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Home My WebLink About01-0739 Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Lois T. Tarr also known as No. .2/'" 6 ,-- 73q , Deceased Social Security No. 118 - 01- 7934 Barbara S. Palmer Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) IT] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut r ix named in the last Will of the Decedent, dated 03/17/1989 and codicil(s) dated None Earl G. Tarr died May 30, 1989 State relevant circumstances, e.g., renunciation, death of executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: none D B. Grant of Letters of Administration (c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: I Name Relationship Residence I (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her last family or principal residence at 226 8th Street, New Cumberland Borough (list street, number, and municipality) Decedent, then ~years of age, died 07/27/2001 at Manor Care Health Service, PA (Location) 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 80,000.00 $ $ $ $ situated as follows: none T ed or rinted name and residence Barbara S. Palmer 226 8th Street, New Cumberland, PA 17070 /{,-j{9-b Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991) 21-01-739 Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal repre tative(s) of the Decedent, Petitioner(s) will well and truly administer the state according to law. ck before me this L day of Sworn to or affirmed and subscribed ~ ,~I No. 21-01-739 Estate of Lois T. Tarr Deceased Social Security No: 118- 01- 7934 Date of Death: 07/27/2001 AND NOW, AUGUST 9. 2001 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters [!] Testamentary D Of Administration (c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate) are hereby granted to Barbara S. Palmer in the above estate and that the instrument(s) dated 03/17/1989 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters. . . . . . . $ 200.00 '--Jr)17~ ~wJ. ~,tftJ.. ~ a~fH<q. , Register of Wills / Short Certificate(s). .2. $ Renunciation. $ Affidavits ( $ Extra Pages ( 5 ) . $ Codicil. $ JCP Fee. $ Inventory. $ Other $ TOTAL. $ 6.00 Attorney: Donna M. Mullin 1.0. No: 30392 JAMES, SMITH, DURKIN & CONNELLY 134 Sipe Avenue 15.00 Address: Hummelstown, PA 17036 5.00 Telephone: 717/533 - 3280 FILED AUGUST 9, 2001 MAILED LETTERS TO ATTORNEY 8-10-01 226.00 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991) 10<;.80<; RFV 9/8(, This is to certify that the information here given is correctly copied fro~ an original certificate of death dul~ 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. p 7619036 Fee for this certificate, $2.00 ) Rev. 2187 NAME ~ DECEDENT (For.. Middle. LaII) t. Lois UNDER , YEAR MonItl8 Ollya Cumberland .. No. ~L~e~ JUL 3 0 2001 Date COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH 8IAT~ (Cly and PlACE ~ DERH4Ct>ecl& .,.....,.",. - .... .....,uct.ons on _ .. S-or Fct8l\ll'CounllYl HOSPITAl.; OTHER: Deposit ,NY ......._0 ~O ~rl 7. ... FACILITY NAME 1M no! ",...-..-. ~ SUHl and numllIIf. Camp Hill Borough Manor Care Health Service ... KINO ~ 8USlHESS/lNOUSTRY T. Tarr sremale a. UNDER , 0111I HculI ! ........ to. DECEDENT'S USUAl 0CCUflQl0H I~.:=:'=:oc:r::~:r n..homemaker n domestic IllECEIlENT'S MAIUNG ADDAESS (SIr"'~, SIMa. l"opCode! DECEDENT'S 226 8th Street :r~~ New Cumberland, PA 17070 ::-..::::- t.. FMlV'S NAME IF"st. MiOclIe. LaII) t;rnest 11. ~'a~ (TypeIf'rinI) ... ~~~ ~D:::: c.--.O It.. Old ...... Mill. ,7It.~ Cumberland -.Np? 17"'~ =--===ar Tha t che r MOTHf."asm iForst. Moclde. M_Surnamel Harrie t t ". INFORMANTS IoWUNOADOAESS(Slr.... ~ ~ ZipCodeI .J268th Street, New Cumberland, PA 17070 PlACE OF 0lSP0Sm0N. Name 01 c.-..y. Cr...-y ~0CRl0N' Cily(Ibwn. SlaIe: Zip ~ lit OIlIer ..... Ite. Oakwood Cemetery . I~~ .... of Depo~t, NY A. S. Palmer "--'1Iom.....0 STRE FIlE NUUIIEA SOCIAL SECURfl'l' NUMBER :a118 -01 7934 DATE ~ OEATH IM~. Oa~. ...., .. July 27, 2001 ~O MAflITAL STATUS. Married N_ ....._. Widuwed. ~(SpecIy) widowed 14. "c.O .... cIecedenlll\oecl 110 SUfMVlNG SPOUSE 1M..... \lIW-- ....! New Cumberland ~., Beck ........ 24-28 _lie ClDlIlIlIMed by .=;"'-_"-dNIII. :N. JJl:.50 (J M. 21. a ~. ~ if: ....,. f: E_1he cliMaMs. injuNS 01 ~ wIliCII c:iUMCllhe deadl. 00 __Ihe mode 01 dyiIIg. suc/la _lIIK 01 ,aspiralory .11". _ 01_""'.. i ~ LisloNy__onNCll_. :=-..= -..aTE CAUSE IF.... _lItcondilion _I-.Iing on ClUIIlI- =~..____ b .-:iI' ~ -.no 10......... I' :=_. E.- UNDEJlL.Y1NG __ ~ lOiseMeOlIlllUfY c. -...~- 4iii'....-ng on deeIIl)l.AlT d- '. WI'S AN AUlOPSY WERE AU10PSY FINDINGS .;;;PERFOflME01 ~~~SE '= 0EATH1 "". ...ONo ...0 PART .: OIlIer signiIIcanl ClllIlCIlIiana c:anlriIIuling 10 dNdl. but lllII,-, III -llIIdellWilllI- gIMl iIll'MT I. c.. ~p Q. ........ Hamicide ........~ O OREOFIHJURY .I~~ (Month. Day. ....) o o PlACEOf' lNJUl'ly. Alhome. .......IUHt..acIOfy.CIllIi:e u. tluiIdIng. -.lSpecllvl ... ~:::-[~:~~- Loc.crlOHcs.-.~ ~- --- --- - ---- NoD MANNER OF OERH ~ o o Could IlOI be deI_ Aa:idenl Suicide ... 2a. CERT.... rCheck........ onet "CERTIFYlNG PHYSICIAN (Ph.,...,., ~ cauMoI dull> _ anolhlII ll/>vIoC- "'". pI~ de""'.na Ccmpleled IItorn 231 To........."'Y"--lIe..-GCCUrNoIt-,.....""...e(.I--.-__.................................................... . :; '.!!iI .-; :3 ~ ~ a. -"RONOUNCING AND CERTIFYINGI'ltYSICIAN (PhysIaan llOOn pronouncong oed> ...a cerulyorlg 10 U.... '" "."1 To""" ar my........... de.... GCCUrNoIt .. .... _. dala. and plec.. and _ to.... caUM(sl_ m......'.s ."Ied.. . . . . . . . . . . . . . . . . . . . . . . . . ".DICAl EllAIIINEAICOAONER On \he besIe of ..amlnatlon and/or Inv.st..,ion. in my opinion. daaU. occun.d at'he Ikne. dal.. and plK.. and due 10 the cauM(sl and _ a. "atad.. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . .. . . . . . . . . . . . .... . . . . . . . . . . . . . .. ... . . . . .. . . . . " . . . . . . . . . .. ... 31.. REGISTRAR'SSlGNRURE ANONUM~ ~ U. ~ 12,/1'2-,/1/1 :tOt. ~:~_~~:R:::__ft...~[.~r-~ o r:NSE~~~-~qS"~-ET-1::1i~.~':I;:. , NAME AND ADOAESS~ PERSON WHOCOUPlETEO CAUSE ~ DERH (hem 27) Type lit Prine TY ,.., t>.4"'" , 0 f:J L 0..... 'ti, a.v- l..e,.tt.?'l'N E... P.z. , 70 't"'3 o 34. . , LU' WILL UD ""adM' or 21-01-739 LOIS ,. ,aDD I, Lois T. Tarr, of New Cu.berland, Cu.berland County, Pennsylvania, being of sound and disposing aind, .e.ory and understanding, do hereby .ake, publish and declare this as and for.y Last Will and Testa.ent, hereby revoking any and all prior Wills and all Codicils .ade by.e at any ti.e heretofore. IYIN 1. I direct that all .y legally valid debts, funeral and adainistration expenses, and inheritance and estate taxes incurred on account of ay death shall be paid by .y personal representatives out of ay residuary estate as soon after ay death as practicable. I~ 2. I give, devise and bequeath all the rest, residue and reaainder of ay estate, of every nature and wherever situated to ay husband, Earl G. Tarr, provided that he survive ae by a period of one hundred twenty (120) days. Should Earl G. Tarr not be living on the one hundred twentieth (120th) day after ay death, then I give, devise and bequeath all the rest, residue and re.ainder of my estate unto.y daughters, Barbara S. Palmer, Anne E. Stacy and Nancy J. Stone, in equal shares per capita and not per stirpes. IYIN 3. hereto shall alienation. No interest of any beneficiary under this lill or any Codicil be subject to anticipation or VOluntary or involuntary Page One of Three (~. . " c1 'Q"~' , / - ' '~',.. /' '- ,tf (~ ' (,(/1./ t.....-' Lois T. Tarr . .. .. IBM 4. My Executor acting hereunder shall have the following powers in addition to those vested in hia by law and by other provisions of this lill, applicable to all property, real, personal and aixed and wheresoever situated, including property held for ainors, whether principal or incoae, exercisable without court approval and effective with respect to each itea of said property, until actual distribution: 1. To retain as investaents of ay estate, any or all of ay estate, real or personal or aixed, without regard to any principal of diversification, and to hold any or all of such real and personal property retained or acquired without aaking the saae productive of incoae; B. To pay all taxes, charges and expenses of aaintenance, upkeep, iaproveaent, developaent, protection, preservation and investaent of any retained or acquired real or personal property, such payaents to be aade froa either principal or Incoae as ay said Executor shall deteraine; c. To retain or invest any and all funds, whether principal or incoae, in any real or personal property, without restrictions to legal investaents; D. To purchase investaents at preaiu.s; to exercise all rights of a security holder or shareholder in any corporation; and to lease, aortgage, pledge, give options upon or sell at public or private sale and without approval of any court and without any responsibility to the buyer or buyers to see to the application of the purchase price, any real or personal property, or portion or portions thereof, irrespective of the aanner or the aeans by which the saae was acquire by .y said Executor; Page Two of Three ~4u 02 Lois T. Tarr /l (?/ ad,Lr # E. To .ake any payaent or distribution herein provided for in cash or in kind, or partly in cash and partly in kind, at valuations fixed by ay Executor at the ti.e of distribution. I~ S. Mo fiduciary acting hereunder shall be required to post bond or enter security in any jurisdiction. IHM 6. I no.inate, constitute and appoint .Y husband, Earl G. Tarr, as .Y Executor of this ay Last Will and Testa.ent. If he does not act or continue to act as .y Executor, then I no.inate, constitute and appoint Barbara S. pal.er, as Executrix of this, .Y Last Will and Testa.ent. If she does not act or continue to act as .y Executrix, then I no.inate, constitute and appoint .y daughter, Anne E. stacy as Successor Executrix of this. If she does not act or continue to act as .y Executrix, then I no.inate, constitute and appoint .y daughter, Maney J. Stone, as Successor Executrix of this, .y Last Will and Testa.ent. II IIfRlSS lHI2~r, I set.y hand and seal to this, .y Last Will and 'I'estallent, this 11- day of ~ 1989. Page Three of Three . ~ \~'~ ;,).r'"'( ,~,_ ~/ V) t>"t6Zj _./, // t-t..