT AND AFFIDAVIT WE, VERA M. PURNELL, RHONDA S. IRWIN and HEATHER A. BARBOUR, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her last will and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. v~.y), r~ ~PURN:r ~ - . ~ VIm) RHONDA S. IRWIN '-{'/~ /&/4- 01- d- /~ HEATHER A. BARBOUR COMMONWEALTH OF PENNSYLVANIA :ss: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by VERA M. PURNELL the testatrix herein, and subscribed and sworn to before me by RHONDA S. IRWIN and HEATHER A. BARBOUR, witnesses, this 29111 d of June, 2001. Notarial Seal HarOld S. :{W1n IIi, Nctary Public Cari:sl'3 Bore, Cumberland County My Cnmml$sion Exoires Sect. 23, 2002 M...'mcer. iJ,=:",nsyl\'Jnla ,1~sCclatlor. at 0lolanes A. US Department of Housing & Urban Development THE INFORMATION CONTAINED IN BLOCKS E,G,H,I AND LINE 40115 IMPORTANT TAX INFORMATION AND IS BEING FURNISHED TO THE IRS, IF YOU ARE REQUIRED TO FILE A RETURN, A NEGLIGENCE SETTLEMENT STATEMENT PENALTY OR OTHER SANCTION WILL BE IMPOSED ON YOU IF THIS ITEM IS REQUIRED TO BE REPORTED AND THE IRS DETERMINES THAT IT HAS NOT BEEN REPORTED. B. Type of Loan 1. FHA 2. FmHA 3. Cony. Unins. 16. File No: I 7. Loan No: I 8. Mortgage Ins Case No: 4. VA 5. Conv. Ins. I I I C. NOTE: This form IS furnished to give you a statement of actual settlement costs. Amounts paid to and by the selllement agent are shown. Items marked "POC" were paid outside the closing: they are shown here for informational purposes and are not included in the totals. D. Name and Address of Buyer: E. Name and Address of Seller: F. Name and Address of Lender: D. WAYNE REID VERA M. PURNELL ESTATE G. Property Location: H. Settlement Agent: I. Settlement Date: HAROLD S. IRWIN, III 570 WEST LOUTHER STREET Place of Settlement: DECEMBER 14, 2001 CARLISLE, PA 17013 35 EAST HIGH STREET CARLISLE PA 17013 J. SUMMARY OF BUYER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contract Sales Price 58.000.00 401. Contract Sales Price 58,000.00 102 Personal Property 402. Personal Property 103 Settlement Charges to Borrower (line 1400) 1.130.50 403 104 404 105 405 Adjustments for items paid by Seller in advance Adjustments for items paid by Seller In advance 106 CityfTown Taxes 12/14/01 TO 12/31/01 13.43 406 CitylTown Taxes 12/14/01 TO 12/31101 13.43 107 County Taxes 407 County Taxes 108 School Taxes 12/14/01 TO 06/30/02 352.44 408 School Taxes 12/14/01 TO 06130/01 352.44 109 Water/Sewer 409 Water/Sewer 110 410 111 411 112 412 120, GROSS AMOUNT DUE FROM BORROWER 59,496.37 420. GROSS AMOUNT DUE TO SELLER 58,365.87 200. AMOUNTS PAID BY OR FOR BORROWER: 500. REDUCTIONS IN AMOUNT DUE SELLER: 201 Deposit or Earnest Money 1,000.00 501 Excess DepOsit 1,000.00 202 Principal amount 01 new loan(s) 502. SeUlement charges 10 Seller (line 1400) 1,385,00 203. Existing loan(5) taken subject 10 503 Exisbng loan(s) taken subject to 204 504 Payoff first mortgage loan PNC BANK 6,721.21 205 505 206 506 Payoff second mortgage loan 207 507 208. SOB 209 509 Adjustments for ilems unpaid b Seller Adjustments for items unpaid by Seller 210. CitylTownTaxes 510. CityfTownTaxes 211. County TaKes 511. County taxes 01101/98 TO 02126/98 212 School Taxes 512. School Taxes 213. Water/Sewer 513. Water/Sewer 214 514. 