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Home My WebLink About01-0924 Estate of Chester J. Radnor also known as FETITIUN tUKPROIDl:~aDU u.KANT OF .LE1-I'~ A}-OJ- q.:J. '-/ No. To: Register of Wills for the Deceased. County of Cumberland in [he Social Security No. 193-16-8981 Commonwealth of Pennsylvania The petition of the undersigned respectfuJJy represents that: Your petitioner(s), who is/are 18 years of age or older an ~he executors in the last wiII of the above decedent, dated Aprll 25, 1996 and cOdicil(s) dated (state refevant circumstances, e.g. renunciation, deuh of executor. etc.' Decendent was domiciled at death in Cumberland County, Pennsylvania, with h is last family or principal residence: at Manor Care Health Services, 1700 Market Street. Borouqh of Camp Hill, Cumber land Collntv. Fennsy I vania (list street, number aDa muuc:ipa!ity) Decendem, then _JL- years of a~e, died SP.nternber 24, 2001 . 19 at Manor Care, Borouqh_ of Camp H1II, Cumber lann County, PA . Except as follows, decedem did not marry, was not divorced and did not have a child born or adopted after execution of the wiII offered for probate; was not the victim of a killing and was never adjudicated incompetent: Dece:ndem at death owned propeny with estimated values as foJJows: (If domiciled in Pa.) All personal propeny (If not domiciled in Pa.) Personal propeny in PennsylVania (If not domiciled in Pa.) Personal prope:ny in County Value of real estate in Pennsylvania situated as follows: ,_ S 30.000.00 S S S WHEREFORE, petitioner(s) respectfully rc:quest(s) the probate of the last wiII and codicil(s) presemed herewith and the grant of letters testaIl'lP-ntrlry (tcstamentary; administration Cot.a.; administr.uion d.h.n.c.l.a.) theron. ... 'ii " c u ~2: u - =~ ~c -.- ;': '" ~c. ~c' :i c ... in Ch~~~ 816 N. Atlantic Ave.~ A~t. 31 Daytona Beach, FL 3 11 ~d-/2-~ Dale R. Radnor 1 6 W. Keller St. Mechanicsburg, FA 17055 OATH OF PERSONAL REPRESENTATIVE COMMON\VEALTH OF PENNSYLVANIA } ss COUNTY OF aJMBER1.J',ND , 17-'/~~r The petitioner(s) above-named sw<:ar(s) or affinn(s) that the statements in the foregoing petition are [rue and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- 13!ive(s) of ,he above decedent petidoner(s) will well and 'rnly ~e ~e according to law. Sworn to or affirmed and 'Jubscribed ~ ~ CI'I before me this 5 th day of ester J j:;~II €' ctober ~200 ~/.'.k. ~ Da e R. Radnor :; "':l ~ '- Register. ~o. 21~2001-q?4 Estate of Chester J. Radnor , Deceased . DECREE OF PROBATE AND GRANT OF LETIERS AND NOW October 8th ~001 . 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 April 25, 1996 described therein be admitted to probate and filed of record as the last will of Chester J. Radnor and Letters Testamentary are hereby granted to Chester J. Radnor, II, and Dale R. Radnor ~(!~~~~ Register of Wills 'Mary c. Lewis ~ FEES Probate, Letters, Etc. ......... S 60.00 Short Cerrificates(2) .......... S 6.00 Renunciation ................ S x-Pages (5) S 15.00 JCP ~ TOTAL _ S 86.00 Filed .Oct9P.~:r;- .~tp....~QQ+................ Gerald J. Shekletski #40486 ATIORNEY (Sup. Ct. 1.0. No.) 414 Bridge St.,' New CUmberland, PA 17070 ADDRESS. (717) 774-7435 PHONE MAILED LE'lTJ.'ERS 'IO ATI'ORNEY LAST WILL AND TESTAMENT OF CHESTER J. RADNOR 21-2001-924 I, Chester 1. Radnor, of Enol a, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare as and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST I direct the payment of my debts and expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. SECOND I direct that all inheritance and estate taxes becoming due by reason of my death, whether such taxes may be payable by my estate or by any recipient of any property, shall be paid by my co-executors out of the property passing under this Will which is not specifically bequeathed or devised, as an expense and cost of administration of my estate. My co- executors shall have no duty or obligation to obtain reimbursement for any such tax paid, even though on proceeds of insurance or other property passing under this Will. THIRD I hereby exercise all powers of appointment which I may have at the time of my death in favor of my co-executors and all property subject to all such powers of appointment shall be included in my estate. FOURTH I give, devise and bequeath my entire estate be divided into three equal shares and be distributed as follows: one share to my beloved son Chester 1. Radnor II, one share to my beloved son Dale R. Radnor, and one share to be distributed in equal portions to each of my beloved grandchildren who by name are Stephen Radnor, Michelle Radnor and Chester 1. Radnor III. The aforementioned grandchildren are to have their shares held in trust. Each grandchild will receive his or her share of the trust upon reaching his or her twenty fifth birthday - subject to the provisions of paragraph five. 2 FIFTH If at any time any grandchild named in Paragraph Four above has not reached the age of twenty-five at the time of my death, I appoint my brother, Donald Radnor of 4 Hickory Drive, Mountaintop, P A as trustee of the assets payable to such grandchild or grandchildren, and shall have full authority to use such assets in any manner such trustee shall deem advisable for the best interests of such child, including support, maintenance and education, including college, university, post-graduate or other education, without securing court order. Said trustee is specifically relieved of the obligation to file my bond. SIXTH I hereby nominate, constitute and appoint my beloved children, Chester 1. Radnor II and Dale R. Radnor as Co-Executors of this my Last Will and Testament. My Co-Executors are specifically relieved of the duty or obligation of filing any bond or bonds. IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding two (2) pages, this d-{' day of April, 1996. /):; c/ 2'.- I /.y.....cf .......