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Home My WebLink About01-0716 PETITION FOR PROBATE and GRANT OF LETTERS Estate of ~,\~~ C. t-1e..~W~~ No. 2\- 0\ -"to also known as To: Register of Wills for the Deceased. County of ~Q9.< \c.vC in the Social Security No. \ C\ S - ~<?") - <2>oS J Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an t~ executr(~ in the last will of the above decedent, dated O('~\Q)l.< \ and codici1(s) dated named , 19-9..l- (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent, then 5?> years of age, died ~ v..; , .. d<::C \ , at \~\ S's (\- .~~ c...U(T\~\ \- ~ .\'-0f. Except a 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: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: N00e '1C(A $ '-\ ~ OOJ . OJ ~ a $ 0 WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) preC\ented herewith and the grant of letters '\-€5;:, ~fY"Qs'\~ ~ (testamentary; administr\.lon c.La.; administration d.b-.n.c.t.a.) theron. '" '" ~ iU <:J C iU " .-.. .V; ~ iU ... lX~ c "00 c'= ~.= 3~ iU <- ;0 ~ c Ql) ti5 tFt,u, ~ (!{, t JLc~/'ck rt\VL' \J€ ~. \J E.OWlc:....~ \ \0 L~~ l)\,~ C~ 'U . "9A. \'l()\ \ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 'I S'" COUNTY OF CUMBERLAND J :s The petitioner(s) above-named swear(~) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirme~ N Bnd before me this G S flh'} ~ ~ if, tf,LO c-J I.)I/.L /.../A-- 0/-'/ NE ~, N~DWfC K: . 'ftc- CI3 QQ' ;::s ~ - ;:: ~ ~ \ \0 - di~ '1 -- \ D No. 21 - 01 - 716 Estate of ~\~ C. ~~~w~~c , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW AUGUST 3, x~ 2001 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 OCTOBER 11, 1991 described therein be admitted to probate and filed of record as the last will of ARLENE C NEDWICK TESTAMENTARYT PAULINE F. NEDWICK and Letters are hereby granted to $ 80.00 $ 6.00 $ ~.uu $ S.OO TOTAL _ $ 100 00 Filed .... .8U.G.UST. .3.~ . 20.Q1. . . . . . . . . . . . . Probate, Letters, Etc. ......... Short Certificates( 2) .. . . . . . . . . Renunciation ................ X-Pages JCP ~d~ ~ r:.~7ii~Om$hClf1 MARY CLEWIS ~ (\0t:. . \=ZhOrr~ '-\C;(O~ \ \ ATTORNEY (Sup. Ct,!.D. No.) \ \ Lo CJ.-..\. ~\- s~ , Q.O. ~y~ \\.CO'-\.l \-\~~~~\ ~.A \\\0<0- \<O~I \\\--:L.~'?).- \,~) PHONE FEES ,:-... Mailed letters to attorney on 8-3-01 HI05.905 REV.(09/00) This is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. ~/I~ ~~s.~/'6r' Robert S. <ZirJnerman, J r., MPH Secretary of Health Charles Hardester State Registrar 1639268 OCT 0 4 2001 Date .... z l!l ~ w a ~ w 2 < Z COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH (Coroner) Oi.. l).,\. \ to TYPElPAINT IN PERMANENT BlACK INK C UNDER 1 OM DATE OF BIRTH BIRTHPlACE (City and Hours Minutes (Month. Day. 'IItar) Stale ex Fexeign Counlry) Mar. 16, 1948 HAIl.tlJ~6UIl& J PA. 7. ... CITY. DEATH FACILITY NAME (If noI.noIitution. give street and number) SEX 2. Female swe FILe NUMBER SOCIAL SECURITY NUMBER 3. /95'- 38 -80S? DATE OF DEATH (Month. Day, Year) July 8, 2001 ~D Pennsboro 10. MAR/TAL STATUS. M.rriad SURVIVING SPOuSE N_ Married. _. (If wile, give maiden name) Diwl'c:ad (Spacily) 14. AiEl/Ell I"'IAu.l E. ~ 15. 17..~Veo,_llvedln ,{I)wetr A //~N Iw~ citylbor<- Fte rEa / 'JOII a w rJl ~ rJl < :J < b. 23b. 230. WAS CASE REFERRED 10 ME~L EXAMINERICORONER? Yes I}II.. NoD H. I Appro,lmal. PART II: Other signific8nl conditions conlribuling 10 daath, but : interval be_n not resuttlng In the underlying cause given In PART I. lonset and daalh 238. TIME OF OEATH OATEPRONOUNCEODEAD(Manlh,Day, Year, 24 10: 57 PM. 25. July 8, 2001 27. MIlT I: Enter II.. __ injuries or complications which cauoad the daath. 00 not enter the mode 01 dying. euc:h IS cardl8c or reoplralOry arrest. shock 0< heart failure. LI8l only or-. ca_ on each Hna. Be Determined DUE 10 (OR /'oS A CONSEOUENCE OF): d WERE AU10PSY FINDINGS MlL.AllLE PRIOR 10 COMPLETION OF CAUSE OF OERH? MANNER OF DEATH TIME OF INJURY INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED. DATE OF /NJURY (Month. Olly. Year) ~ Hornldde 0 flit D AccIdenl 0 Pending InveIlIgalIon 0 3011. 3Gb. M. - T" No SuIctde 0 Could not be clatennlned D =. <:CINJ~A1_, farm. street. factory. oIIice 2IL 2Ib. 21. 3011. CERTIFIER P>eck <rif one) "CEATI'YfIIIG I'tlVlIICIAN (PhyWciar> cartJylng cause 01 deelh when 8IlClthet' phyllIcian has prlll1OUl1C8d deelh and compIeled "em 23) lO.......olmy--.....__duelolheC8UM(.)....ma......~.................................................... . Natlll1ll Vas tJ No 0 ~ C)'~..~e.tie J ~ crlY\ ~rt'r\\\C~ SIGNATURE D 31b. llCEN N MBE o 31c. 31d. Se . 18, 2001 NAME ANOAOORESS OF PERSON WHO COMPLETED CAUSE OF DEATH (1Iem27)TypeorPrlnt~Uchael L. Norris, Coroner ~ 6375 Basehore Road, Suite #1 /" 32. Mechanicsburg, Pa. 17050 DATEFlLED(Mon~SfP"2 ,r~C()\ 34. Coroner .~ AND CERTJFYlNG PIfYSICIAN (Physician boCh pronouncing _ and certifying to cauw 01_) To.._ol""--.....__atlhellme....._plece._duelO....C8UM(.)and_...-ad...... .................... "MEDICAL EXAMINEAICORONER On the...... ot.._IMtIon endIor InVestigation. In my opinion. deelh occurnd at the tl..... dIlt.. and place, and cIu. to the caUM(.) and __eteted................................................................................................. . ~L . REGISTRAR'S SlGNMU I.U-LJ 10".80" iF',' niSh This is. to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent pIing. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. (~ca~1:: fu!'<f1 Fee for this certificate, $2.00 p 7555186 ~~. IS '-00 t ( Date 1\ W', 1-'''11"" lltl! COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH (Coroner) TYPE/PRINT IN PERMANENT BLACK INK o ~ o G c SEX 2. Female STATE FilE NUMBER SOCIAL SECURITY NUMBER 3. DATE OF DEATH (Monlh. DdY 'teal) 4. July 8. 2001 UNDER 1 DAY Hours Minules DATE OF BIRTH BIRTHPLACE (Cdy alld PLACE OF DEATH (Ctl8Ck only one -, ~e6 inSlluctl(.HI,:> on oilier SIde) (Mourn, Day Year, Stelld or Foreign CUlJIl1I y) HOSPITAL. Inpalionl ~ ... FACILITY NAME (If nm InShlution. ~ve stJeet and number) g~=lliIO SURVIVING SPOUSE (It wife, give rniJIden name) Iwp CltV/ooro DATE SIGNED (MOlllh, Day, '(t::~1/ 23.. TIME Of DEATH DI'JE PRONOUNCED DEAD (Month Day. Yeaoj 23b. 230. WAS CASE REfERRED 10 ME~AL EXAMINER/CORONER? Ye.~ NoD 26. . ApptolCimate PART U: Olher Significant conditions contributing 10 dealh, but : interval between not resulting in 1he undet1yiog cause given in PART I ! onsel and dealh 24. 10:57 P. M 25 July 8,2001 27. PART I; Emer the diseases. injurio5 Of compbcahoos ....hich caused the deaCh. Do not enter the mode of dying, such a$ cardiac Of respiratory arrest, shock or heart tailure lt$t only one c;;aus. on each line. Pending Investigation DUE TO IDA AS A CONSEOUENCE OF): DUE TO lOR AS A CONSEQUENCE OF} Homicide I -r- DUE TO (on .AS ACUNSEOlJENCE or) d WERE AU10PSY fiNDINGS A\IAlLABlE PAlOR TO COMPLETION OF CAUSE Of DEATH? MANNER Of DEATH DATE Of INJURY (Month. Day, Yt!af) Ye. D Accl(jenl [J D [J [J No,Q(J Pen(hng Invtftoligdllon 2". alb. CERTIFIER (Chock only one) .CERTIfYING PHYStCIAN (PhY:iI(:IGII (.:t:IIJliIlICj C<.h.:.t:: d d6.lIn IIotll.:n anoltlel pll~~ICld.rll,d~ PWrH.JlIOl.:clU Ue.dh dllU cornjJl\!It:O 1It:!111 2J) To the be.t o. my knowledge. death occurred due to the C.UHta' and m.nner.. stilted. . , Suicloe 21. Could 001 be de1eHIlIned Coroner .MEDICAL EXAMINER/CORONER On the b.... oIexamln'llon .nd/or Inv..lIgatlon,ln my opinion, death occurred at the lime, date, and place, and dua 10 tha cauae(a) and manner ea Itated ...............................,........,....... ................... 31.. REGIST R'S SIGNATURE AND NUMBER l1u~ .. Jul__y_ "1_0':"'2:001_ __no LJ 310. ___._____ 31d_ _ __ __ __ NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE Of DEATH (1Iem27)TypeorPrinl Michael L. Norris. Coroner ~ 6375 Basehore Road. Suite #1 ~n Mechanicsburg. Pa. 17050 Dl'JE fiLED IMolllh. Day. Year) . PRONOUNCING AND CERTIfYING PHYStClAN 11-'11~Jl(.kll\ l;u(fl ~IOlIUl.lk,fn~ deall, dlld curlllyulY lucau::>e (II dt;;,jlll) To the but ot my knowledge, death occurred.1 the Ume, date, .nd place. .nd due to the Clusa(S) end manner ...latH.. 34. LAST WILL AND TESTAMENT OF ARLENE C. NEDWICE I, ARLENE C. NEDWICE, of Lower Allen Township, Cumberland County, Pennsylvania, declare this to be my Last will and Testament and revoke any and all wills and codicils heretofore made by me. ITEM I: My personal representative shall pay from the residue of my estate the expenses of my last illness, funeral and burial debts duly allowed against my estate, and estate taxes "~ occasioned by my death and incurred with respect to property passing by this will. ITEM II: I bequeath those articles of my automobiles, personal effects, household goods, and other tangible property of like nature (not including cash or securities) together with any existing insurance thereon, as set forth in a separate memorandum which I shall place with my will to the persons therein designated. If I shall leave no separate memorandum, or with regard to my automobiles, personal effects, household goods, and other tangible personalty of like nature (not including cash or securities) not referenced by such memorandum, I bequeath such property to my Mother, PAULINE F. NEDWICE. ITEM III: I devise and bequeath the residue of my estate, of every nature and wherever situate, to my Mother, 2 PAULINE F. NEDWICX. Should my Mother, PAULINE F. NEDWICX, predecease me, I give, devise and bequeath the residue of my estate, of every nature and wherever situate, to the following organizations in the following shares: 25% to: The Salvation Army 1122 Green Street Harrisburg, PA 25% to: Bethesda Mission 611 Reily Street Harrisburg, FA 25% to: Humane Society West Shore Shelter Sinclair & Eppley Roads Mechanicsburg, PA 25% to: The Nature Conservancy-Pennsylvania Chapter 1815 North Lynn Street Arlington, VA 22209 ITEK IV: I appoint my Mother, PAULINE F. NEDWICX, Executrix of this my Last will and Testament. Should my Mother, PAULINE F. NEDWICX, fail to qualify or cease to act as Executrix, I appoint TAYLOR P. ANDREWS, ESQUIRE, of Andrews & Johnson law office of Carlisle, Pennsylvania, as Executor of my estate. ITEK V: I direct that my Executrix and her successors shall not be required to give bond for the faithful performance of their duties in this or any other jurisdiction. . 3 IN WITNESS WHEREOF, I, ARLENE C. NEDWICK, have hereunto set my hand and seal to this my Last Will and Testament, consisting of three (3) typewritten pages, each of which bears my signature, this / I day of C) c1;-t~/) , 1991. Cd {)fln-,-f C 0)~da.