215. 515. 216 516. 217 517 218 518 '" 519. 220. TOTAL PAID BY/FOR BORROWER 1,000.00 520. TOTAL REDUCTIONS FROM SELLER 9,106.21 300 CASH AT SETTLEMENT TO/FM BORROWER 600, CASH AT SETTLEMENT TOIFM SELLER 301 Gross amount due from Borrower (line 120) 59,496.37 601 Gross amount due to Seller 58,365.87 302 Less amounts paid by/for Borrower (tine 220) 1,000.00 602 Less reductions from Seller (line 520) 9,106.21 303. CASH _X_ FROM - TO BORROWER 58,496.37 603. CASH - FROM -L TO SELLER 49,259.66 I have carefully reviewed this Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and diSbursements made on my account or by me in this transaction. I further certify that I have received a copy of this HUO-1 Settlement Statement. I direct and authorize the Seltlement Agent to make the distributions indicated for my account, recognizing thatlhe Settlement Agent is not responsible for the accuracy or validity of the disbursement amounts or the completeness of charges made by others. Arly interest earned on funds deposited with Settlement Agent hereunder may be retained by Settlement Agent. J) 11k~h;f &J BUYER D. W~E REID ESTATE ., F VERA M. PURNELL 'j , b~!.-<- l../ SHIRLEY ~'t/Ji . KNARR, Executrix SELLER BUYER SELLER wledge. the HUD1 Settlement Statement which I have prepared is a true & accurate account of the funds which were received and d by the underSIgned as pan of the setUement of this transac~on. 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OU!l!JMJapUn .soe OJ aaJ OO!N6S XBJ. .90e OJ UO!leJedaJd luawnoOa .LOe OJ aa,j .ddV' .sul a5e5)J0~ .90e 01 aa:f uo!paaSUI s,Japu81 .gOe OJ jJodal:J jlpaJ:) .v09 OJ aa.::lleS!2JddV .W9 OJ % lUnOOS!O ueol .~oe -- aa.::! uO!leu!5po ueol .~09 01 % NVOl HollM NOI1::l3NNO:J NI318VAVd SW311 .008 luawalnas le Pled UO!SS!WW08 .COL OJ $ .~OL I.1N3W31J..L3S OJ $ . ~OL lN3W31.1.l3S :sMolloJ S2 (OOL au!!) UOjSS!LUWO:) jO UO!S!^!O .1" saNn~ J.,,"SONn.:J $ = % $ 3:)Il:Jd NO 03SV'8 S@nu 'nqullI"s to ~ernbersl57; FEDERAL CREDIT U:\IION 5000 L.ouille Drive F'Q Box 40 Mechalilicsburg. F'A 17055 www.memberslst.org Member's Statement of Account Accounl Num~r P",m TO j F'.g. 57795 07-01-01 09- 30-0 d 1 of 2 Main Switchboard: Call-24: TOO: TeleBranch: (717) 697.1161 or (800) 283.2328 (717) 697.4372 or (800) 283-4372 (717)697-5312 or (800) 283-2328 ex!. 3312 (7l?) 795.6049 or (800) 237-7288 CATCH THE SPIRIT AS WE CELEBRATE INTERNATIONAL CREDIT UNION DAY! SEE THE ENCLOSED INSERT FOR MORE INFORMATION. 