-. ~( Lois T. Tarr The preceding instruaent, consisting of this and three (3) other typewritten pages, signed at the bottoa of each page for security purposes, was on the date thereof signed, published and declared by Lois T. Tarr, the Testatrix herein naaed, as and for her Last Will and Testaaent in our presence, who, at her request, in her presence and in the presence of each other, have subscribed our naaes as witnesses whereof. ~,hr.~~ WI '1'11188 ~~. ITNE8S .'" C(IH)IIDL!II or '_8IL'UI1 COOl,., 0' I, Lois T. Tarr, the Testatrix whose naae is signed to the attached or foregoing instruaent, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instruaent as ay Last li11; and that I signed it willingly and as ay free and voluntary act for the purposes therein expressed. Sworn to or aff~aed and acknowledged before ae by Lois T. Tarr, the Testatrix, this /7 day of 1YJ~/. 1989. '-15 7 ~r (-7f tf-tiL/ ~/, C/{;U,{./ Lols ,. 'arr tq. ~~ ~IIY '~IC Nota;:;;;'-s~~;'----"'----'~' . Marie K. Setter, Notary Public d New Cumberland Bore. . cumbe.rlan.d County My Commission EXDir~ C.iC! 26,199" Mi';"tll~~r, P~fl~"',ll."ll';". ':'''''~v,,':- '('1':-0-' I"I"'~;' "9$ "Jf '- IIf.;Ol. . ....,..) ..A":J. J...;j t I' ')~"..Il"" .." aGlIIOU.AI.... or ...."'..11 COUIft or ~ Ie, J..,U/Et.t...fi{ 5H EI.. 7 ZoZ( and ME'PA BilL fI Ai , the witnesses whose naaes are signed to the attached or foregoing instruaent, being duly qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the instru.ent as her Last Will; that the Testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the Testatrix signed the lil1 as a witness; and that to the best of our knowledge the Testatrix was at that tiae 18 or .ore years of age, of sound alnd and under no constraint or undue influence. Sworn to or affiraed and subscribed to before .e by LU'e,-~,f-,4(. SA-( {:c..; Z-t,p and FREi>R iJ/lloAl , witnesses, this ~y of fr;~ . 1989. ~ j", k.aF ~.ltnelS . ~ ~~~~ 1IM1IY P I G---t~~:.;;;;::~;:.:u' ...~.. .-....---.- , Marie K. Softer, Notary Public .N.ewcumOOrland Boro., Cumb.. orland County I . MYCOmmissio~E:~r~~:t 26, 1991 ~ M!:liflbl=lr, PI'1nnSvlV8ma ,':'$)(,iahon of Notaries e: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: LOIS T. TARR Date of Death: July 27,2001 Will No. Adm. No. 2001-00739 To the Register: I certify that notice of 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 August 21,2001. Nancy 1. Fern Address 226 8th Street, New Cumberland, PA 17070 1490 NW 64th Terrace, Kansas City MO 64118 ~ Barbara S. Palmer Anne E. Tarr 3000 Monterey Ave SE, Albuquerque, NM 87106 Notice has now been given to all personal entitled thereto under Rule 5.6(a) except Date: 0/9--[/0 I , Signature ~ /11. ~, Name Donna M. Mullin Address 134 Sipe Avenue Hummelstown, P A 17036 Telephone (717) 533-3280 Capacity: Personal Representative x Counsel for Personal Representative ;: ... Register of Wills of CUMBERLAND County, Pennsylvania INVENTORY Estate of Lois T. Tarr No. 2001- 00739 Date of Death 07/27/2001 also known as ,Deceased Social Security No. 118 - 01- 7934 Barbara S. Palmer, Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I /We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Donna M. Mullin Esq. Attorney: 1.0. No.: 30392 Address: 134 Sipe Avenue Hummelstown, PA 17036 Telephone: 717/533-3280 P.~:i:::::r.&~ ~ ~ Barbara S. Palmer Signature: Address: 226 8th Street New Cumberland, PA 17070 Telephone: 717/774-2261 11(10/ ;)'i)v I Dated: Description Value (See continuation page(s) attached) (Attach additional sheets if necessary) Total: 54,252.27 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form #RW-7 (1992) . .. ... Estate of: Date of Death: County: INVENTORY Lois T. Tarr 07/27/2001 Cumberland CASH: Insurance premium refund 158.45 Waypoint Bank - Checking Account #700028220; Opened 10/24/1986; Held in decedent's sole name alone 2,820.98 Accrued interest through date of death 0.49 Waypoint Bank - Savings Account #760009128; Opened 10/24/1986; Held in decedent's sole name alone 42,323.68 Accrued interest through date of death 45.92 Zacharias Funeral Home, Deposit, New York - Pre-Paid funeral 7,102.75 52,452.27 PERSONAL PROPERTY: Gold coins in safe deposit box - appraised value 1,800.00 1 ,800 . ( -1- .' .~ TOTAL RECEIPTS OF PRINCIPAL............... 