~~r~ (SEAL) Arlene C. NedwIck, Testatrix ." .. COMMONWEALTH OF PENNSYLVANIA) SSe COUNTY OF CUMBERLAND WE, ARLENE C. NEDWICE, TAYLOR P. ANDREWS, and Sfe~~ &. ~~S~ , , the Testatrix and witnesses, respectively, whose names are signed to the foregoing or attached instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as and for her Last will and Testament and that she signed willingly and that she executed as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the will as witnesses and that to the best of their knowledge the Testatrix was at the time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. -c~ _.~. , witness Subscribed, sworn to and acknowledged before me by ARLENE C. NEDWICK, the Testatrix, and subscribed tOjaPd sworn or affirmed to before me by TAYLOR P. ANDREWS and 0~~N^~. ~Sh'-. , witnesses, this //iL day of C1::k~r , 1991. ~-<<.. Y~L..". Notary Public ( SEAL) Not.... Seal Brenda l. Brehm, Nobwy PubIc I Ca'fiat& ~, Cumberrald Colny My ComIrN88ion Expires Jan. S, 1992 I ~ ~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: ARLENE C. NEDWICK Date of Death: JULY 81 2001 Will No. Admin. No. 2001-00716 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court ~ules was served on or mailed to the following beneficiaries of the above-captioned estate on 08/08/01 Name Address Pauline F. Nedwickl 110 Linden Drivel Camp Hil11 PA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: 8/8/01 ~~.~ Signature Name Ann E. Rhoadsl Esquire Address P. O. Box 11847 Harrisburgl PA 17108-1847 Telephone(71~ 238~1731 Capacity: Personal Representative x Counsel for personal representative - Inventory Of tn.. r.a' and pe~onal Istate of Jj. -...., ARLENE C. NEDWICK decea~ed ," 1. Members First Savings Acct. #132195-00 2,.215 33 2. Members First Checking Acct. #132195-11 3,430 30 3. Members First ,C/D #132195-40 5 YR 17,212 34 4. Members First C/D #132195-42 5 YR 2,741 06 5. Members First C/D #132195-43 5 YR 5,434 32 6. Members First C/D #132195-44 2 YR 9,679 26 7. 1992 Pontiac Grand Am Automobile 3,000 00 8. 2001 Federal Income Tax Refund 698 00 TOl'AL 44-,4110 61 . tun~) c''. . ~') ${ ~~'. L L\i () l HdV ZOo :;.01:1 Pauline F. Nedwick bein9 duly sW9rn .ccordin9 to I.w, depose. .nd ,.y. th.t she is Executrix 01 the Est.te of Arlene C. Nedwick t.t. of _-19~~_~~~I.l...1.Q~~.l1ip__. --- . Cumb.rland County. P... dec...ed and that th. within i. .n inventory m.de by Pauline F. Nedwick , the ..icl Executrix 01 the entire edat. of uid decedent, consisting of .11 the person.1 prop~rly .nd real estat.. exc.pt r..r .dat. ouisid. the Commonw..lth of Pennsylv.nia, and th.t the figures opposite ..ch item of the Inventory represent it'. f.ir vllue ts of the date of decedent's death. COMWONWlALTH 0' 'INNSYLYAN~A COUNTY O' CUM.llLAND ~ &oar/'\. io 'l J ., and subscribed before me, AD r ,./ Y' I ~ OC ;).... -.: I I ~~~ d. /~ / Notarial Seal ,Jenny. A. Tobias, Notary Public .",l-fAlri1lburg, Dauphin County 'I ~ . .m.,ml,,'on ExpIres Flb.1S, 2005 ,"i::';.:';';,.;~ Date of Death 8th O.Y '" .:~t#!' tf'r~~-~ 1-. 'Al'~;ek Execufo, . XIiK*,1i>>XH.'( PAULINE F. NEDWICK 110 Linden Drive Camp Hill, PA 17011 Acldr." Julv Month 200] Y.., INSTRUCTIONS I. . An inventory must b. filed within three months after appointment of personal representriive. 2: ~. supplement i"venfory .mus! be filed within t~irly days ~f discovery of additional .ssets. 3. Additional sheets may be aHa.ched as to personalty or realty- 4. See Article IV, Fiduciaries Act of 1949. ~ ; I I o Z >- t- w ex: t- w -< a. t- O VOl w ex: w J: a. ~ u. ..J o -< z o 0 ...., z ffi -< a. >- IX o J- Z UJ > Z -oJ U. -< 0 w c:: iI l! . I CJ! CIJ ffi ~ ~ I i i I I ~i CJ; H! ~; CiI Z I ~ ~I wi ~I ;1 ~I 31 I .,; . .. . . u . C (l) s... ..... ~ ~ rJ) >- . CiI . c.. ..:: ~ 0 co ~ ~I< eLl r:: r:: ..:( - o . c.. .;. - c: :J o (J -c c . "'i: . ..Q E :s U -W o o ~ ." .= . - . ..J 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 RHOADS ANN E CLECKNER AND FEAREN POBOX 11 847 111 LOCUST ST HARRISBURG, PA 17108-1847 -------- fold ESTATE INFORMATION: SSN: 195-38-8057 FILE NUMBER: 21-2001- 0716 DECEDENT NAME: NEDWICK ARLENE C DA TE OF PAYMENT: 09/13/2001 POSTMARK DATE: 09/12/2001 COUNTY: CUMBERLAND DATE OF DEATH: 07/08/2001 NO. CD 000259 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $4,900.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: ANN E RHOADS ESQUIRE CHECK# 93 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS $4,900.00 MARY C. LEWIS REGISTER OF WILLS \/ / b -c:2~~ - /0 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG~ PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ANN E RHOADS ESQ CLECKNER & FEAREN PO BOX 11847 HBG .02 !'1J\Y 17 P 2 :/10 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-20-2002 NEDWICK 07-08-2001 21 01-0716 CUMBERLAND 101 Allount Rellitted * REV-1547 EX AFP Ul-02) ARLENE C L:i:~, PA r~~~~- 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'EY=is4j-EX-AFP--(,l'-f:ozi--NO"ficE--OF-'rtiHEififANCi-YAX-APPRA-iSEMENY-,--ii.i-OWANCi-oi----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF NEDWICK ARLENE C FILE NO. 21 01-0716 ACN 101 DATE 05-20-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Hortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 44.410.61 .00 57.689.85 (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) (10) 14,045.58 547.81 (11) (12) (13) (14) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYIIBnt. 