1",111",111"""11,,11,,1,,1,,11,,1,,1,1,1,,,,11,,1,11,1,,1 VERA M PURNELL C/O SHIRLEY KNARR 412 LIMESTONE RD CARLISLE PA 17013 11069 T,ftTNES I ~:fE i TRANSACTION DESCRIPTION I SUFFIX:OO SAVINGS 073101 DIVIDEND 081301 TFR FROM SHARES 57795-02 081301 SHARE DIVIDEND 081301 SHARE WITHDRAWAL AMOUNT .22 793.74 .09 -874.61 Y-T-D DIVIDENDS: 1.80 TRUTH IN SAVINGS INFORMATION ANNUAL PERCENTAGE YIELD / 2.50% ANNUAL PERCENTAGE YIELD EARNED / 2.52% . ' . : ------------------------------------------------------------------------------~--- . , , 1.691 .661 -793.741 i SUFFIX:02 HOLIDAY ,073101 DIVIDEND C81301 SHARE DIVIDEND ~81301 TFR TO SHARES CLUB 57795-00 Y-T-D DIVIDENDS: TRUTH IN SAVINGS INFORMATION ANNUAL PERCENTAGE YIELD / 2.55% ANNUAL PERCENTAGE YIELD EARNED / 2.55% 12.28 SUFFIX:l0 IRA SAVINGS 1092601 IRA DEPOSIT '09260 I: ! RA WITHDRAWAL '109260 I' IRS WITHHOLD I NG 09260 II IRA WITHDRAWAL 09260 I IRS WITHHOLD I NG r92601 IRA WITHDRAWAL , 23585.221 -7861.74' -786.17: -7075.57 -786.17' -7075.57 I BALANCE 105.56 105.78 899.52 899.61 25.00 791.39 793.08 793.74 .00 .00 23585.22 15723.48 14937.31 7861.74 7075.57 .00 BENEFICIARIES: DENNIS L PURNELL DUANE C PURNELL DEBORAH J IRWIN Y-T-D DIVIDENDS: .00 FEDERAL WITHHOLDING: 1572.34 I TRUTH IN SAVINGS INFORMATION , ANNUAL PERCENTAGE YIELD /. 0% 1 ---~-----~------------------------------------------------------------------------ i I SUFFIX:15 IRA 30 MONTH CERTF I I 20498.06 10731011 DIVIDEND 119.951 20618.01 1083101 DIVIDEND 120.651 20738.66 1092601 CERTIFICATE DIVIDEND 97.87 20836.53 0926011 IRA PAYOFF -20836.53 .00 ! NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION. ~~mberslST . .JERAL CREDIT t.:~IO' TRANS EFF. DATE DATE Account Numb.' To of 2 11070 F,om 57795! 07"01-0 l' '! '09-30-01 I, 2 TRANSACTION DESCRIPTION AMOUNT P"g. BALANCE , Y-T-D DIVIDENDS: 1025.08 FORFEITURES: TRUTH IN SAVINGS INFORMATION I ANNUAL PERCENTAGE YIELD I 7.11% I , ANNUAL PERCENTAGE Y I HO EARNED / 7.07% I , , I ---il,-----J-~~~~li;~7-IRA-1B~M~~~~~C~~~~:~~~~~~-~~~~~~~~-~~~~:~~~~br' ~-~~~-~~~~:-l--;;:~~:O 073101! DIVIDEND 11.711 2196.71 1080401! DIVIDEND AT MATURITY 1.141 2197.85 108310]! DIVIDEND _ ' 6.951 2204.80 1092601, CERTIFICATE DIVIDEND I 6.221' 22J1.02 !092601' IRA PAYOFF I -2211.02 .00 .00 i Y-T-D DIVIDENDS: 93.17 FORFEITURES: I i I I ! TRUTH IN SAVINGS INFORMATION I [ ANNUAL PERCENTAGE YIELD I 4.20% I , ANNUAL PERCENTAGE YIELD EARNED I 5.07% I 1 ' 1 CERT NO: 0 ISSUE DATE:080401 MATURITY DATE:0202l3 DIV RATE: 4.1200 - n i- --- - -'-SUF F 1 i;l B-IRA- 30- MONTH - CERTF- ---- - - - - - - - - - --- - - ----- nt - - __n__ - - - -:- n - 528.93 1073101i DIVIDEND 3.101 532.03 !0831011 DIVIDEND 3.11: 535.14 1092601! CERTIFICATE DIVIDEND 2.531 537.67 [0926011 IRA PAYOFF -537.67, .00 , . : : Y-T-D DIVIDENDS: 26.45 FfRFEITURES: 1 TRUTH IN SAVINGS INFORMATION I ! i ~~~~~t ~~~E~~+~g~ ~:~t8 EARNED j ~:6~~ I i I i CERT NO: 0 ISSUE DATE:090500 MATURITY DATE:030603 DIV RATE:' 6.8900 , -----------------------------------------------------------------r---------------- I 1 ! FOR 2001 1 , * IRA YTD * OTHER YTD * TOTAL YTD * TOT L YTD * TOTAL YTD * i DIVIDENDS DIVIDENDS DIVIDENDS WITHrOLDING FOR~EITURES 1144.70 14.08 1158.78 11572.34 ! .00 I i I I I I .00 .00 rl:1 M&TBank ... STATEMENT PERIOO PAGE - ACCOUNT NO. ACCOUNT n Ole 15004201140388 PERSONAL STATEMENT SAVINGS AUG.IO-NDV.09,2001 1 OF 1 00 0 04334H Ntt 017 68636 VERA M PURNELL 570 W LOUTHER ST CARLISLE PA 17013-2212 INTEREST EARNED FOR STATEMENT PERIOD INTEREST PAID YEAR TO DATE 5.44 0.04 N08LE 80ULEVARD BEGINNING DEPOSITS I WITNDRAWALS I OTHER CURRENT ENDING BALANCE OTHER ADDITIONS SUBTRACTIONS INTEREST PAID BALANCE NO. I AMOUNT NO. AMOUNT 656.80 01 0.00 1 656.80 (). 