~ Chester i. Radnor 3 SIGNED, SEALED, PUBLISHED AND DECLARED by the above named testator, as and for his Will, in the presence of us, who, at his request, in this presence, and in the presence of each other, have hereunto subscribed our names as witnesses in attestation thereof Clif(~ ~ / residing at ~ () 3 N. 2nd Sf. I-Ib8 m / "7-10 B '7( !l/>1/_yi ~0<-'L- residing at I (J L/tl 3 ff ;:l /7c/ ~ 116(/ .Iff 17/cJF d ACKNOWLEDGMENT COMMONWEAL TH OF PENNSYLVANIA COUNTY OF DAUPHIN I, Chester 1. Radnor, Testator, 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 Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. . /' '7 . ) . /~;L)Z:", -/7f/'/t ;"" ct. 1~ L, ~ .,..- v/ Sworn or affirmed to and acknowledged before me, by Chester 1. Radnor, Testator, this c;~ day of April, 1996. c::::i~~yj. JJu,fM!-)O~j/'--./ (j -- Notary Public Notarioi Seal Sandra G. Dragovan, Notary Public Harrisburg, Dauphin County My Commission Expires Sept. 16, 1996 ember. PennsylvaniaAssociaton of Notaries ( / b AFFIDAVIT We, j OD'{ L'<NN {J(2lS,-r- and rVCtx1GC1;:- - '?D-(TCI \ I 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 CHESTER J. RADNOR sign and execute the instrument as his; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge, information and belief, the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to an~ subscribed to before me by -rod} ~t" " ('" ,:.21. and -na~(j I'. f~ witnesses, this ~ day of April, 1996. iJ ' dp~ c7w;::(Lij L- ~ <5 - 7t~1t:t E >07- WITNES '. .'; 0,_,-(/' U^r^----/ , NOTARY PUBLIC NOlana~ Seal Sandra G. Dragcvan, Notary Public Hamsburg, Dauphin County My Commis.'1ion Expires Sept. 16, 1996 em r, ennsylvania Association of Nolalies f .....- CERTIFICATION OF NOTICE UNDER RULE 5.6{a) Name of Decedent: Chester J. Radnor Date of Death: September 24, 2001 Will No. 2001-00924 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans I Court rules was served on or mailed to the following beneficiaries of the above captioned estate on November 16, 2001. Chester J. Radnor, II 816 N. Atlantic Ave., Apt. 31 Daytona Beach, Fla. 32118 Dale R. Radnor 16 West Keller St. Mechanicsburg, PA 17055 Michelle Radnor 1917 Daybreak Circle Harrisburg, PA 17110 Stephen Radnor 3803 Caldwell Circle Las Vegas, NV 89115 Chester J. Radnor, III 10,..East L~ust St. En61~, P~l 702:~;:cE a.. "\ ,"i:) D~,gj: era:: " ,,,' No~i;ce h~ now~een given Ru;I.,e: 5. 6 ~) . ;:~ o I ,ej ) //l~/o/ P 'I>::: ijCS .; ') itled thereto under hekletski, Esquire 414 Bridge Street New Cumberland, PA 17070 717-774-7435 Capacity: Personal Representative x Counsel for Personal Representative CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Chester J. Radnor Date of Death: September 24, 2001 Will No. 2001-00924 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court rules was served on or mailed to the following beneficiaries of the above captioned estate on November 16, 2001. Chester J. Radnor, II 816 N. Atlantic Ave. Apt. 31 Dale R. Radnor 16 West Keller St. Mechanicsburg, PA 17055 Michelle Radnor 1917 Daybreak Cir. Harrisburg, PA 17110 Stephen Radnor 3803 Caldwell Cir. Las Vegas, NV 89115 Chester J. Radnor,III 10 East Locust St. Enola, PA 17025 Notice has now been Rule 5.6(a). :1/ 5-/()'~ I . given to all persons entitled thereto under /~ .t:. /<~~C/ <a.t:C:~ "Gerald J.~ hekletski, Esquire 414 Bridge Street New Cumberland, PA 17070 717-774-7435 Date: r- r:"-~'I 0-. Capacity: Personal Representative f"- I co w..J L.l- x Counsel for Personal Representative :l~ eX: ~ c_L.l ,;~': ~ ";'1) = _.. '-' "'..,r' -" '- " REV-1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECE- DENT CHECK APPRO- PRIATE I BLOCKS I I COR- RE- SPON DENT RECA- PITULA- TION TAX COMPU- TATION o PA15001 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Radnor, Chester J. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 09/24/01 03/27/1927 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~ 1. Original Return 4. Limited Estate 6. Decedent Died Testate (Attach copy 01 Will) 9. Litigation Proceeds Received ~ 2. Supplemental Return 4a. Future Interest Compromise (date ot death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach a copy of Trust) 10. Spousal Poverty Credit (date ot death between 12-31-91 and 1-1-95) 1 7 -- J~ -J 9 6,/ OFFICIAL USE ONLY FILE NUMBER 21 2001 00924 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 193-16-8981 THIS RETURN MUST BE FilED IN DUPLICATE WITH THE REGISTER OF WillS SOCIAL SECURITY NUMBER 3. Remainder Return o (date of death prior to 12-13-82) o 5. Federal Estate Tax Return Required o 8. Total Number of Safe Deposit Boxes O 11. Election to tax under Sec. 9113(A) (Attach Sch 0) I THIS. SECTION .MUST. BEC()MPLETE[)...A.I.L..C:Df~ftf=$p()Nbf=~g;~(i9~fIQf=ijtIAtTAX~ijj:'QRMA'hqij$Hql@.P.l!lgQtR$qTf=P.t9~.. I NAME COMPLETE MAILING ADDRESS Gerald J. Shekletski, Esq. 414 Bridge St. I FIRM NAME (If Applicable) P.O. Box. E 'Stone, lafaver & Shekletski New Cumberland, PA 17070 TELEPHONE NUMBER (717) 774-7435 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debls 01 Decedent. Mortgage liabilities. & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount ot Line 14 taxable at the spousal tax rate. or translers under Sec. 9116 (a)(I.2) X _0 (15) 16. Amount 01 Line 14 taxable at lineal rate 13,210.42 X.O 45 (16) 17. Amount of Line 14 taxable at Sibling rate 0 . 00 x .12 (17) 18. Amount 01 Line 14 taxable at collateral rate 0 . 00 x .15 (18) 19. Tax Due (19) 20. 0 ICHECK.HERE..lf..'(dtl.ME.REQlJE.$"ttij$..A..R~NPQfAijQ~apAYM~NI...I 1. Real Estate (Schedule A) 1 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporalion. Partnership or Sole-Propnetorshlp 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested (1 ) (2) (3) (4) (5) (6) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) (7) None 555.03 ~ None OFFICIAL USE ONLY 7,746.79 None 19,094.15 (8) 9,871.30 4,314.25 (11 ) (12) (13) 27,395.97 14,185.55 13,210.42 None (14) 13,210.42 594.47 0.00 0.00 594.47 >>BESUHETOANSWEBALl.CllJEstJQN$QNf'AGg2ANQRgGl-lEOkMAt8~",< NTF 29755 Copynght 2000 Grealland/Nelco LP - Fanns Soltware Only PA REV-1500 EX (6-00) Decedent's Complete Address: STREET ADDRESS 1700 Market St. Page 2 CITY Carrp Hill Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount STATE PA ZIP 17011 (1 ) 594.4 7 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (0 + E) 4 If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check (3) 0.00 (4) (5) (5A) (58) 594.4 7 0.00 594 .4 7 PLEASE ANSWER THE 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. retain the right to designate who shall use the property transferred or its income; . . . . . . . . . . . . . . . . . c. retain a reversionary interest; or. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of either payments. benefits or care? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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. 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 01 preparer other than the personal representative is based on information of which preparer has any knowledge. SIGNATU E OF PERSO~,..REJ'PO~, BlE FOR):lUNG RETURN DATE ~ ~k2 A ,h'~~- '-er....-/r-- c; 0)- ADDRESS See Sc SIGNAT Yes No ~ I B ~ ~ D ~ SENT A TlVE 17070 For dales on on use spouse I72PS.99116(a)(1.1)(i)] For dates of death on or atter January 1. 1995. the tax rate is Imposed on the net value of transfers to or forthe use of the surviving spouse is 0% 172 P.S. 9 9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only benefiCiary. For dates of death on or atter 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 slepparent of the child is 0% [72 P.S. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or forthe use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72.P.S. 6 9116(1.2) (72 P.S. %9116(a)(1)J. The tax rate Imposed on the net value of transfers to or forthe use ot the decedent's siblings IS 12% [72 P.S. 99116(a)(1.3)J. 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. o PA1S002 NTF 29756 Copynght 2000 GreatiandlNelco LP - Forms Sottware Only Estate of: Chester J. Radnor 21-2001-00924 The following person (s) are signing the return as representative (s) of the estate: Chester J. Radnor I II 816 N. Atlantic Ave. Apt. 31 Daytona Beach I FL 32118 Dale R. Radnor 16 West Keller St. Mechanicsburgl PA 17055 REV-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Chester J. Radnor SCHEDULE B STOCKS & BONDS FILE NUMBER 21-2001-00924 All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 21 Shares MetLife Common Stock/Investor 8063 6599 9514 Date of Death Value - $26.43 per share x 21 = $555.03 555.03 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 555.03 7 CPA31 NTF 10905 Copynght Forms Software Only, 1997 Nelco, Inc. Historical Pnces Page 1 of 1 Y.A.HOO!FINANCE df1 Search - Finance Ho~e - Yahoo! - Hele Historical Prices - MET (MetLife Inc) As of 24-Sep-01 More Info: Qu()tE;! I Chart I News I Profile I Research I SEe I Msgs I Profile Month Day Year @ Daily o Weekly o Monthly o Dividends Start: I Sep ..:1 ~ ~ End: ISep -.:J' ~ ~ Ticker Symbol: Imet Get,Data I ~....., Date Open High Low Clo:ie Volume Adj. Close* ::1_____ 24-Sep-0 1 26.00 26.46 25.75 26.43 1,642,100 26.24 - --=~'''.,::.... Download Spreadsheet Format * adjusted'for divia"ends and splits, pl~ase see F AQ. Questions or Comments? Copyright is! 2002 Yahoo' Inc:AWrignfsreserved. Prhiar.y P0licy - Terms of Service Historical chart data and daily updates provided byCornn'1oditySystems, Inc. (CSI). Data and information is provided for informational purposes only, and is not intended-for"frading purposes. Neilher Yahoo nor any of its data or content providers (such as CSI) shall be liable for any errors or delays in the content, or for any actions taken in reliance thereon. http' itable. finance. yahoo.com/d?a=9&b=24&c=0 1 &d=9&e=24&f=O 1 &g=d&s=met 4/4/2002 REV-15G8 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Chester J. Radnor SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-2001-00924 Include proceeds of litigation & date proceeds were received by the estate. All prop. Jointly-owned with right of survivorship must be disclosed on Sch. F. ITEM VALUE AT NO. DESCRIPTION DATE OF DEATH 1 Waypoint Checking Account Number 100064418 5,615.46 2 Waypoint Bank Checking Account Number 900032244 2,131.33 7 CPA81 .\HF 10908 Cc::)\:r.ght F'Jrms Software Only. 1997 Neice. Inc TOTAL (Also enter on line 5. Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 7,746.79 ? IWaynoint .I .J IBANK ::'-~:~J'=. WE'lL GET YOU THERE. 10/23/2001 STONE LAF AVER & SHEKLETSKI 414 BRIDGE ST NEW CUMBERLAND P A 17070 The information which you requested on the account(s) of CHESTER RADNOR DECEASED (Social Security Number 193-16-8981 ) is/are as follows: Account Number Class of Account 100064418 CHECKING 07/09/98 5614.46 1.00 5615.46 900032244 CHECKING 06/30/97 Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership SOLE Name of Joint Owner. if any 213 1.22 .1 ] 2131.33 SOLE Date Ownership Was Established Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account O-,vnership Name of Joint Owner. if any Date Ownership Was Established Additional Information Requested PLEASE COr/1PLETE W-9 ~~ SENIOR SERVICES REP. PO. Box 1711. HARRISBURG. PENNSYLVANIA 17105-1711 Toil FrEE 1-865-WAYPOINT (I-B66-929-7646) . www.waypointbank.com REV-1510 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Chester J. Radnor SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21-2001-00924 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. DESCRIPTION OF PROPERTY "10 OF EXCLUSION ITEM INCLUDE NAME OF THE TRANSFEREE, THEIR DATE OF DEATH DECO'S (IF TAXABLE VALUE RELATIONSHIP TO DECO & DATE OF TRANSFER. NO. ATTACH COpy OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST APPLICABLE) 1 ING Aetna IRA Account 19,094.15 100% 0.00 19,094.15 1931689819016IA TOTAL (Also enter on line 7, Recapitulation) $ 19,094.15 7 CPA01 NTF10910 (If more space is needed, insert additional sheets of the same size) Copynght Forms Software Only. 1997 NelcQ. Inc JOYCE FINANCIAL GROUP 9 N. fvtlin Street, Pittston, PA 18('-W (570) b55-2831 ) FAX (57D) (,55-0170 October 22, 2001 Gerald J Shekletski Stone LaFaver & Shekletski 414 Bridge St. P.O. Box E New Cumberland, PAl 7070 Atty Shekletski Per your request I have attained the account value for Chester Radnor's ING Aetna IRA as of his date of death. (9/24/01) The account value was $19,094.15. This account (193l6898l90l6IA) is the only account we have for Mr. Radnor. Any questions please call me at 570-655-2831. Thank You, ~/ /~'./. / ~ ./// ~..._ /x--L-L<~~ Daniel R. CromlUef Sr. Vice President Joyce Financial Group DC/jv Se(uritie~ ,1l1d 1l1\'L'~tment Adyice offered through FSC SECURITIES CORPORATION '\ rL'gi~tl'red bn,ker! dealer. \.1ember NASD /SIPC and A registered investment advisor. REV-1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Chester J. Radnor SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-2001-00924 Debts of decedent must be reported on Schedule I. ITEM NO. A. FUNERAL EXPENSES: DESCRIPTION AMOUNT 1 Partherrore Funeral Hare and Crerration Services, Inc. 1303 Bridge St. New Cumberland, PA 17070 6,400.20 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN No. of Personal Representative(s) Street Address City State 0.00 Zip Year(s) Commission Paid: 2. Attorney Fees Narre: Gerald J. Shekletski, Esq. 