102,100.46 14.;93 39 87,507.07 .00 87,507.07 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 ~ 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 (15) .00 X 00 = .00 (16) 87,507.07 X 045 = 3,937.82 (17) .00 X 12 = .00 (18) .00 X 15 = .00 (19)= 3,937.82 TAX CREDITS: r",nCN' ICC~CJ.rl (+) AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 09-12-2001 CDOO0259 196.89 4,900.00 TOTAL TAX CREDIT 5,096.89 BALANCE OF TAX DUE 1,159.07CR INTEREST AND PEN. .00 TOTAL DUE 1,159.07CR . 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.) /6 - ~'/y'J- /GJ ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-U01 EX AFP CDI-Otl ANN E RHOADS ESQ CLECKNER & FEAR EN PO BOX 11847 HBG JUL -1 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-03-2002 NEDWICK 07-08-2001 21 01-0716 CUMBERLAND 101 ARLENE C .02 :07 Allount Rellitted \.~. ,- PA O:~:jl;9..8 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 .. REY=i6'iff-Ex-AFP-col-.:o2i-------.D--xNifERiTANc'E-yiX--STAfEME-tiy-CfF-iccouiff--...--------------------- ESTATE OF NEDWICK ARLENE C FILE NO. 21 01-0716 ACN 101 DATE 06-03-2002 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND~ IF APPLICABLE~ A PRO~ECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-20-2002 P R I NC I PAL TAX DUE: ..u.u..u.u.......u...............................u.u..................u....................._..........................u......................u...................u.u..........u........................... 3,937.82 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 09-12-2001 CDOO0259 196.89 4~900.00 05-15-2002 REFUND .00 1,159.07- TOTAL TAX CREDIT 3,937.82 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 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. ) PLEASE FILE TillS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION ~vI STATUS REPORT UNDER RULE 6.12 Name of Decedent: ARLENE c. NEDWICK Date of Death: 07/08/01 Will No.: Admin. No.: 2001-0716 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 Clerk of the Orphans' Court and may be attached to this report. Date: 05/30/02 ~~.~ Signature (MAH:rmtl AM;?) C"-l ~ ,.....A "" !" .~ -~ ........... ANN E. RHOADS, ESQUIRE Name (Please type or print) CLECKNER AND FEAREN 119 LOCUST STREET Address HARRISBURG, PA 17101 (717) 238-1731 Telephone No. \-.0 ;-"1 I --~ Capacity: Personal Representative x Counsel for Personal Representative R.W. - 27 R~-'5QDEXI5.{lOI REV-1500 OFFICIAL USE ONLY ../ Jtp- 24-'1- J[) ----~-~~------- FilE NUMBER 2 1 -~~ 00716 ----- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 INHERITANCE TAX RETURN RESIDENT DECEDENT COUNTY CODE YEAR NUMBER I- Z W C W U W C DECEDENTS NAME (LAST, FIRST. AND MIDDLE INITIAL) NEDWICK, ARLENE C. DATE OF DEATH (MM-DD-YEAR) 07/08/01 SOCIAL SECURITY NUMBER 195 38 8057 DATE OF BIRTH (MM-DD-YEAR) 03/16/48 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) None w ... ~:!!;CI.l "",>< w"" ,,00 ,,"'-' .." .. .. [i] 1. Original Return D 4. Limited Estate [X] 6. Decedent Died Testate (Attach copy afWill) D 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (date of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy of Trust) D 10. Spousal Poverty Credit (dafeofdeath between 12-31-91 and 1-1-95) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3, Remainder Return (date of death prior to 12-13-82) D 5. Federal Estate Tax Return Required .2... 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) ... Z W o Z o .. Ul W '" '" o " NAME FIRM NAME (If AjJplicable) Cleckner and Fearen TELEPHONE NUMBER 717-238-1731 COMPLETE MAILING ADDRESS Cleckner and Fearen 119 Locust Street P. o. Box 11847 Harrisburg, PA 17108-1847 OFFICIAL USE ONLY 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (1) 0 (2) 0 (3) 0 (4) 0 (5) 44,410.61 (6) 0 (7) 57,689.85 ............ d f-.....:I 'T' z o ~ ::l l- ii: <( u w Q:: 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 & Misceilaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & AdministraUve Costs (Schedule H) 14,045.58 547.81 :ro. ;t; - , .'J1 (8) 102,100.46 (9) (10) 10. Debts of Decedent, 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/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o !cc I-' ::l II.. :E o u ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 0 x.O_ (15) 87,507.07 ,-0 45 (16) x .12 (17) x .15 (18) (19) (11) (12) (13) 14,593.39 87,507.07 o 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibiing rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due (14) 87,507.07 o 3,937.82 o o 3,937.82 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Decedent's Complete Address: . STREET A~IfOSt inden Drive CITY Camp Hill I STATE PA PiP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 3,937'.82 o 4,900.00 207.25 Total Credits (A + 8 + C) (2) 5,107.25 (3) 0 (4) 1,169.43 (5) 0 (5A) 0 (58) 0 3. InteresVPenalty if applicable D.lnterest E. Penalty o o TotallnteresVPenalty ( D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Yes ...0 ...0 ..0 ..0 ....0 ..... lXI 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;....................... ........................................ ..................... b. retain the right to designate who shall use the property transferred or its income; ................. ...................... c. retain a reversionary interest; Of........................... ............................... . ............................ ........................ d. receive the promise for life of either payments, benefits or care? ........ .......................... ................... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....... ............................ .................................... .......................... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ........ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................... ..................... .............................. No [] [] KI IX] KI o ...~ 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN, Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. - - ~ DATE NEDWICK ADDRESS 110 Linden Drive, Camp Hill, PA c:'IaNATURE OF PREPA OTHER THAN REPRESENTATIVE ~-" ANN ADDRESS Cleckner and Fearen, 119 Locust 17011 DATE ~--OL E. RHOADS, ESQUIRE St., P.O. Box 11847, Harrisburg, PA 17108-1847 I For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 PS 99116 (a) (1.1) (i)]. For dates at 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. 99116 (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. 99116(a)(I.2)]. The tax rate imposed on the net value at transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(I)]. 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. 99116(a)(I.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. IlEV.l~EX.(I.U\ ~_ . .~ COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF NEDWICK, ARLENE C. FILE NUMBER 21-01-00716 Indude the proceeds of litigation and the date the proceeds were received by the estate, AU property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Members First Savings Acct. #132195-00 2,215.33 2. Members First Checking Acct. #132195-11 3,430.30 3. Members First C/D #132195-40 5 YR 17,212.34 4. Members First C/D #132195-42 5 YR 2,741.06 5. ~lembers First C/D #132195-43 5 YR 5/434.32 6. Members First C/D #132195-44 2 YR 9/679.26 7. 1992 Pontiac Grand Am automobile 3,000.00 8. 2001 Federal Income Tax Return 698.00 TOTAL (Also enteron line 5, Recapitulation) $ 44,410.61 (If more space is needed, insert additional sheets of the same size) REV-1510~X~il-97) ~ ..~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIV6s TRANSFERS & MISC. NON.PROBA TE PROPERTY ESTATE OF NED1,ICK, ARLENE C. FILE NUMBER 21-01-00716 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER 1, DESCRIPTION OF PROPERTY INCLlfoeHtENAMEOFTHETRANSFEREE,THEIRRELATIONSHIPTODECEDENTANO THE DATE OF TRANSFER ATTACH A COPV OF THE DEED FOR REA!. ESTATE DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST EXCLUSION TAXABLE VALUE IF APf>LICABLE) VarioIDs U.S. Savings Bonds, all payable on death to decedent's mother, Pauline R. Nedwick. Please see attached list. 57,689.85 100% 57,689.85 The Decedent had a retirement plan with the federal government. She was aged 53 at the time of her death and could not access the money in her retirement fund prior to age 59~ without incurring a penalty. The asset, therefore, is not subject to tax. TOTAL (Also enter on line 7, Recapitulation) $ 57,689.85 (If more space Is needed, insert additional sheets of the same size) , NEDIV!CK, ARLENE C. FILE NO. 21-01-00716 Attachment to Schedule G ESTATE OF ARLENE C. NEDWICK Value Face Amount Issue Date Julv 2001 1977 L 2096669788E $50.00 10/01/77 $209.72 L 2096677801 E $50.00 10/01/77 $209.72 L 21 07907116E $50.00 11/01/77 $192.32 L 21 07899868E $50.00 11/01/77 $192.32 L 21 07922957E $50.00 12/01/77 $192.86 L 21 07915490E $50.00 12/01/77 $192.86 1978 L 2115475481 E $50.00 01/01/78 $192.86 L 2112503922E $50.00 01/01/78 $192.86 L 2112496775E $50.00 01/01/78 $192.86 L2115481189E $50.00 02/01/78 $187.24 L 2115488893E $50.00 02/01/78 $187.24 L 2115509529E $50.00 03/01/78 $169.68 L 2115495960E $50.00 03/01/78 $169.68 L 2127528430E $50.00 04/01/78 $169.68 L 2127536073E $50.00 04/01/78 $169.68 L 2127512906E $50.00 05/01/78 $161.68 L 2127550160E $50.00 05/01/78 $161.68 L 2134442183E $50.00 06/01/78 $162.10 L 2134434772E $50.00 06/01/78 $162.10 L 2134451484E $50.00 07/01/78 $162.12 L 2134458464E $50.00 07/01/78 $162.12 L 2134466714E $50.00 08/01/78 $158.94 L 2139463341 E $50.00 08/01/78 $158.94 L 21394681 97E $50.00 08/01/78 $158.94 L 2139481696E $50.00 09/01/78 $158.94 L 2139474313E $50.00 09/01/78 $158.94 L 2139490702E $50.00 10/01/78 $158.94 L 2143790143E $50.00 10/01/78 $158.94 L 2143797567E $50.00 11/01/78 $160.46 L 2143804906E $50.00 11/01/78 $160.46 L 2143820396E $50.00 12/01/78 $160.88 L 2143813713E $50.00 12/01/78 $160.88 1979 L 2152371716E $50.00 01/01/79 $160.92 L 2152383426E $50.00 01/01/79 $160.92 L 2152378880E $50.00 01/01/79 $160.92 L 2167876070E $50.00 02/01/79 $157.76 L 2152389043E $50.00 02/01/79 $157.76 L 2167882271 E $50.00 03/01/79 $157.76 L 2167890211E $50.00 03/01/79 $157.76 L 2167897444E $50.00 04/01/79 $157.76 L 21679031 95E $50.00 04101/79 $157.76 L 217 4892890E $50.00 05/01/79 $159.28 L 2174898697E $50.00 05/01/79 $159.28 Value