00 o. . . ACCOUNT SUMMARY ~~J POSTING DEPOSITS, INTEREST W/DRAWALS & OTHER DAILY DATE TRANSACTION DESCRIPTION I OTHER ADDITIONS SUBTRACTIONS BALANCE 08-10-01 BEGINNING BALANCE $656 .Bl 08-13-01 CLOSEOUT 656.80 i i).or l I ENDING BALANCE I $0 .Ol ACCOUNT ACTIVITY ANNUAL PERCENTAGE YIELD EARNED 0.74 % REFER A FRIEND TO MIT BANK AND GET A FREE GIFT! NOW, WHEN YOU ASK A FRIEND TO OPEN A CHECKING ACCOUNT WITH H&T, NOT ONLY WILL YOU GET A FREE GIFT - SO WILL YOUR FRIEND. STOP BY ANY MIT BRANCH OR CAll M'T'S TELEPHONE BANKING CENTER AT 1-800-724-2440 TO GET A REFER-A-FRIEND COUPON. HURRY, GIFT ~UANTIT:ES A~E L!MITED. OPENING. FREF GIFT PROVIDED AT TIME OF ACCOUNT L008A(12i93) I 'I STATENENT PERIOD PAGE rl;1 M&fBank . ACCOUNT NO. ACCOUNT TYPE 1307924 CLASSIC CHECKING AUG.04.SEP.03,2001 I OF I 00 o 04334N NN 017 47839 VERA M PURNELL 570 W LOUTHER ST CARLISLE PA 17013-2212 NOBLE BOULEVARIi BEGINNING DEPOSITS & OTHER CURRENT ENDING BALANCE OTHER ADDITIONS CHECKS PAID SUBTRACTIONS INTEREST PO BALANCE NO. I ANOUNT NO. I ANOUNT NO. I ANOUNT 2,016.95 0' 0.00 0 0.00 II 2,016.95 0.00 0.00 ACCOUNT SUMMARY POSTING OEPOSITS,INTEREST CHECK~ & OTHER DAILY DATE TRANSACTION DESCRIPTION & OTHER ADDITIONS SUBTRACTIONS BALANCE 08-04-01 BEGINNING BALANCE $2,016.95 08-13-01 CLOSEOUT 2,016.95 0.00 ENDING BALANCE $0.00 ACCOUNT ACTIVITY TAKE ADVANTAGE OF N&T WEB BANKING, WHERE YOU CAN CHECK BALANCES, VIEW ACCOUNT HISTORY, TRANSFER FUNDS AND NUCH, NUCH NORE. IN FACT, N&T WEB BANKING GIVES YOU ACCESS TO PRACTICALLY YOUR ENTIRE N&T BANK RELATIONSHIP, 24 HOURS A DAY, 7 DAYS A WEEK ~ AND BEST OF ALL 1T.S FREE! TO ENROll IN WEB BANKING, SINPLY VISIT WWW.NANDTBANK.CON, STOP BY ANY N&T BANK BRANCH OR CALL THE N&T TELEPHONE BANKING CENTER AT 1-800-790-9130. N&T WEB BANKING - IT CLICKS WITH YOUR LIFE! 4 LOOBA 1121'31) AMERICAN Y SERVICES CORPORATION P.O. Box 419784 . Ka !y, MO 64141-6784 1-800-34~2345 K<<p this infirmation wim, au ..I -- - ocml98 001 SP NT 1 ~ lJ711iOt3-2212 i'04 0198 1,,,111...111.,,,,,11,,11...1,1,,1,1,,,11,,1,11...111....1,,11 VERA M. PURNELL 570 W LOUT HER ST CARLISLE, PA 17013-2212 CATEGORY OF DISTRIBUTION, LUMP SUM 7 NORMAL DISTRIBUTION FROM CTS CORPORATION RETIREMENT SAVINGS PLAN PLAN NO, 056597 CHECK NUMBER,00000483057 DATE, 09/20/2001 TOTAL DISTRIBUTION TAX-FREE RETURN OF OWN CONTRIBUTIONS TAXABLE AS ORDINARY INCOME TAXABLE AS CAPITAL GAINS UNREALI2ED APPRECIATION ON SHARES l ,730 99 o 00 t ,736 99 o 00 o 0 ,) GROSS AMOUNT ~EDERAr.. INCOME TAX ,:'31) 99 347 40 NET PAYMENT L , 389 59 I-CPP'I7242 AMERICAN CENTIiay SERVIcisC;CJRI'ORAmON,: r~i:~,~~'"':~:;;:~~:;~t~~,:~,,:::~_.,Yf ~d:): -_ ,Check Number ""'/' . ....,.' -,..,,-. :-; ,;- '"1{,,;' ..t.,~: ~ ~ !;d~'''8,i;ociq <; ~II. " ~..