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 3,000.00 0.00 4. Probate Fees 86.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 7 Cumberland law Journal - legal advertising 75.00 8 The Patriot-News - legal advertising 113.10 9 Short Certificates 12.00 10 Death Certificate 10.00 11 Filing Fee - Inheritance Tax Return and Personal Inventory 25.00 12 Filing Fee-First and Final Account 150.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 9,871.30 7 CPA11 NTF 10911 Copynght Forms Software Only, 1997 ~~elco. Inc. REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Chester J. Radnor Include un reimbursed medical expenses. ITEM NO. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-2001-00924 DESCRIPTION AMOUNT 1 HRC Manor Care 2,148.62 2 Hershey Medical Center 869.24 3 MSHMC Physicians Group 413 . 94 4 !'v1endelson Foer Harrison Dental Associates 402.00 5 Neighlx)Ycare Pha.rm3.cy 157.57 6 West Shore EIrergency Medical Services 164.70 7 Emily W. Maitlin, D.O. 91.76 8 Mobile X-Ray Imaging, Inc. 43.78 9 Quantum Imaging and Therapeutic Associates, Inc. 22.64 7 CPA12 NTF 10912 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 4,314.25 Copynght Forms Software Only. 1997 Nelco. Inc. REV-1513 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF 6 SCHEDULE J BENEFICIARIES FILE NUMBER Chester J. Radnor No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 21-2001-00924 RELATIONSHIP TO DECEDENT AMOUNT OR Do Not Ust Trustee(s) SHARE OF ESTATE 1 Chester J. Radnor, II 816 N. Atlantic Ave. Apt. 31 Daytona Beach, FL 32118 Son 35% of Schedule G + 1/3 of Residue, if any 2 Dale R. Radnor 16 West Keller St. Mechanicsburg, PA 17055 Son 35% of Schedu Ie G + 1/3 of Residue, if a ny 10% of Schedu Ie G + 1/9 of Residue, if a ny 10% of Schedu Ie G + 1/9of Residue, if a ny 10% of Schedu Ie G + 1/ 9 of Residue, if a ny 3 Chester J. Radnor, III 10 East Locust St. Enol a , PA 17025 Grandchild 4 Stephen Radnor 3803 Caldwell Circle Las Vegas, NV 89115 Grandchild 5 Michelle Radnor 1917 Daybreak Circle Harrisburg, PA 17110 Grandchild ENTER DOLLAR AMTS. FOR DISTRIBS. 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 None B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS None TOTAL OF PART II n ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 7 CPA13 NTF 10913 (If more space is needed, insert additional sheets of the same size) Copynght Forms Software Only. 1997 Nelco. Inc. 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 SHEKLETSKI GERALD J 414 BRIDGE STREET NEW CUMBERLAND, PA 17070 -------- fold ESTATE INFORMATION: SSN: 1 93- 1 6-8981 FILE NUMBER: 2101-0924 DECEDENT NAME: RADNOR CHESTER J DATE OF PAYMENT: 06/20/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 09/24/2001 NO. CD 001313 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $594.47 I I I I I I I I TOTAL AMOUNT PAID: $594.4 7 REMARKS: STONE LAFA VER & STONE CHECK# 6185 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS Inventory of the real and personal estate of Chester J. Radnor deceased PERSONAL PROPERTY 1: Met Life common stock 2. Waypoint checking account number 100064418 3. Waypoint checkink account number 900032244 REAL PROPERTY NONE l 555 J TOTAL 5,615. 6 2,131. 3 I I' II li$8,301.82 Ii i: Ii iI 'I I, ,I :/ I I I i r I I AONWEALTH OF PENNSYLVANIA JNTY OF CUMBERLAND ss: ();/ Dale R. Radnor being duly sworn is Co-Executor according to law, deposes and says that he of the Estate of Chester J. Radnor late of ~a~p_J:!~ll _B_~~,?u_gh ----___ , Cumberland County, Pa., deceased and that the within is an inventory made by Dale R. Radnor_ _, the said Co-Executor of the entire estate of said decedent, consisting of all the personal prop~rty and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. and subscribed before me, rBdZ Executor - Aaministr or 2i~ 2002 16 West Keller St., Mechanicsburg, PA 17055 Addren J Date of Death 24 Day September Month 2001 Year INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. 0 S-I r-- a ..c: 0 ~ b"l r-- >- '"d ::::J -c rl ~ rc1 0: III ..... W p:; Hi .. 0: ..... 'll >- W <: 0' ell r<l; e::: 0.... ..... CO! u P-l 0 ell 0 V'l ~ c II w 0: w rll l- I 0.... II Z ..... ...J U. S-I MI 'll . '"d If) ...J <: 0 Q) .,...j 0.... +J~(V) oj W u. <: w +J :1::, Cl)rc1~ 0 .;.. ~I > z 0: UJ - Mr-- Z 0 ai 0.. <: OJ H I I C ...0 S ::> b"lQ)~ Vl Z 0 0 0: ~ rc1 U '"d..Qr-- Z w <: u - .,...j S r-- I 0.... " H ::::J c: 'll COU- /: - ... r-- 0 ell ~~rl ..a ell E " rlOJr-- - <l> ~Z- OIl ::> ...J U ~ 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 SHEKlETSKI GERALD J 414 BRIDGE STREET NEW CUMBERLAND, PA 17070 -------- fold ESTATE INFORMATION: SSN: 193-16-8981 FILE NUMBER: 2101-0924 DECEDENT NAME: RADNOR CHESTER J DATE OF PAYMENT: OS/27/2005 POSTMARK DATE: OS/27/2005 COUNTY: CUMBERLAND DATE OF DEATH: 09/24/2001 NO. CD 005370 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $2,031.00 I I I I I I I I TOTAL AMOUNT PAID: $2,031.00 REMARKS: CHECK#1599 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WillS //j. /.2 )>' ~ BUREAU OF INDIVIDUAL TAXES ~ INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX \ DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-15-2002 RADNOR 09-24-2001 21 01-0924 CUMBERLAND 101 ,.) ~! GERALD J SHEKLETSKI 414 BRIDGE ST PP 0 BOX E NEW CUMBERLAND PA 17070 *' REY-15~7 EX AFP (DI-D2) CHESTER J Anount Renitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=i.5'4-j-EX--AFP--foY:02Y-NOTicE--OF-YNHEifi'TAifcE-TAX-A-PPRA-isEirE'NT:--ALL-OWANCE-cfi------------ - - --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF RADNOR CHESTER J FILE NO. 21 01-0924 ACN 101 DATE 07-15-2002 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. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 555.03 .00 .00 7,746.79 .00 19,094.15 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adn. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governnental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) nO) 9,871.30 4.314.25 (11) (12) (13) (4) NOTE: IT an assessment was issued previously, lines reTlect Tigures that include the total oT ALL ASSESSMENT OF TAX: 15. Anount of Line 14 at Spousal rate (15) 16. Anount of Line 14 taxable at Lineal/Class A rate (16) 17. Anount of Line 14 at Sibling rate (17) 18. Anount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS. NOTE: To insure proper credit to your account, subnit the upper portion of this forn with your tax paynent. 27,395.97 14.185 55 13,210.42 .00 13,210.42 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. .00 X 00 = 13,210.42 X 045 = .00 X 12 = .00 X 15 = (19)= .00 594.47 .00 .00 594.47 . ..- n..........~1 l+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) INTEREST IS CHARGED THROUGH 07-30-2002 TOTAL TAX CREDIT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 594.47 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 3.51 TOTAL DUE 597.98 · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expresslY reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGISTER OF HILLS. AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and I or speaking needs: 1-800-447-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administrativelY correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%) percent per annum calculated at a dailY rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are: Year Interest Rate Daily Interest Factor Year Interest Rate Da ily Interest Factor 1982 20% .000548 1992 9% .000247 1983 16% .000438 1993-1994 n .000192 1984 11% .000301 1995-1998 9% .000247 1985 13% .000356 1999 n .000192 1986 10% .000274 2000 8% .000219 1987 9% .000247 2001 9% .000247 1988-1991 11% .000301 2002 6% .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. 1?-/c:'2 - f? BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISIDN DEPT. 280601 HARRISBURG, PA 17128-0601 . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* \ REV-IU7 EX AFP cDI-02) GERALD J SHEKLETSKI 414 BRIDGE ST PP 0 BOX E NEW CUMBERLAND 'l} ~~ \ :",JL~ DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-22-2002 RADNOR 09-24-2001 21 01-0924 CUMBERLAND 101 CHESTER J Allount Rellitted PAp 07 0 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV =i6"ifj-EX--AFP--foY:ozY------...--iNHEiiITANCE--YAX--STA-fEMENY-OF-ACcouiff--...------------------ - -- ESTATE OF RADNOR CHESTER J FILE NO.21 01-0924 ACN 101 DATE 07-22-2002 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-15-2002 P R I NC I PAL TAX DU E : ......................................................................................................................................................................................................................... 594.47 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-20-2002 CDOO1313 .00 594.47 TOTAL TAX CREDIT 594.47 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. ) PAVMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. If RESIDENT DECEDENT make check or money order payable to: REGISTER OF WILLS, AGENT. If NON-RESIDENT DECEDENT make check or money order payable to: COMMONWEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-13l3). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Dffices or from the Department's 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and I or speaking needs: 1-800-447-3020 (TT only). REPLV TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (570) discount of the tax paid is allowed. PENALTV: The 1570 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (670) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are: Vear Interest Rate Daily Interest Factor Vear Interest Rate DailY Interest Factor 1982 2070 .000548 1992 970 .000247 1983 1670 .000438 1993-1994 77- .000192 1984 1170 .000301 1995-1998 970 .000247 1985 1370 .000356 1999 77- .000192 1986 1070 .000274 2000 870 .000219 1987 970 .000247 2001 970 .000247 1988-1991 1170 .000301 2002 670 .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. STATUS REPORT UNDER RULE 6.12 Name of Decedent: CHESTER J. RADNOR Date of Death: SEPTEMBER 24, 2001 Will No. 2001-00924 To the Register: 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: l. Yes ~ State whether administration of the estate lS complete: 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: N/A (c) Did the personal representative state an account informally to the parties in interest? Yes~ 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: fJ /0/0 J. erald J. Shekletski, 414 Bridge Street New Cumberland, PA 17070 717-774-7435 Capacity: Personal Representative X Counsel for Personal Representative CJIu~ LAST WILL AND TEST AMENT OF CHESTER J. RADNOR I, Chester J. Radnor, of Enola, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare as and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST I direct the payment of my debts and expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. SECOND I direct that all inheritance ana estate taxes becoming due by reason of my death, whether such taxes may be payable by my estate or by any recipient of any property, shall be paid by my co-executors out of the property passing under this Will which is not specifically bequeathed or devised, as an expense and cost of administration of my estate. My co- executors shall have no duty or obligation to obtain reimbursement for any such tax paid, even though on proceeds of insurance or other property passing under this Will. THIRD I hereby exercise all powers of appointment which I may have at the time of my death in favor of my co-executors and all property subject to all such powers of appointment shall be included in my estate. FOURTH I give, devise and bequeath my entire estate be divided into three equal shares and be distributed as follows: one share to my beloved son Chester J. Radnor II, one share to my beloved son Dale R. Radnor, and one share to be distributed