Face Amount Issue Date Julv 2001 1979 L 2174911557E $50.00 06/01/79 $159.66 L 2174906500E $50.00 06/01/79 $159.66 L 2174924843E $50.00 07/01/79 $159.66 L 2174919755E $50.00 07/01/79 $159.66 L 2174929385E $50.00 07/01/79 $159.66 L 2174934208E $50.00 08/01/79 $156.52 L 2174943033E $50.00 08/01/79 $156.52 L 2174949952E $50.00 09/01/79 $156.52 L 2174955120E $50.00 09/01/79 $156.52 L 2174961742E $50.00 10/01/79 $156.52 L 2174967154E $50.00 10/01/79 $156.52 L 2187990308E $50.00 11/01/79 $158.00 L 2187984684E $50.00 11/01/79 $158.00 L 2188004744E $50.00 12/01/79 $158.00 L 2187999213E $50.00 12/01/79 $158.00 1980 L 2188011496E $50.00 01/01/80 $118.38 L 2202872840E $50.00 01/01/80 $118.38 L 2188016278E $50.00 01/01/80 $118.38 L 2202877847E $50.00 02/01/80 $116.04 L 2202882848E $50.00 02/01/80 $116.04 L 2202892217E $50.00 04/01/80 $116.04 L 2202892215E $50.00 04/01/80 $116.04 L 2202892216E $50.00 04/01/80 $116.04 L 2203574198E $50.00 04/01/80 $116.04 L 22046061 04E $50.00 05/01/80 $117.20 L 2204600980E $50.00 05/01/80 $117.20 L 2204611 066E $50.00 06/01/80 $117.20 L 2204616479E $50.00 06/01/80 $117.20 L 23704631 EE $50.00 07/01/80 $117.20 L 23704630EE $50.00 07/01/80 $117.20 L 23716738EE $50.00 07/01/80 $117.20 L 23696918EE $50.00 07/01/80 $117.20 L 23724209EE $50.00 08/01/80 $113.78 L 2372421 OEE $50.00 08/01/80 $113.78 L 23734794EE $50.00 08/01/80 $113.78 L 23740729EE $50.00 09/01/80 $113.78 L 23751563EE $50.00 09/01/80 $113.78 L 23740728EE $50.00 09/01/80 $113.78 L 23761523EE $50.00 10/01/80 $113.78 L 23761522EE $50.00 10/01/80 $113.78 L 23768192EE $50.00 10/01/80 $113.78 L 31560592EE $50.00 11/01/80 $105.32 L 31551498EE $50.00 11/01/80 $105.32 L 31551499EE $50.00 11/01/80 $105.32 L 31567765EE $50.00 12/01/80 $105.32 L 31567764EE $50.00 12/01/80 $105.32 L 31577465EE $50.00 12/01/80 $105.32 Value Face Amount Issue Date Julv 2001 1980 L 31582684EE $50.00 12/01/80 $105.32 L 31582685EE $50.00 12/01/80 $105.32 1981 L 40902427EE $50.00 01/01/81 $105.32 L 40909207EE $50.00 01/01/81 $105.32 L 40909208EE $50.00 01/01/81 $105.32 L 40924511 EE $50.00 02/01/81 $103.26 L 40924510EE $50.00 02/01/81 $103.26 L 40917009EE $50.00 02/01/81 $103.26 L 40931591 EE $50.00 03/01/81 $103.26 L 48157136EE $50.00 03/01/81 $103.26 L 48157135EE $50.00 03/01/81 $103.26 L 48169865EE $50.00 04/01/81 $103.26 L 48169866EE $50.00 04/01/81 $103.26 L 48164924EE $50.00 04/01/81 $103.26 L 48177 462EE $50.00 05/01/81 $98.86 L 48183807EE $50.00 05/01/81 $98.86 L 48183808EE $50.00 05/01/81 $98.86 L 58465230EE $50.00 06/01/81 $98.86 R 3826499EE $200.00 07/01/81 $395.44 R 3827264EE $200.00 08/01/81 $387.68 R 7370537EE $200.00 09/01/81 $387.68 R 7371388EE $200.00 10/01/81 $387.68 R 7372537EE $200.00 12/01/81 $387.68 R 7373261 EE $200.00 12/01/81 $387.68 1982 R 7375171 EE $200.00 03/01/82 $380.08 R 7374427EE $200.00 02/01/82 $380.08 R 7376248EE $200.00 04/01/82 $380.08 R 7376943EE $200.00 05/01/82 $380.08 R 7377991 EE $200.00 06/01/82 $380.08 R 7376618EE $200.00 07/01/82 $380.08 1993 C 423433247EE $100.00 05/93 $74.52 C 413069012EE $100.00 05/93 $74.52 C 413035554EE $100.00 04/93 $74.48 C 423455863EE $100.00 06/93 $74.52 C 43664811 DEE $100.00 07/93 $74.52 C 436671201 EE $100.00 08/93 $72.64 C 439704276EE $100.00 09/93 $72.64 C 399621605EE $100.00 03/93 $74.48 C 446070473EE $100.00 11/93 $72.80 C 446047567EE $100.00 10/93 $72.64 C 399S96885EE $100.00 02/93 $80.24 C 391677379EE $100.00 01/93 $82.68 C 457814694EE $100.00 12/93 $72.80 Value Face Amount Issue Date Julv 2001 1994 1994 C 479600087EE $100.00 07/94 71.28 C 461806398EE $100.00 06/94 71.28 C 461781842EE $100.00 05/94 71.28 C 461736680EE $100.00 04/94 70.96 C 461759651 EE $100.00 04/94 70.96 C 461692592EE $100.00 02/94 70.96 C 461669326EE $100.00 01/94 72.8 C 461714656EE $100.00 03/94 70.96 C 479651925EE $100.00 09/94 69.48 C 479625439EE $100.00 08/94 69.48 C 479699763EE $100.00 11/94 69.68 C 479675881 EE $100.00 10/94 69.48 C 479722386EE $100.00 12/94 69.68 1988 C 166615991EE $100.00 01/01/88 $107.88 C 159955779EE $100.00 02/01/88 $105.76 C 160027149EE $100.00 03/01/88 $105.76 C 165624027EE $100.00 04/01/88 $105.76 C 165628364EE $100.00 05/01/88 $105.76 C 165680712EE $100.00 06/01/88 $105.76 C 182380776EE $100.00 07/01/88 $105.76 C 183849034EE $100.00 08/01/88 $103.68 C 183863785EE $100.00 09/01/88 $103.68 C 197089096EE $100.00 10/01/88 $103.68 C 197093940EE $100.00 11/01/88 $103.68 C 196676572EE $100.00 12/01/88 $103.68 C 178824756EE $100.00 07/01/88 $105.76 1989 C 196782485EE $100.00 01/01/89 $103.68 C 208022742EE $100.00 02/01/89 $101.64 C 208025622EE $100.00 03/01/89 $101.64 C 21 0201373EE $100.00 04/01/89 $101.64 C 21 0253923EE $100.00 05/01/89 $101.64 C 211535402EE $100.00 06/01/89 $101.64 C 225396748EE $100.00 07/01/89 $101.64 C211541297EE $100.00 07/01/89 $101.64 C 228538759EE $100.00 08/01/89 $98.68 C 230352797EE $100.00 09/01/89 $98.68 C 230358743EE $100.00 10/01/89 $98.68 C 232036691 EE $100.00 11/01/89 $98.68 C 242636579EE $100.00 12/01/89 $98.68 1990 C 242638540EE $100.00 01/01/90 $98.68 C 240731147EE $100.00 02/01/90 $95.84 C 255813073EE $100.00 03/01/90 $95.84 C 240889453EE $100.00 04/01/90 $95.84 C 255820041 EE $100.00 05/01/90 $95.84 C 258746986EE $100.00 06/01/90 $95.84 Value Face Amount Issue Date Julv 2001 1990 