\ .aC\J:r:EV.1500 EX (6-00) \, COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRIi;>BURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST AND MIDDLE INITIAL) PURNELL, VERA M. DATE OF DEATH DATE F BIRTH JULY 20, 2001 SEPTEMBER 5, 1935 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT IlP ~F~4G?~LY(~ .lL 2. Supplemental Return _ 4a. FtJture Interest Compromise (for dates of death after 12-12-82) _ 7. Decedent Maintained a Living Trust (Attach copy of Trust) _ 10. Spousal Poverty Credit (date of death between 12.31-S1 and 1-1-S 1. Original Return 4. Limited Estate X 6. Decedent Died Testate - (Attach copy of Will) EX, A 9. Litigation Proceeds Received FILE NUMBER 21 COUNTY CODE SOCIAL SECURITY NUMBER 171 - 28.4539 01 YEAR 0705 NUMBER / 3. Remainder Return (dates of death prior to 12-13-82) _ 5. Federal Estate Tax Return Req _ 8. Total No. of Safe Deposit Boxes _ 11. Election to tax (Sec. S113(A)) (Attach Sch 0) NAME HAROLD S. IRWIN, III TELEPHONE NUMBER 717-243-6090 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortsages and Notes Receivable (Schedule D) 5. Cash, Bank Dep & Mise Personal Property (Schad E) 6. Jointly Owned Property (Schedule F) 7. Transfers I Misc. Property(Schedule G) (Schedule L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schad H) 10. Debts, Mortgage Liabilities & Liens (Schedule I) 11. Total Deductions (total Lines S & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests (schedule J) 14. Net Value Subject to Tax (Line 12 minus line 13) 15. Amount of Line 14 taxable at the spousal rate 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of line 14 taxable at collateral rate 1S. Tax due COMPLE E MAILING ADDRESS 35 EA;t HIGH STREET, SUITES 2011202 CARL LE, PA 17013 (1) ~ OFFICIAL USE ONLY 58,000.00 :-" d (2) -- "', 0.00 1< (3) 0.00 (4) 0.00 '~J::' (5) 41,339.66 (6) 0.00 _0 w (7) 0.00 (8) 99,339.66 (S) 25,095.03 (10) 10,353.34. (11) 35,448.37 (12) 63,891.29 (13) 0.00 (14) 63,891.29 x. - = (15) 0.00 $63,891,29 x.045 = (16) 2,875.11 x .12 = (17) 0.00 x .15 = (18) 0.00 (19) 2,875.11 Decedent's Complete Address: STREET ADDRESS 570 WEST LOUTHER STREET CITY I STATE I ZIP CARLISLE PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 18) 2. Credits f payments A. Spousal Poverty Credit B. Prior Payments $3.936.44 C. Discount (1) $ 2.875.11 Total Credits (A+B+C) (2) 3.936.44 3. Interest I Penalty if applicable D. Interest E, Penalty TotallnteresUPenalty (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) $1.061.33 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. (SA) (5) B. Enter the total of Line 5+5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BV PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Ves a. retain the use of income of the property transferred; ................................... b. retain the right to designate who shall use the property transferred or its income; ........ C. retain a reversionary Interest; or ........................................................................... d. receive the promise for life of either payments, benefits or care? ............................... 