54,252.27 -2- 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 MULLIN DONNA M 134 SIPE AVENUE HUMMELSTOWN, PA 17036 u______ fold ESTATE INFORMATION: SSN: 118-01-7934 FILE NUMBER: 21-2001- 0739 DECEDENT NAME: TARR LOIS T DA TE OF PAYMENT: 10/18/2001 POSTMARK DATE: 10/17/2001 COUNTY: CUMBERLAND DATE OF DEATH: 07/27/2001 NO. CD 000401 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $3,088.62 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: DONNA M MULLIN ESQUIRE CHECK#102 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS $3,088.62 MARY C. LEWIS REGISTER OF WILLS 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 CHURCH ROBERT R P.O BOX 11963 210 WALNUT ST HARRISBURG, PA 17108-1 963 -------- fold ESTATE INFORMATION: SSN: 162-22-1098 FILE NUMBER: 2101-0793 DECEDENT NAME: KANARR WILLIAM R DA TE OF PAYMENT: 02/26/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: OS/27/2001 NO. CD 000890 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,496.72 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: ROBERT R CHURCH ESQUIRE CHECK# 11 658933 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS $1,496.72 MARY C. LEWIS REGISTER OF WILLS "" /6-021"9-.6 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ReCOfGE;G Regis\J;r- of Viills DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 12-10-2001 TARR 07-27-2001 21 01-0739 CUMBERLAND 101 .01 ole 17 P12 :03 DONNA M MULLIN ESQ JAMES ETAL 134 SIPE AVE HUMMELSTOWN Clerk" _, PA 'H~enancj PA * REV-1541 EX AFP [12-00) LOIS T A.ount Re.itted ) CHANGED 1I) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 54,252.27 4,250.00 25,879.23 (8) 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=is4-j-iif-AFP-fi'2=ocir-NCffici--OF-i-NHijfiTANCi-y-A'X-jrPPRA-isiifEN:r,--ALi-oWANCi-o"R-------------- --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF TARR LOIS T FILE NO. 21 01-0739 ACN 101 DATE 12-10-2001 TAX RETURN WAS: (X) ACCEPTED AS FILED 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 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad.. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Govern.ental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax 10,044.09 2.088.99 1I1) 1I2) 1I3) 1I4) (9) lID) NOTE: To insure proper credit to your account, sub.it the upper portion of this for. with your tax pay.ent. 84,381.50 12 133 08 72,248.42 .00 72,248.42 NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ~ returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate 16. A.ount 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 lIS) .00 X 00 = .00 1I6) 72,248.42 X 045 = 3,251.18 1I7) .00 X 12 = .00 1I8) .00 X 15 = .00 1I9)= 3,251.18 TAX CR~DITS: PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 10-17-2001 CDOO0401 162.56 3,088.62 TOTAL TAX CREDIT 3,251.18 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.) 'j;{ , C/ STATUS REPORT UNDER RULE 6.12 Name of Decedent: LOIS T. TARR Date of Death: July 27.2001 Will No. Admin. No. 2001-00739 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 Orphan's 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. ...- E: ~7l1.~' Signature Donna M. Mullin. ESQ..uire JAMES. SMITH. DURKIN & CONNELLY 134 Sipe Avenue Hummelstown. P A 17036 (717) 533-3280 Date: 'i 11/0 J -- () r- 'Ct . . ~ c...J o 'i"'") .,'.Sf Capacity: _ Personal representative _X_ Counsel for personal representative ;;:~~I:fi (:5 'f:h u ~J) (DCC a: .,- p , :''L) ;,.0 cE \1)- GO c:2/-CJ 1- "'7.39 LAW OFFICE JAMES, SMITH, DURKIN & CONNELLY LLP P. 0. BOX 650 HERSHEY, PENNSYLVANIA 17033-0650 Mary C. Lewis, Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, P A 17013-3387 /'~~.~':~'-' ~'o ' '. i ( .;.s. pc' ~:~rh(e:i:' +r \ ~~~~"'i ~ ::>::l:1r.. '~ ~ .L......./' ~ 1"'.... 'W," I! ,...\ ~ :A~?~'/ U Of), ' U ; \ / * '''''-. P A / : -1 1'--1 [ T E P : S '} (~ c: S ..;.. '...... -- - .-~-"'/ ' REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT REV-1S00 EX + (6~OO) CAPB HpRL EplO CRAC KOTK ES o E C E o E N T COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128.0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Tarr Lois T. DATE OF DEATH (MM-DO-YEAR) OFFICIAL USE ON!.. Y FILE NUMBER 21-01-0739 NUMBER COUNTY CODE YEAR SOCIAL SECURITY NUMBER 118-01-7934 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMB R 1 3 date of death . AemalnderReturn prior to 12-13-82) S. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes DATE OF BIRTH (MM-DD-YEAR) 07/27 2001 05/09/1919 IF AP L1CABLE Sl.!AVIVING SPOUSE'S NAM LAS, FIRS ,AND MIDDl..E INITIAL X 1. Original Return 4. LImited Estate X 6. Decedent DIed Testate (Attach copy of Will) o 9. LItIgation Proceeds Received 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12~12~82) 7. Decedent Maintained a UvingTrust (Attiilch copy of Trust) 010. Spousal Poverty Credit (date of death between 12-31~91 and 1-1~95) o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) C P o 0 R N R 0 E E S N T C o M P T U A T X A T I o N h COMPLETE MAILING ADDRESS Donna M. Mullin Es . FIRM NAME (If Applicable) JAMES, SMITH, DURKIN & CONNELLY, LLP TELEPHONE NUMBER 134 Sipe Avenue Humme1stown, PA 17036 533 - 80 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscetlanecus Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. T cta' Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (line 12 minus Line 13) (1) (2) (3) R E C A P I T U L A T I o N (4) (5) None None None OFFICIAL USE ONLY (6) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of L.ine 14 taxable at collateral rate 19. Tax Due 20. 72,248.42 None 54,252.27 4,250.00 25,879.23 10,044.09 2,088.99 (8) 84,381. 50 (11) 12,133.08 (12) 72,248.42 (13) (14) 72,248.42 X X X X .0 0 .045 .12 .15 (15) (16) (17) (18) (19) 3,251.18 3,251.18 CopyrIght (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 226 8th Street CITY I STATE I ZIP New Cumberland PA 17070 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 3,251. 