in equal portions to each of my beloved grandchildren who by name are Stephen Radnor, Michelle Radnor and Chester 1. Radnor III. The aforementioned grandchildren are to have their shares held in trust. Each grandchild will receive his or her share of the trust upon reaching his or her twenty fifth birthday - subject to the provisions of paragraph five. 2 REV-1500 &.. (6-00) OFFICIAl USE ONLY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 2001 -90924 __ YEAR NUMBER COUNlY CODE DECEDENTS NAME (LAST. FIRST, AND MIDDLE INITIAL) Radnor, Chester J DAlE OF DEATH (MM-DD--YEAR) SOCIAL SECURITY NUMBER 193-16-8981 f- Z W o w u w o 09/24/2001 DATE OF BIRTH (MM-DD-YEAR) 03/27/1927 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) REGISTER OF WILLS SOCIAL SECURITY NUMBER ~ D 1 Original Return ::.::~(I)D 00::::':: 4. limited Estate w"O :I:OO ~ o O::...J LLJ 6. Decedent Died Testate (Attach copy of Will) ..., ~ 00 9 litigation Proceeds Received [X] 2. Supplemental Return D 3 Remainder Return (date of death prior to 12-13-82) D 4a. Future Interest Compromise (date of death after 12-12-82) D 5. Federal Estate Tax Return Required [] 7. Decedent Maintained a living Trust (Attach copy ofTrusl) _ 8. Total Number of Safe Deposit Boxes D 10. Spousal Poverty Credit (d~te 01 dealh between 12-31-91 ;nIl.1-9~) D 11. Election to tax under Sec. 9113(A) (AHad1 Sch 0) ... Z W " Z " "- '" Iii! '" o " THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Gerald J. Shek1etski, Esq. FIRM NAME (If Applicable) Stone, Lafaver & Shekletski TELEPHONE NUMBER 414 Bridge St. P.O. Box E New Cumberland, PA 17070 (717) 774-7435 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds {Schedule B} (2) 3 Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) IS} :z 5 Jointly Owned Property (Schedule F) 15} 0 D Separate Billing Requested i= :s 7 Inter-Vivos Transfers & Miscellaneous Non-Probate Property 17} ::;) (Schedu~ G or L) f- a: B. Total Gross Assets (total lines 1-7) 0( U UJ 9 Funeral Expenses & Administrative Costs (Schedule H) 19} IX 10 Debts of Decedent. Mortgage liabilities, & liens (Schedule I) (10) 11 Total Deductions (total lines 9 & 10) 0.00 0.00 0.00 0.00 75,000.00 0.00 OFFICIAL USE ONLY 0.00 75,000.00 IB} 29,853.80 0.00 (13) 29,853.80 45,146.20 0.00 (11) 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) (12) 14. Net Value Subject to Tax (Line 12 minus line 13) see INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15 Amount of line 14 taxable at the spousal tax 0.00 Z rate, ortransfers under Sec. 9116 (a)(1.2) 0 F 15 Amou nt of line 14 taxabte at lineal rate 45,146.20 < ... :> 0.00 '- 17 Amount of line 14 taxable at sibling rate :; 0 0.00 L> " Amounl of Line 14 taxable at collateral rate )( < T ax Due ... 19. (14) 45,146.20 1'9} 0.00 2,031. 58 0.00 0.00 2,031.58 x.OO~(15) x.04~(16) x .12 (17) x .15 (18) 20. o CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 2VV46451000 Oec'edent's Complete Address: SlREET ADDRESS 1700 Market St. CITY I STATE ! lIP CarnD Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A Spousal Poverty Credo B. Prior Payments C. Discount (1) 2,031.58 0.00 0.00 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + 8 + C) (2) 0.00 0.00 0.00 Totallnterest/PenaOy (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 2,031.58 A. Enter the interest on the tax due. (SA) 0.00 8. Enter the total of Line 5 + SA This is the BALANCE DUE. Make Check Payable to: REGISTER OF WlLL5, AGENT (58) 2,031.58 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;. . . . . . . . . . . . . . . D b, retain the right to designate who shall use the property transferred or its income; . D c. retain a reversionary interest; or ........ . . . . . . . . . . . . . . . . D d, receive the promise for life of either payments, benefits or care? . . . . . . . . . D 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D 4. Did decedent own an Individual Retirement Account, annuity, or other non.probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D IZJ 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 retum. including accompanying schedules and statements, and to the best of my knowledge and belief, it is true. CQrrect and complete. Declaration of preparer other than the personal representative is based 0f1 aU information of which preparer has any knowledge Yes No [Z] [Z] [Z] [Z] IZJ IZJ SIGNATURE O::e:R::{NS~OR FI:G "7'RN _ ADDRESS b43B Locust pOJ..n~a~ Di11sburg, PA 17019 SIGNAlURE OF PREPA DATE .-/ s-:.Z ..>- (J J ADOR 414 Bridge New Cumberland, PA 17070 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 far the use of the surviving spouse is 3% (72 P.S.s 9916 (a) (l.l)(i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% (72 P.S. 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. 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. S 9116(1.2) (72 P.S. ~9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. 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 2W46461.000 Estate of: Chester J Radnor 193-16-8981 Co-Executor Chester J Radnor, II 429 Auburn Drive Apartment 205 Daytona Beach, FL 32118 REV-l50B EX..-(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Radnor, Chester J FILE NUMBER 21-2001-00924 Include the pmceeds of litigation and the date the proceeds were received bylhe estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION Settlement Proceeds/Survival Action- Civil Action in the Court of Common Pleas of Dauphin County, Pennsylvania, Docket No: 2003-CV-3428. Copies of Petition For Approval of Settlement and Court Order approving settlement are attached hereto. VALUE AT DATE OF DEATH 75,000.00 2W46AD 2.000 TOTAL (Also enter on line 5 Recaoitulation) $ (If more space is needed, insert additional sheets of the same size) 75,000.00 REV-15t1 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Radnor, Chester J FILE NUMBER 21-2001-00924 Debts of decedent must be reooried on ScheduJe I. ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: 1. B ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 0.00 Name of Personal Representative(s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2 Attorney Fees 0.00 3 Family Exemption. (If decedent's address is not the same as claimant's, aUach explanation) 0.00 Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 0.