2. If death occurred on or before December 123. 1982, did decedent within two years preceding death transfer property without receiving adequate consideration? If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ...................................................... .............. 3. Old decedent own an "in trust for" or payable upon death bank account or security at his or her death? ...................................................................................................... 4. Did decedent own an individual retirement account, annuity, or other non-probate property? ...... No J.- -1L -1L -1L N/A -1L --L IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than personal representative is based on all information of which preparer has any knowledge. ~E OF PERSON RESPONSIBLE FOR FILING RETURN [ . A.A Y"">--. . k"~ cvi/\. ADDRESS I 412 LI ESTONE ROAD, CARLISLE, PA 17013 S N URE OF PREP HER THAN PERSONAL REPRESENTATIVE DA April , 2002 DA);E 35 EAST HIGH STREE CAR SLE, PA 17013 April l'i ,2002 For dates of death on or afte uly 1 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ctlon 9116 (a)(l.l )(i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. Section 9116 (a)(1.1 )(Ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. Section 9116 (a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P .S, Section 9116 (1.2)[72 P,S. Section 9116 (a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P .S. Section 9116 (a)(1.3)). A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX + (12-85) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER VERA M. PURNELL 2101 - 0705 (Property jointly-owned with Right of Survivorship must be disclosed on Schedule F) All real estate should be reported at fair market value which is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. ITEM DESCRIPTION NUMBER SCHEDULE A REAL ESTATE VALUE AT DATE OF DEATH 1. HOUSE AND LOT AT 570 WEST LOUTHER STREET, CARLISLE, PA 17013 (Value based on sale price. See HUD-1 settlement statement attached as Exhibit "B") $ 58,000.00 TOTAL (Also enter on Line 1, Recapitulation) $ 58,000.00 (If more space is needed. insert additional sheets of same size.) REV-1503 EX + (4-861 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF VERA M. PURNELL (All property jointly-owned with Right of Survivorship must be disclosed on Schedule F.) ITEM DESCRIPTION NUMBER SCHEDULE B STOCKS AND BONDS FILE NUMBER 2101 - 0705 VALUE AT DATE OF DEATH NONE TOTAL (Also enter on Line 2, Recapitulation) NONE (If more space is needed, insert additional sheets of same size.) REV-1504 EX + (3-92) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY HELD STOCK PARTNERSHIP AND PROPRIETORSHIP ESTATE OF VERA M. PURNELL ITEM NUMBER NONE DESCRIPTION FILE NUMBER 2101 - 0705 VALUE AT DATE OF DEATH (If more space is needed, insert addiUonal sheets of same size.) TOTAL (Also enter on line 3. Recapitulation) NONE REV-1507 EX + (6-86) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES AND NOTES RECEIVABLE ESTATE OF