18 162.56 Total Credits ( A + B + C) (2) 162.56 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E) (3) 4. \f Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58) Make Cheek Payable 10: REGISTER OF WILLS, AGENT "';"i;!ii;!i!iiiHn::[[ijii!jil!FH i:i;;!;!lii:ii>i,:;;::;:::::>:""" '" . .....::;:.:::;,;:;~;::;:;:;:::::m:::::::::::::'.:. .'. "":';'::;;'::I;:i;;i; !:iiiiW:W::' ::i:::::;:::::::;::;::,:..... ."".",::,;!;!;!:!!!!;:!:!::,)!:""""""" . .... FiLEASEANSWER THEFOLLOWINGGUESTiONSSY pLACING AN i:'~'i:' iNiHE 'APPROPRIATE-SLOCKS 1. 3,088.62 3,088.62 Did decedent make a transfer and: a. retain the use or income of the property transferred; b. retain the right to designate who shall use the property transferred or its income; . c. retain a reversionary interest; or. d. receive the promise for life of either payments, benefits or care? 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? IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Yes No ~~ o o o [R] [R] [R] Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledgeal1d belle~, 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. Barbara S. Palmer 226 8th Street --------------------------~-----------~-------------- New Cumberland, PA 17070 SIGNATURE OF PREPARER oTHER THAN REPRESENTATIVE JAMES, SMITH, DURKIN & CONNELLY, LLP S Avenue DATE )O./(j.ot DATE lo/p/OI 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. 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. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2) [72 P.S. 91 16(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, 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. Copyright (c) 2000 ~orm software only The lOlckner Group, Inc. Form REV-1500 EX (Rev. 6-00) REV-1S08 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCETAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Lois T. Tarr SS# 118-01-7934 07/27/2001 21-01-0739 Include the proceeds of litigation and the date the proceeds were received by the estate. AU property jointty-owned with the right ot survivorship must be disclosed on Schedule F. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 158.45 Insurance premium refund 2 Waypoint Bank - Checking Account #700028220; Opened 10/24/1986; Held in decedent's sole name alone 2,820.98 Accrued interest on item 2 to date of death 0.49 3 Waypoint Bank - Savings Account #760009128; Opened 10/24/1986; Held in decedent's sole name alone 42,323.68 Accrued interest on item 3 to date of death 45.92 4 Zacharias Funeral Home, Deposit, New York - Pre-Paid funeral 7,102.75 5 Gold coins in safe deposit box - appraised value 1,800.00 TOTAL (Also enter on line 5, Recapitulation) $ 54,252.27 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97) REV-1509 EX + (1-97) COMMONWEAL.TH OF PENNSYL.VANIA INHERITANCET/J:X RETURN RESIDENT DECEDENT ESTATE OF Lois T. Tarr SCHEDULE F JOINTL V-OWNED PROPERTY SS!I 118-01-7934 07/27/2001 FILE NUMBER 21-01-0739 If an asset was made joint within one year of the decedent's date of deathl it must be reported on Schedule G. A. SURVIVING JOINT TENANT(S) NAME Nancy J. Fenn ADDRESS 1490 NW 64th Terrae Kansas City, MO 64118 RELATIONSHIP TO DECEDENT Daughter B. c. JOINTLY-OWNED PROPERTY, LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of flnancfallnstltutfon and bank DATE OF DEATH DECO'S VALUE OF account number or sImilar fdentlfy(l"\g number. NUMBER TENANT JOINT Attach deed for Jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1 A 04/01/74 V.S Savings Bonds Series H; 8,500.00 50.007, 4,250.00 issued 04/1974 - 9 bonds all jointly held with daughter, Nancy J. Fenn TOTAL (Also enter on line 6. Recapitulation) $ 4,250.00 (If more space is needed insert additional sheets of the sa.me size) Copyright (c) 1996farm software only Cpsystems,lnc. Form REV-1509 EX (Rev. 1~97) REV-1510 EX + (1~97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Lois T. Tarr SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY SSjl 118-01-7934 07/27/2001 FILE NUMBER 21-01-0739 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. DESCRIPTION OF PROPERTY % OF ITEM RELAW5~Mgl~ t~b~~5f~l~~J~A~1f}T~E5F ~~~I~SFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER ATTACH A COPYOF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST QF APPLICABLE) 1 Jackson National Life 25,879.23 25,879.23 Insurance Company - Annuity jI0058962790; Beneficiaries are daughters Nancy Fenn, Barbara Palmer and Anne Tarr TOTAL (Also enter on line 7, Recapitulation) $ 25,879.23 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1510 EX (Rev. 1-97) REV-1511 EX.. (1-97) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHEAITANCETAX RETURN RESIDENT DECEDENT ESTATE OF Lois T. Tarr SSlI 118-01-7934 07/27/2001 FILE NUMBER 21-01-0739 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 Zacharias Funeral Home, Dep os it, New York - Funeral bill 7,102.75 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name oi Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative{s) Street Address City State Zip - Year(s) Commission Paid: 2. Attorney's Fees JAMES, SMITH, DURKIN & CONNELLY, LLP 2,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip - Relationship of Claimant to Decedent 4. Probate Fees Register of Wills 226.00 5. Accountant's Fees 6. "Tax Return Preparer's Fees 7. Other Administrative Costs 1 Cumberland Law Journal - estate notice 75.00 2 Paralegal expense to travel to Carlisle to probate Will 25.60 3 The Patriot News - estate ad 102.24 4 Waypoint - charge for estate checks 12.50 TOTAL (Also enter on line 9, Recapitulation) $ 10,044.09 (Ii more space is needed, insert additional sheets of the same sjze) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97) REV-1512 EX +(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE T p.j( RETURN RESIDENT DECEDENT ESTATE OF Lois T. Tarr SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SSII 118-01-7934 07/27 /2001 FILE NUMBER 21-01-0739 Include unreimbursed medical expenses. ITEM NUMBER 1 East Pennsboro Ambulance DESCRIPTION charge for transport AMOUNT 35.33 2 Manor Care - final bill 1,527.50 3 Waypoint Bank - Check in transit on Checking Account #700028220 526.16 TOTAL (Also enter on line 10, Recapitulation) $ 2,088.99 (If more space is needed, insert additional sheets of the same size) Copyrlght(c} 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) REV~ 1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIAR IES ESTATE OF Lois T. Tarr 07/27/2001 SS11 118-01-7934 NUMBER I. RELATIONSHIP TO DECEDENT Do Not List Trustee(s) NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [Include outrIght spousal dIstrIbutions, and transfers under Sec. 9116{aX1.2)] 1 Nancy J. Fenn 1490 N.W. 64th Terrace Kansas City, MO 64118 Daughter 2 Barbara S. Palmer 226 8th Street New Cumberland, PA 17070 Daughter 3 Anne E. Tarr 3000 Monteray Avenue S.E. Albuquerque, NM 87106 Daughter FILE NUMBER 21-01-0739 AMOUNT OR SHARE OF ESTATE 1/3 of res idue 1/3 of residue 1/3 of residue ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU la, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS, A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) Copyrlght{c} 2000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00) L1ST WILL ABC TIST1MmMT OF LOIS T. TAM If Lois T. Tarr, of New Cumberland, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last will and Testament, hereby revoking any and all prior Wills and all Codicils made by me at any time heretofore. ! TEH 1. ! direct that all my legally valid debts, funeral and administration expenses, and inheritance and estate taxes incurred on account of my death shall be paid by my personal representatives out of my residuary estate as soon after my death as practicable. I'l'EH 2. I give, devise and bequeath all the rest, residue and remainder of my estate, of every nature and wherever situated to my husband, Earl G. Tarr, provided that he survive me by a period of one hundred twenty (120) days. Should Earl G. Tarr not be living on the one hundred twentieth (120th) day after my death, then! give, devise and bequeath all the rest, residue and remainder of my estate unto my daughters, Barbara S. Palmer, Anne E. stacy and Nancy J. stone, in equal shares per capita and not per stirpes. IrEM 3. No interest of any beneficiary under this Will or any Codicil " hereto shall be subject to anticipation or voluntary or invpluntary alienation. Page One of Three 7fj. /,C " .~../ " ./ , .....0.6'~ / Lois rl -I" / .,--, "/ , C"'J"L/a'I/fL../" T. Tarr ITEM 4. My Executor acting nereunder shall have the following powers in addition to tnose vested in him by law and by other provisions of this Will, applicable to all property, real, personal and mixed and wheresoever situated, including property held for minors, whether principal or income, exercisable without court approval and effective with respect to each item of said property, until actual distribution: A. To retain as investments of my estate, any or all of my estate, real or personal or mixed, without regard to any principal of diversification, and to hold any or all of such real and personal property retained or acquired without making the same productive of income; B. To pay all taxes, charges and expenses of maintenance, upkeep, improvement, development, protection, preservation and investment of any retained or acquired real or personal property, such payments to be made from eitner principal or income as my said Executor shall determine; C. To retain or invest any and all funds, whether principal or income, in any real or personal property, without restrictions to legal investments; D. To purchase investments at premiums; to exercise all rights of a security holder or shareholder in any corporation; and to lease, mortgage, pledge, give options upon or sell at public or private sale and without approval of any court and without any responsibility to the buyer or buyers to see to the application of the purchase price, any real or personal property, or portion or portions thereof, irrespective of the manne~ or the means by which the same was acquire by my said Executor; Page Two of Three '-,L.