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 7. Legal Fee - R.J. Marzella & Associates 26,250.00 8 Costs associated with Civil Action - No:2003-CV-3428 2,448.80 9 Gerald J. Shekletski, Esq. - Legal Fee for 1,000.00 preparation of FA Supplemental Inheritance Tax Return 10 Cumberland County Register of Wills - Additional 140.00 Probate Fee TotaL rrom cont~nuat~on pages. ,.. .L~.UU TOTAL (Also enter on line 9, Recapitulation) $ 29,853.80 2W46AG2,OOO (If more space is needed, insert additional sheets of same size) Estate of: Radnor, Chester J Schedule H, Part B -- Administrative Costs Item No. Description 11 Cumberland County Register of Wills - Filing fee for Supplemental Inheritance Tax Return. TOTAL. (Carry forward to main schedule) Page 2 21-2001-00924 Amount 15.00 15.00 REV-1'S13 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Radnor Chester J NUMBER I. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (0)(1.2)J Radnor, II, Chester J 429 Auburn Drive Apartment 205 Daytona Beach, FL 32118 1. 2 Radnor, Dale R 643B Locust Point Road Dillsburg, PA 17019 3 Radnor, III, Chester J 4357 North 2nd Street Harrisburg, PA 17110-1603 4 Radnor, Steve 1008 Hunters Ridge Way North Las Vegas, NV 89032-7897 5 Radnor-Whitehead, Michelle 4008 Gulf View Drive Mechanicsburg, PA 17050 FILE NUMBER 21-2001-00924 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Son Son Grandchild Grandchild Grandchild AMOUNT OR SHARE OF ESTATE 1/3 of Re,,1.du" 1/3 of Residue 1/9 of Residue 1/9 of Residue 1/9 of Residue ENTER DOLlAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVlE ON LINES 15 THROUGH 18, 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. 2W46All,OOO TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DlSTRIBUTlONS ON LINE 13 OF REV-1500 COVER SHEET (Jf more space IS needed, Insert additional sheets of the same size) $ 0.00 LAST WILL AND TEST AMENT OF CHESTER J. RADNOR I, Chester J. Radnor, of Enola, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare as and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST I direct the payment of my debts and expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done SECOND I direct that all inheritance ana estate taxes becoming due by reason of my death, whether such taxes may be payable by my estate or by any recipient of any property, shall be paid by my co-executors out of the property passing under this Will which is not specifically bequeathed or devised, as an expense and cost of administration of my estate. My co- executors shall have no duty or obligation to obtain reimbursement for any such tax paid, even though on proceeds of insurance or other property passing under this Will. THIRD I hereby exercise aU powers of appointment which I may have at the time of my death in favor of my co-executors and all property subject to all such powers of appointment shall be included in my estate. FOURTH I give, devise and bequeath my entire estate be divided into three equal shares and be distributed as follows: one share to my beloved son Chester J. Radnor II, one share to my beloved son Dale R. Radnor, and one share to be distributed in equal portions to each of my beloved grandchildren who by name are Stephen Radnor, Michelle Radnor and Chester J. Radnor III. The aforementioned grandchildren are to have their shares held in trust. Each grandchild will receive his or her share of the trust upon reaching his or her twenty fifth birthday - subject to the provisions of paragraph five. 2 I FIFTH If at any time any grandchild named in Paragraph Four above has not reached the age of twenty-five at the time of my death, I appoint my brother, Donald Radnor of 4 Hickory Drive, Mountaintop, P A as trustee of the assets payable to such grandchild or grandchildren, and shall have full authority to use such assets in any manner such trustee shall deem advisable for the best interests of such child, including support, maintenance and education, including college, university, post-graduate or other education, without securing court order. Said trustee is specifically relieved of the obligation to file my bond. SIXTH I hereby nominate, constitute and appoint my beloved children, Chester J. Radnor II and Dale R. Radnor as Co-Executors of this my Last Will and Testament. My Co-Executors are specifically relieved of the duty or obligation of filing any bond or bonds. IN WITNESS WHEREOF, I have set my himd and seal to this, my Last Will and Testament, consisting of this and the preceding two (2) pages, this~"- day of April, 1996. /..'C-_" '-" } //' " '\ r_ rL- . ~_"_-<,---__ Chester 1. Radnor 3 , I SIGNED, SEALED, PUBLISHED AND DECLARED by the above named testator, as and for his Will, in the presence of us, who, at his request, in this presence, and in the presence of each other, have hereunto subscribed our names as witnesses in attestation thereof residing at .1/<';-3 N. 2nd SI. I-! DfJ m /=1-10 e II clz'lfr-L" 4r residing at I L/tl 3 AI //7c/ Y /lbv ?ff 17/01y () - --",",- ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN I, Chester J. Radnor, Testator, 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 Will; that 1 signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. " . I . -_.- /'/ /, " , ''--' /~:"jL~"~ / / l~(c( 1....-L....'I.-- ~. /'/ v Sworn or affirmed to and acknowledged before me, by Chester J. Radnor, Testator, this _....::.;- day of April, 1996. ~~.JJ. ,fAul!--<'f'..)C0v..---'-/ /1 J Notary Public Notana; Seal Sandra G. Dtagovan, Notary PubiC HanisOOrg, Dal.l'hin County My Commission Expires Sept. 16, 1996 Memller, . i\sSOCialiOIl of Notaries . AFFIDAVIT We, j OO'{ LYN N {' 12-1'.:,;\ and flJa-ncc-\ ;: - 70.,rei 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 CHESTER J. RADNOR sign and execute the instrument as his; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge, information and belief, the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by and !7Mt.L(f C. ~d- witnesses, rd-cJ--~r" Jt r't,',/- this % day of April, 1996. ~ ~.1 W~ ~ 7t{l'1~<L- f' >4 ^7J- WITNES ~~fl41CL(o 11. Jy (/(;-// C/~ NOTARY PUBLIC , . NOlAna: Seal SandIa G. Otagc-,.n, NotaJy Public Harrisburg, O.uph'n County My CommiSSlOn E'piresSept.16, 1996 ., r, Bnl1$ylvania Asso<:iallen of Notaries ., c -" 'CO' 1:J; c-- .