VERA M. PURNELL (All property jointly-owned with Right of Survivorship must be disclosed on Schedule F.) ITEM DESCRIPTION NUMBER FILE NUMBER 2101 - 0705 VALUE AT DATE OF DEATH NONE TOTAL (Also enter on Line 4. Recapitulation) NONE (If more space is needed, insert additional sheets of same size.) REV-1508 EX + (2-87) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY ESTATE OF VERA M. PURNELL (All property jointlYwQwned with Right of Survivorship must be disclosed on Schedule F.) ITEM DESCRIPTION NUMBER FILE NUMBER 2101 - 0705 VALUE AT DATE OF DEATH 1. MEMBERS FIRST FEDERAL CREDIT UNION - Account No. 57795 (Value based on bank statement attached at Exhibit "C") Suffix:OO - Savings $ 105.56 Suffix:02 - Holiday Club 793.74 Suffix:15 -IRA 30 Mo. Cert. 20,498.06 Suffix:17 -IRA 18 Mo. Cert. 2,185.00 Suffix:18 -IRA 30 Mo. Cert. 528.93 TOTAL Members 1st $24,111.29 $ 24,111.29 M & T BANK (Value based on bank statement attached at Exhibit "0") 2. Account No. 15004201140388 $ 656.80 Account No. 1307924 2.016.95 TOTAL M & T $2,673.75 COMCAST - Cable Refund 2,673.75 5.91 3. I.R.S. - Income Tax refund ~ ~~ AMERICAN CENTURY - Retirement Account (Value based on statement attached at 5. Exhibit "En) GROSS PROCEEDS OF PUBLIC SALE OF PERSONAL PROPERTY 1,389.59 12,410.25 6. MEMBERS FIRST FEDERAL CREDIT UNI.ON -Insurance Refund TAX PRO-RATION ON SALE OF REAL ESTATE 25.00 365.87 7. 8. DONEGAL MUTUAL - Car Insurance Refund 9. 50.50 M & T BANK - Safety Deposit Box Refund 10. 7.50 TOTAL (Also enter on Line 5. Recapitulation) $ 41,449.66 (If more space is needed, insert additional sheets of same size.) 'REV-1509 EX + (12-88) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF VERA M. PURNELL SCHEDULE F .JOINTLY-OWNED PROPERTY FILE NUMBER 2101 - 0705 Joint tenant(s): NAME ADDRESS RELATIONSHIP TO DECEDENT A. NONE 8. c. Jointly-owned property: ITEM LETTER DATE DESCRIPTION OF PROPERTY TOTAL DECD'S DOLLAR NO. FOR MADE VALUE 0/. INT. VALUE OF JOINT JOINT OF ASSET DECEDENrS TENANT INTEREST TOTAL (Also enter on Line 6. Recapitulation) NONE (If more space is needed, insert additional sheets of same size.) REV-151Q EX + (2-87). COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF VERA M. PURNELL SCHEDULE G TRANSFERS FILE NUMBER 2101 - 0705 THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OF THE COVER SHEET IS YES. ITEM DESCRIPTION OF PROPERTY EXCLUSION TOTAL DECD.'S DOLLAR NUMBER Include name of/he transferee, their relationship to decedent, date of transfer VALUE % OF INT. VALUE OF OF ASSET DECEDENT'S INTEREST NONE TOTAL (Also enter on Line 7, Recapitulation) NONE (If more space is needed, insert additional sheets of same size.) REV-1511 EX + (7-88~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT .SCHEDULE! H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES ESTATE OF VERA M. PURNELL FILE NUMBER 2101 - 0705 ITEM DESCRIPTION AMOUNT NUMBER A. Funeral Expenses: 1. HOFFMAN - ROTH FUNERAL HOME, INC. $ 6,674.00 2. GEORGE'S FLOWERS - Reimbursement for Funeral Flowers 202.40 3. CUMBERLAND VALLEY