C 259778448EE $100.00 06/01/90 $95.84 C 263874350EE $100.00 07/01/90 $95.84 C 255345556EE $100.00 08/01/90 $93.04 C 258461204EE $100.00 09/01/90 $93.04 C 258524850EE $100.00 10/01/90 $93.04 C 265131821EE $100.00 11/01/90 $93.04 C 263121073EE $100.00 12/01/90 $93.04 1991 C 288882093EE $100.00 01/01/91 $93.04 C 281089218EE $100.00 02/01/91 $90.32 C 284757830EE $100.00 03/01/91 $90.32 C 290180198EE $100.00 04/01/91 $90.32 C 290280720EE $100.00 05/01/91 $90.32 C 302387248EE $100.00 06/01/91 $90.32 C 302392218EE $100.00 06/01/91 $90.32 C 309098708EE $100.00 08/01/91 $87.68 C 306380262EE $100.00 09/01/91 $87.68 C 324609864EE $100.00 10/01/91 $87.68 C 324611920EE $100.00 11/01/91 $87.68 C 324614458EE $100.00 11/01/91 $87.68 C 324616781 EE $100.00 12/01/91 $87.68 1992 C 324619260EE $100.00 01/01/92 $87.68 C 324624896EE $100.00 02/01/92 $85.16 C 326051571 EE $100.00 03/01/92 $85.16 C 377661106EE $100.00 04/01/92 $85.16 C 377665007EE $100.00 05/01/92 $85.16 C 362425958EE $100.00 06/01/92 $85.16 C 362472305EE $100.00 07/01/92 $85.16 C 362575392EE $100.00 08/01/92 $82.68 C 377570898EE $100.00 06/01/92 $85.16 L 481241217EE $50.00 09/01/92 $41.34 K 973592007EE $75.00 09/01/92 $62.01 C 361830169EE $100.00 09/01/92 $82.68 C 361841266EE $100.00 09/01/92 $82.68 R 8592201 DEE $200.00 09/01/92 $165.36 X 2194912EE $10,000.00 09/01/92 $8,268.00 M 45798424EE $1,000.00 09/01/92 $826.80 V 2360065EE $5,000.00 09/01/92 $4,134.00 V 2359240EE $5,000.00 09/01/92 $4,134.00 D 29906902EE $500.00 09/01/92 $413.40 M 45798422EE $1,000.00 09/01/92 $826.80 M 45798423EE $1,000.00 09/01/92 $826.80 C 370518972EE $100.00 10/01/92 $82.68 C 385229707EE $100.00 11/01/92 $82.68 C 391654299EE $100.00 12/01/92 $82.68 Value Face Amount Issue Date Julv 2001 1995 C 509922403EE $100.00 01/01/95 $69.68 C 509946148EE $100.00 02/01/95 $67.88 C 509969950EE $100.00 03/01/95 $67.88 C 521368517EE $100.00 04/01/95 $67.88 C 521390683EE $100.00 05/01/95 $65.76 C 521414101EE $100.00 06/01/95 $65.76 C 532892885EE $100.00 07/01/95 $65.76 C 532916179EE $100.00 08/01/95 $64.08 C 532938351 EE $100.00 09/01/95 $64.08 C 53622104 7EE $100.00 10/01/95 $64.08 C 536348201 EE $100.00 11/01/95 $64.04 C 536457296EE $100.00 12/01/95 $64.04 C 509993413EE $100.00 04/01/95 $67.88 1996 C 544678479EE $100.00 01/01/96 $64.04 C 549841959EE $100.00 02/01/96 $62.40 C 558247152EE $100.00 03/01/96 $62.40 C 558377738EE $100.00 03/01/96 $62.40 C 562305205EE $100.00 04/01/96 $62.40 C 562433640EE $100.00 05/01/96 $62.56 C 569639336EE $100.00 06/01/96 $62.56 C 569774729EE $100.00 07/01/96 $62.56 C 574915438EE $100.00 08/01/96 $60.92 C 575046465EE $100.00 09/01/96 $60.92 C 581 090597EE $100.00 10/01/96 $60.92 C 581201131EE $100.00 11/01/96 $61.24 C 581337546EE $100.00 12/01/96 $61.24 1997 C 590492096EE $100.00 01/01/97 $61.24 C 598472851EE $100.00 02/01/97 $59.64 C 598631315EE $100.00 03/01/97 $59.64 C 598760959EE $100.00 03/01/97 $59.64 C 598885909EE $100.00 04/01/97 $59.64 C 599034400EE $100.00 05/01/97 $61.16 C 596206413EE $100.00 06/01/97 $60.88 C 612294433EE $100.00 07/01/97 $60.64 C 612457512EE $100.00 08/01/97 $60.36 C 612601882EE $100.00 09/01/97 $60.08 C 617390023EE $100.00 10/01/97 $59.80 C 617529090EE $100.00 11/01/97 $59.44 C 622964125EE $100.00 12/01/97 $59.20 1998 C 623096766EE $100.00 01/01/98 $58.92 C 623248414EE $100.00 01/01/98 $58.92 C 637199159EE $100.00 02/01/98 $58.64 C 637324015EE $100.00 03/01/98 $58.40 C 641572003EE $100.00 04/01/98 $58.12 C 643293930EE $100.00 05/01/98 $57.84 Value Face Amount Issue Date Julv 2001 1998 C 645353744EE $100.00 06/01/98 $57.56 C 645463701EE $100.00 07/01/98 $57.28 C 645583809EE $100.00 08/01/98 $57.04 C 652115743EE $100.00 09/01/98 $56.76 C 652232996EE $100.00 10101/98 $56.52 C 657868332EE $100.00 11/01/98 $56.44 C 658683087EE $100.00 12/01/98 $56.16 1999 C 672689079EE $100.00 01/01/99 $55.92 C 669948114EE $100.00 01/01/99 $55.92 C 664725662EE $100.00 03/01/99 $55.40 C 664725663EE $100.00 03/01/99 $55.40 C 664725659EE $100.00 03/01/99 $55.40 C 664725660EE $100.00 03/01/99 $55.40 C 664725661EE $100.00 03/01/99 $55.40 C 665473536EE $100.00 04/01/99 $55.16 D 54142668EE $500.00 05/01/99 $275.80 M 72737539EE $1,000.00 05/01/99 $551.60 V 0010485201 $5,000.00 08/01/99 $5,580.00 2000 L S90752099EE $50.00 12/01/00 $25.46 TOTAL $57,689.85 REV.1~11E>(+ (1-97) '*' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NEDWICK, ARLENE C. FILE NUMBER 21-01-00716 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Reese Funeral Home, Inc. 911 N. 2nd Street 7,132.48 Harrisburg, PA 17102 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) None Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Yea~s) Commission Paid: 2 Attorney Fees Cleckner and Fearen 3,000.00 3. Family Exemption: ((f decedent's address is not the same as claimant's, attach explanation) Claimant Pauline F. Nedwick 3,500.00 Street Address 110 Linden Drive City CamP Hill State PA Zip 17011 Relationship of Claimant to Decedent mother 4. Probate Fees 8/3/01 100.00 5. Accountant's Fees 6. Tax Return Preparer's Fees - estimate 100.00 7. Cumberland Law Journal - advertising 75.00 8. The Patriot-News - advertising 113.10 9. Register of Wills - filing fees Inventlory and Inheritance Tax Return 25.00 TOTAL (Also enter on line 9, Recapitulation) $ 14,045.58 (If more space is needed, insert additional sheets of the same size) . . REV-I';\l EX' {\-;~\ '. . SCHEDULE) DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEA1,.THOF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21-01-00716 ESTATE OF NEDIHCK, ARLENE C. Include unreimbursed medical expenses. ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. AMOUNi DESCRIPTION Chase Mastercard Acct. #5491-0406-3098-0820 295.56 Fleet P1atinium Mastercard Acct. #5491-0000-6349-2693 8.18 Hecht's Account #896-693-55 37.44 Wa1mart Account #6032-2074-6045-9365 17.98 American Express Acct. #3722-815523-0100 63.49 AAA Financial Service: Acct. #4264-2960-2406 7370 2.90 Quantum Imaging & Therapeutic Associates, Inc. Acct. #460991A93 36.00 Holy Spirit Hospital 10.50 Quest Diagnostics 37.50 2001 Pa. Income Taxes 38.26 547.81 TOTAL (Also enter on line 10, Recapitulation) S (It more space is needed, insert additional sheets of the same sIze) "[""""""'~{) "w COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NEDWICK, ARLENE C. SCHEDULE J BENEFICIARIES FilE NUMBER 21-01-00716 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do t:olllsl Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1. Pauline F. Nedwick 110 Linden Drive mother entire Camp Hill, PA 17011 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17. AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II . ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0 (II more space Is needed, insert additional sheels otthe same size) ~ " , ~~ ~u ~~ ~ w ~z , , LAST WILL AND TESTAMENT OF ARLENE C. NEDWICK I, ARLENE C. NEDWICK, of Lower Allen Township, Cumberland County, Pennsylvania, declare this to be my Last will and Testament and revoke any and all wills and codicils heretofore made by me. ITEM I: My personal representative shall pay from the residue of my estate the expenses of my last illness, funeral and burial debts duly allowed against my estate, and estate taxes occasioned by my death and incurred with respect to property passing by this will. ITEM II: I bequeath those articles of my automobiles, personal effects, household goods, and other tangible property of like nature (not including cash or securities) together with any existing insurance thereon, as set forth in a separate memorandum which I shall place with my will to the persons therein designated. If I shall leave no separate memorandum, or with regard to my automobiles, personal effects, household goods, and other tangible personalty of like nature (not including cash or securities) not referenced by such memorandum, I bequeath such property to my Mother, PAULINE F. NEDWICK. ITEM III: I devise and bequeath the residue of my estate, of every nature and wherever situate, to my Mother, "", , ,,<-'< ""U \ .r-i '. :3 '0 <1! "'.~Z , U \~ <1! , " .~ Q.l _rl " ...... ':"'..::: v :--J -....- ,~ 2 PAULINE F. NEDWICK. Should my Mother, PAULINE F. NEDWICK, predecease me, I give, devise and bequeath the residue of my estate, of every nature and wherever situate, to the following organizations in the following shares: 25% to: The Salvation Army 1122 Green Street Harrisburg, PA 25% to: Bethesda Mission 611 Reily Street Harrisburg, PA 25% to: Humane Society West Shore Shelter Sinclair & Eppley Roads Mechanicsburg, PA 25% to: The Nature Conservancy-Pennsylvania Chapter 1815 North Lynn Street Arlington, VA 22209 ITEM IV: I appoint my Mother, PAULINE F. NEDWICK, Executrix of this my Last will and Testament. Should my Mother, PAULINE F. NEDWICK, fail to qualify or cease to act as Executrix, I appoint TAYLOR P. ANDREWS, ESQUIRE, of Andrews & Johnson law office of Carlisle, Pennsylvania, as Executor of my estate. ITEM V: I direct that my Executrix and her successors shall not be required to give bond for the faithful performance of their duties in this or any other jurisdiction. 3 IN WITNESS WHEREOF, I, ARLENE C. NEDWICK, have hereunto set my hand and seal to this my Last will and Testament, consisting of three (3) typewritten pages, each of which bears my signature, this I ( day of -, :t;/ ( \ r ~ '~/7 ~ -" \ -(.~~j , 1991. G;'1 VfJ7l1 C rj 7J2~.(,/k (SEAL) Arlene C. Nedwxck, Testatrix COMMONWEALTH OF PENNSYLVANIA) COUNTY OF CUMBERLAND SS. WE, ARLENE C. NEDWICK, TAYLOR P. ANDREWS, and Sle,<'14~ /:3. ,G~7:;,^, , , the Testatrix and witnesses, respectively, whose names are signed to the foregoing or attached instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as and for her Last will and Testament and that she signed willingly and that she executed as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the will as witnesses and that to the best of their knowledge the Testatrix was at the time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. ~ -~ Andrews, witness C~YlOr P. /.. A_~'L .. .Kff". ---- <:...J. .~ , witness Subscribed, sworn to and acknowledged before me by ARLENE C. NEDWICK, the Testatrix, and subscribed to~d sworn or affirmed to before me by TZ;YLOR P. AND~EWS and ~,<'q?N'< /.3. ~.s"r-- , wl.tnesses, thl.s //:Y. day of C.o0&~ , 1991. ~hrd", ~-AeA"" Notary Public (SEAL) Brenda Notarial Seal . L Blehm, Notary Public I Carli.>l9 Bore CU""-'--" Coun M Co; . .' "'-_OJ Iy Y """'.'"00 Expires Jan. 6, 1992 !