-f) (7) {;t-L~.j Lois ."7 Q/:: T. Tarr -/ (~I__./c.1!./{..i/ E. To make any payment or distribution herein provided for in cash or in kind, or partly in cash and partly in kind, at valuations fixed by my Executor at the time of distribution. ITEM 5. No fiduciary acting hereunder shall be required to post bond or enter security in any jurisdiction. ITEM 6. I nominate, constitute and appoint my husband, Earl G. Tarr, as my Executor of this my Last Will and Testament. If he does not act or continue to act as my Executor, then I nominate, constitute and appoint Barbara S. Palmer, as Executrix of this, my Last Will and Testament. If she does not act or continue to act as my Executrix, then I nominate, constitute and appoint my daughter, Anne E. stacy as Successor Executrix of this. If she does not act or continue to act as my Executrix, then I nominate, constitute and appoint my daughter, Nancy J. stone, as Successor Executrix of this, my Last Will and Testament. IN WITNESS WHE~OF , '1- I day I set my hand Of~, l and seal to this, my Last Will and Testament, this 1969. Page Three of Three mvJ . (J ;.li..l:..:!) r-; . (I / m~ . _..,.C' ; -' 2/(a,..i.)~__/ Lois T. Tarr . . The preceding instrument, consisting of this and three (3) other typewritten pages, signed at the bottom of each page for security purposes, was on the date thereof signed, published and declared by Lois T. Tarr, the Testatrix herein named, as and for her Last Will and Testament in our presence, who, at her request, in her presence and in the presence of each other, have subscribed our names as witnesses whereof. v J./' r- (J.A_~.AA!4.?7 , ~JA..,()t~~ WITNESS JJ41_ ik~ _ ITNESS C:OHHOlfWEAL'l'H OF P!I!lffSYLVlJIIA C:OUH'l'Y OF I, Lois T. Tarr, the Testatrix whose name is signed to the attached or .foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Willi and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by Lois T. Tarr, the .-:L .. Testatr ix/this /1 day of 1rlti-r7;.J )/ 1989. . I -L) 4 "7 ~,.,' -,..~-( "7 I (f /, ' (~/! t!-t1L--" \'-/, ,'-../?<>,,&t...../ Lois '1'. Tan , .~ ~~.' Ir(. RO'l'.Y PUBLIC: ,/ --------- Nota.rlai S~C::;' _. I Marie K. Setter, Nljtw'y PlJblic I New Cumberland Bc.ro, CiJmb~.:ri.;lnd C1Junty ! MyCommissiOl1 .:mims C...:-: 25, ~9-:J~ Mi?rill:l~n~~;;';Il:I:\l;;U:~:~~2;ries eDlCOMlM11I 01' ,l.IVI,'JAIIU COOMY 0F ~ We, f-,u;,;t-<.t/t{ 51'{".L"7"'....cand f/a:ZJA BIJLu;J, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the instrument as her Last Will; that the Testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the Testatrix signed the Will as a witness; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by Lut:otf-,lA, :SA-I "'.. ' z.C'f' and rRE-l)ff 13f/LD,.J , witnesses, this ~y of 1Y)~ , 1989. .0 z:~~ 1r]~~~=- Nomr,.:il';'lii/; , Marie K Sojle!, Nc.lary PuNic ~ New Cumberland Boro. Cumberl.nd Counly . .. MVGommissionExplre;,Oct.2.6, 1991. ^111#hl:l~f P " ~ '0.'", ! I\lnnsyrvan/6. J"~(;"",1Ilon 01 Notaries '. REV-485 EX+ {9.(0) '*' SAFE DEPOSIT BOX INVENTORY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 HARRIS8URG, PA 1712s..0601 Please Print or Type MUST BE COMPLETED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAFE DEPOSIT BOX IS LOCATED AND RETURNED TO ABOVE ADDRESS COUNTY COOe. FILE NUMBER SOCIAL SECURITY OR DEATH CERTIFICATE NUMBER 21 01-0739 118-01-7934 DECEDENT'S NAME (LAST, FIRST, MIDDLE) Tarr, Lois T. DATE OF DEATH 07/27/2001 ADDRESS OF DECEDENT (STREET) (CITY) 226 8th Street New Curnberlano NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX (NAME) DonnaM. Mullin, Attorney (STREET NAME) (CITY) (STATE) 134 Sipe Avenue Hummelstown PA NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO oeCEDENl OF PERSON(S~ PRESENT A.T THE BOX OPENING 8. (NAME) (RELATIONSHIP) Barbara S. Palmer Executrix/Dauohter (STREET NAME) (CITY) (STATE) 226 8th Street New Curnberlano PA (STATE) PA (ZIP CODE) 17070 (ZIP CODE) 17036 (ZIP CODE) 17070 b. (NAME) (RELATIONSHIP) (STREET NAME) (CITY) (STATE) (ZIP CODE) c. (NAME) (RELATIONSHIP) (STREET NAME) (CITY) (STATE) (ZIP CODE) NAME AND ADDRESS OF ANANCIAL INS11TUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED (NAME) Waypoint Bank (STREET NAME) (CITY) 99 010 York Roao New Curnberlano (STATE) PA (ZIP CODE) 17070 D~ AND TIME OF LAST ENTRY {- :J7_0\ . f TIT~E U~E_R WHICH BOX IS REQUESTED v? I ,(.0;.> ;,1.,.h'" liA-<Ji [:-:X!rh""", ~.r"a- ",0- (STREET ADDRE.SS) 226 8th Street b, (NAME) Barbara S. Palmer (STREET ADDRESS) 226 8th Street (CITY) New Curnberlano, PA (STATE) 17070 (ZIP CODE) (CITY) (STATE) (ZIP CODE) New Cumber1ano, PA 17070 NAME AND TlTLE OF EMPLOYEE TAKING THE INVENTORY WAS A WILL IN THE BOX? 0 ve::s EJ NO If yes, a, Date of wlll: b, Name and address of personal representative, If named in the will (NAME) (STREET NAME} (CITY) {STATE) (ZIP CODE) c. Name. and address of aborne-}'. If any (NAME) (STREET NAME) (CITY) (STATE) (ZIP CODE) INSTRUCTIONS (1) Cash: Report total only. (2) Stocks: Ust in detail every common or preferred certificate, warrant or other rights found in bOK. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stock is registered, and number of shares and class of stock. (3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and type of ownership, i.e., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. (6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and descrIbe as fully as possible. (8) All other contents. ITEM ITEM DESCRIPTION NO. , iI~ ~ l .5e<-, "-' H /)1 ::I.'7'7Q;23(.'1 -1't~DC' d. a.:t~ 4/74 , :s Sc.,O/lrJ tiS' bllnt' ., 2dS S,f-1li:,.,..v.... n tJ/lcf S:'c..., iR~ H. f?1/r,7/(.VT9H ]fjOrD fM-. 9 4/7t( - O.jCr,) ~ f.1 ( 's/hJ, ",A".",S buVl,K .s<2r/~S H /71 Ii? 7 Ii- (p '1? H $/ 1CJr:JD' d RfcJ2 4//74 _'7 "I US S~;"r:,s 7be,'!tI' .$Gt-ies H Vi11i'7/~ft;77 H ~ lorn) cl.1i~J! 4/7'1 " 5 (;f~ .V s;.erJes H, .mJd'7j("", 7(, It !if; mr)) . cfJk)k:P '-1/7 Y 5.e'vl;'~' g,wct &, I){' . .,./ B,ne 5C.-tG'-i Ii flIlcf'ilt '75'1+, ~(frV 0~ '" '-i/7'f 5jYVr"';<,,, c~ tc:..J! -7 I(F, ,C:; in' In'"; .-]5,(;./ J SUri<..s-.I-I hJ;J'7/b''7JfH #Im. d !Pf.:..f! '4/74 ! ),' Ue: S/r'Iv':' ".'; &""J c""A-!Q ~ /iI 1277/(,{' 73 H $/t'nJ d M-r-JJ "'In'! '/~ ,., iJs <:p/,f/'/, Ga...1!.. .s.u-u!:dr 111 f 1/7 It (, '7;1 1-1 41 tn:V M4fl 41'7'-1 ~f 41-"/ . H 8d~ ivl../ /..1"""'-''''' Q+ f-<,';-.s T . L of abo,,<.- ! e:Cl-r ~r fJ'\{0.. IJwc,,",_ -1, Fe.v; '" A . t:cS ,-f!,/ft ;,c..c : l..-cl: .J.J..,$' /e- t15 I-E:J"'O " II "'-- Col.,e AJIJ-+d!. I q 14 !I US r-=-;vc1oi {c.-l- G.oI.JZ.. &a:te.:Q /90b I ' Us t="iil<-- '])Cl/fM-^'GoI./L &~ f ;PCfO . r it; iAS MV"-- po 11....- G-ldL c{ <<:\ <-&. /9010 1'1 lAS p" <^t- UO ( 110- 6~fu d cLh~Q. I P<f'1 V US P,lIe.., vo/I,u- 0olJ!. c€",kQ It'f3 ') /l I~S ~/U.l'L D (; 1fCtk' Gill R- ef! vl--.:-Q IqJO 17 ~t> '-'-:1,v C. fh-. "i it;;' A '( ) GoIJ!.C0,,^ &~ 1~7Cf If' rrD..eJrtJ (B1''i11d, 1) G.;/JZ WiJ<! d) IYt <-Ji / c??O C' C~/V77fi.ff/(~2 -' p ~ I CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS PERSON RECEIVING COPY OF CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY: SIGNATURE --.. .-. _. ~ SIGNATURE ~. ,-,-..-- /J1. 7) . PRINT NAME 0,[/,111>,\ PRINT NAME AND CHECK APPROPRIATE BOX BELOW: ''t')Ov\ r\(1\- m PRINT TITLE DATE CHECK APPROPRIATE BOX; f\ Lh r? L'cr ~f;. ~d1~~ .{){ w kl DEJcecutorllrix) o AllrnlnislraIOT(lrix) I'tIJJI...., '-.1. <- 11/:2,/,-, o Estate Represenlative o Joint owner of safe deposU bm, SAFE DEPOSiT BOX INVENTORY f Page ----L- of "- NOTE: Attach additional 8112" x 11" sheet(s) If necessary or use duplicates of this page of form. INSTRUCTIONS (1) Cash: Report total only. (2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stocj~ is registered, and number of shares and class of stock. ! (3) Obligations of u.s. Government: Number of items, date of issue, face value, names in which registered and I type of ownership, i.e., jointiy held, peyabie on death, etc, (4) 8onds: Designate by name, amount, serial number, Dr other designation. (Bearer Bonds) (5) BanK and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book. name of bank and branch, and balance. (6) Jewelry, Coins. Stamps. Manuscripts, etc: Ust and describe as fully as possible. (7) Deeds. Mortgages, Current }nsurance Policies or other evidences of indebtedness:: List and describe as fully as possible. (8) All other contents. ITEM . ITeM DESCRIPTION NO, r 6'!~. C;C;:J!f'lu.dL -~ IN''':> _. /1 LA ~ ~IUe.. D.,liMo- Ga/'!':' d)~ IfJf2 ~ -' J.o I Ij .> /!ZA\. DlJ Ii <M- G.t./l.L d ..;t--~ jJ> q '7 '7( I U5 - 't.blf~ 60/ !2 d~f2 ,q/O ",.- !-u--_ ).J-.. I , w,!! v( ECJ.A-I G:. 11!U--r- ,I-,t(sT fir' p-V-'f-~ ~, ,~ A- itw P<:+. '" ~-() ls ;;~.; 'V t} -..J<-r' ai- I C....rr- ;2l.1 v .. o-F f~l';;- ~~l- t.'Vll'\ 4 [.11'.1 \ '" I I CERTIFY UNDER PENALTY OF PERJURY tHAT THE-ABOVE RECORD IS PERSON RECEIVING COpy OF CORRECT AND COMPLE:TE TO THE BEST OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOll tNVENTORY, SIGNATURE SIGNATURE PRINT NAM: PRINT NAME AND CHECK APPROPRIATE eox BE.L-OW: PRINT TITLE DATE CHECK APPROPRlA.TE aox: o Execulor(trtx) o Aominislralor{triy.) I OEstatll'ReptesenlBlive o Joinlownerofllllfedeposilbo..': SAFE DEPOSiT BOX INVENTORY Page ~ -'- of 2.-- NOTE: Attach addition a! 8'H' x 11" sheet(s} tf necessary or use duplicates of this page of form. VI WayP.Ri!,,~ LOOK FOR US. WE'LL GET YOU THERE. <2... 08/1 0/200 1 JAMES SMITH DURKIN & CONNELLY POBOX 650 HERSHEYPA 17033 Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership SOLE Name of Joint Owner, if any Date Ownership Was Established The information which you requested on the account(s) of LOIS TARRESTATE (Social Security Number 118-01-7934) is/are as follows: 760009128 SAVINGS ) 0/24/96 700028220 CHECKING 10/24/96 2820.98 .49 2821.47 42323.68 45.92 42369.60 SOLE Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established dditionaJ formation "luested PLEASE COMPLETE W-9 :[dl},!:;~ SENIOR SERVICES REP. IA 17105-1711 P.O, BOX 1711. HARRISBURG. PENN~~tN www.waypointbank.com Toll Free 1_866-WAYPOINT (1_866-929-76 (qjP. [ ~~) l~3/..' . ( ~rt . JI ~) ~)Yo Sd.~ , OJ Ii) ~ , I gq7~o . [~IJ:'3 I (WI-I) tqo& I' j.\-;'''; / v ?-'fe/ IsS/ ,/ I Lt~ - 2~.o. ".. [I \ t, ,.-'.;,. // D&SCOINS .224 . 4tI1 Street New Cumbilriand, PA 17070 ( ".--" ,