MEMORIAL GARDENS 815.00 4. B. Administrative Costs: 1. Personal Representative Commissions: SHIRLEY M. KNARR 6,666.99 Social Security Number of Personal Representative:: Year Commissions Paid: 2001 2. Attorney Fees: HAROLD S. IRWIN, III 6,666.99 3. Family Exemption: Claimant Relationship Address of Claimant at decedent's death: Street Address City State Zip Code 4. Probate Fees: 270.00 C. Miscellaneous Expenses: 1. REGISTER OF WILLS - File Inventory and Inheritance Tax Return 25.00 2. HAROLD S. IRWIN, III - Notary Fees 10.00 3. DONEGAL MUTUAL INSURANCE COMPANY - Car Insurance 92.50 4. SOLLENBERGER'S - Car Registration Renewal 16.90 5. ROWE'S AUCTION SERVICE - Public Sale Expenses 1,595.25 6. LINE & LINE - Repairs to Grandfather Clock for Public Sale 212.00 7. TRANSFER TAXES ON SALE OF REAL ESTATE 580.00 8. HAROLD S. IRWIN, 111- Attorney Fee on Sale of Real Estate 250.00 9. S & S MAINTENANCE SERVICE - Cleaning of Real Estate Prior to Settlement 300.00 10. TERMINEX - Termite Treatment of Real Estate 530.00 11. DARLENE MOYER - Real Estate Taxes 188.00 12. 13. 14. 15. 16. 17. TOTAL (Also enter on Line 9, Recapitulation) $ 35,095.03 (If more space is needed. insert additional sheets of same size.) REV-1S1Z EX'. (1-93) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF VERA M. PURNELL ITEM NUMBER SCHEDULE I DEBTS OF DECEDENT, MORTGAGES, LIABILITIES AND LIENS FILE NUMBER 2101 . 0705 DESCRIPTION AMOUNT $ 150.76 119.81 83.72 84.24 91.68 7,035.11 1. SPRINT - Phone Bills 2. PP&L - Electric Bills 3. BOROUGH OF CARLISLE - Water I Sewer Bills 4. AGWAY - Fuel Oil Bills 5. FASHION BUG - Credit Card Account Payoff 6. PNC BANK - Mortgage Balance 7. MEDICAL BILLS: Belvedere Medical Center Blue Mountain Anesthesia Carlisle Imaging Community Lifeteam, Inc. Cumberland-Goodwill Fire EMS Cary Cummings, III, MD Peter Giessmein, MD Lancaster HMA Physician Management Masland Associates, Inc. Pinnacle Health Hospitals Nita Rastogi, MD RWC Corporation SCCI Hospital of Harrisburg Sedlack Surgery Susquehanna Surgeons, L TO Vascular Associates Women's Health Associates 39.55 40.19 9.55 794.00 24.17 37.95 30.34 107.82 2.05 146.45 208.89 12.45 792.00 343.20 28.61 162.67 8.13 TOTAL (Also enter on Line 10, Recapitulation) $ 10,353.34 (If more space is needed, insert additional sheets of same size.) 'REV-1S13 EX"+ (2-87). COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF VERA M. PURNELL . SCHEDULE" BENEFICIARIES FILE NUMBER 2101 - 0705 ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR NUMBER SHARE OF ESTATE A. Taxable Bequests: 1. DEBORAH J. IRWIN DAUGHTER 1/3 RESIDUE P.O. BOX 162 PLAINFIELD, PA 17081 2. DENNIS L. PURNELL SON 1/3 RESIDUE 570 WEST LOUTHER STREET CARLISLE, PA 17013 3. DUANE C. PURNELL SON 1/3 RESIDUE 1918 RESERVOIR DRIVE CARLISLE, PA 17013 ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE B. Charitable and Governmental Bequests: NONE TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on Line 13, Recapitulation) NONE (If more space is needed, insert additional sheets of same size.)