~ p '- ,~, .---. '. ~ R. J. MARZELLA & ASSOCIATES, P.C. BY: Robin J. Marzella, Esquire Email: rmarzella@rjmarzella.com Pennsylvania Supreme Court I.D. No. 66856 3513 North Front Street Harrisburg, PA 17110 Telephone: (717) 234-7828 Facsimile: (717\ 234-6883 -c f" ~( yC . /' ~ 0>>- -- -- .' Attorneys for Plaintiffs, Chester Radnor, n and Dale Radnor ..... s:- .-l IN THE COURT OF COMMON PLEAS OF DAUPHIN COUNTY, PENNSYLVANIA CIVIL ACTION - LAW CHESTER RADNOR, II and DALE RADNOR, CO-EXECUTORS, of the ESTATE OF CHESTER RADNOR, Plaintiffs DOCKET NO: 2003-CV -3428-CV Civil Action - Medical Professional Liability Action vs. THE MILTON S. HERSHEY MEDICAL CENTER, Defendants JURY TRIAL DEMANDED ORDER AND NOW, this ftdayof ~" 2005, upon consideration of Plaintiff's Petition for Approval of Wrongful Death and Survival Actions against The Milton S. Hershey Medical Center, it is hereby ORDERED that: 1. Settlement in the gross amount of $75,000.000 is APPROVED 2. Distribution shall be made as follows: TO: R.J. Marzella & Associates, as counsel fees $26,250.00 TO: RJ. Marzella & Associates, as reimbursement of costs $2,488.80 1 TO: Chester Radnor, II, Co-Administrator of the Estate of Chester Radnor Wrongful Death Action Survival Action $ 0.00 $15,420.40 TO: Dale Radnor, Co-Administrator of the Estate of Chester Radnor Wrongful Death Action Survival Action $ 0.00 $15,420.40 TO: Stephen Radnor, Grandson designated in Decedent's Last Will and Testament $ 5,140.13 TO: Michelle Radnor, Granddaughter designated in Decedent's Last Will and Testament $ 5,140.13 TO: Charles Radnor, III, Grandson designated in Decedent's Last Will and Testament $ 5,140.14 TOTAL AMOUNT FOR DISTRIBUTION $ 75,000.00 3. Chester Radnor, II and Dale Radnor, as Co-Administrators, are authorized to execute all settlement documents on behalf of the Estate of Chester Radnor. BY THE COURT: ~tf)~ , J. Distribution: Robin J. Marzella, Esq., 3513 North Front Street, Harrisburg, PA 17110 Grant Fleming, Esq., 600 Centerview Drive, Suite 5103, Hershey, PA 17033 _ JAN 272006 k::, ~ ~t lhe f-.-"In,. . fII6f. 00frect ~/{~~ ~<!./~~_ 2 R. J. MARZELLA & ASSOCIATES, P.c. BY: Robin J. Marzella, Esquire Email: rmarzeIla@rjmarzella.com Pennsylvania Supreme Court I.D. No. 66856 3513 North Front Street Harrisburg, PA 17110 Telephone: (717) 234-7828 Facsimile: (717) 234-6883 Attorneys for Plaintiffs, Chester Radnor, II and Dale Radnor IN THE COURT OF COMMON PLEAS OF DAUPHIN COUNTY, PENNSYLVANIA CIVIL ACTION - LAW CHESTER RADNOR, II and DALE RADNOR, CO-EXECUTORS, of the ESTATE OF CHESTER RADNOR, Plaintiffs DOCKET NO: 2003-CV-3428-CV Civil Action - Medical Professional Liability Action vs. THE MILTON S. HERSHEY MEDICAL CENTER, Defendants JURY TRIAL DEMANDED ORDER AND NOW, this _ day of , 2005, upon consideration of Plaintiffs Petition for Approval of Wrongful Death and Survival Actions against The Milton S. Hershey Medical Center, it is hereby ORDERED that: 1. Settlement in the gross amount of$75,000.000 is APPROVED 2. Distribution shall be made as follows: TO: R.J. Marzella & Associates, as counsel fees $26,250.00 TO: R.J. Marzella & Associates, as reimbursement of costs $2,488.80 TO: Chester Radnor, II, Co-Administrator of the Estate of Chester Radnor Wrongful Death Action Survival Action $ 0.00 $15,420.40 TO: Dale Radnor, Co-Administrator of the Estate of Chester Radnor Wrongful Death Action Survival Action $ 0.00 $15,420.40 TO: Stephen Radnor, Grandson designated in Decedent's Last Will and Testament $ 5,140.13 TO: Michelle Radnor, Granddaughter designated in Decedent's Last Will and Testament $ 5,140.13 TO: Charles Radnor, III, Grandson designated in Decedent's Last Will and Testament $ 5,140.14 TOTAL AMOUNT FOR DISTRIBUTION $ 75,000.00 3. Chester Radnor, II and Dale Radnor, as Co-Administrators, are authorized to execute all settlement documents on behalf of the Estate of Chester Radnor. BY THE COURT: J. Distribution: Robin J. Marzella, Esq., 3513 North Frout Street, Harrisburg, P A 17110 Grant Fleming, Esq., 600 Centerview Drive, Suite 5103, Hershey, PA 17033 2 R. J. MARZELLA & ASSOCIATES, P.e. BY: Robin J. Marzella, Esquire EmaiI: rmarzeUa@rjmarzella.com Pennsylvania Supreme Court I.D. No. 66856 3513 North Front Street Harrisburg, PA 17110 Telephone: (717) 234-7828 Facsimile: (7171 234-6883 Attorneys for Plaintiffs, Chester Radnor, II and Dale Radnor IN THE COURT OF COMMON PLEAS OF DAUPHIN COUNTY, PENNSYLVANIA CIVIL ACTION - LAW CHESTER RADNOR, II and DALE RADNOR, CO-EXECUTORS, of the ESTATE OF CHESTER RADNOR, Plaintiffs DOCKET NO: 2003-CV -3428-CV Civil Action - Medical Professional Liability Action vs. THE MILTON S. HERSHEY MEDICAL CENTER, Defendants JURY TRIAL DEMANDED PETITION FOR APPROVAL OF SETTLEMENT The Petition of Chester Radnor, II and Dale Radnor, who were appointed Co- Executors of the Estate of Chester Radnor, deceased, respectfully represents: 1. Petitioner is Chester Radnor, II and Dale Radnor, who were appointed Co- Executors of the Estate of Chester Radnor, deceased on June 22, 2001 by the Register of Wills of Dauphin County. (A copy of the Decree of the Register of Wills is attached hereto as Exhibit "A ".) 2. The Decedent died on February 11, 2001 as a result of complications from a right-sided pleural effusion that, allegedly, went undiagnosed and untreated resulting in Mr. Radnor's death. "B".) 3. The decedent died testate. (A copy of the Will is attached hereto as Exhibit 4. The following settlement has been proposed: $75,000.00 has been offered to Chester Radnor, II and Dale Radnor to resolve any and all claims they may have against the Milton S. Hershey Medical Center. 5. Counsel is of the professional opinion that the proposed settlement is reasonable. Mr. Radnor was 74 years old and suffered from various medical problems including senile dementia Alzheimer's type, coronary disease, prostatic hypertrophy, nephrolithiasis, and urinary incontinence. Moreover, it is unknown whether or not earlier medical intervention would have saved his life. 6. Petitioner is of the opinion that the proposed settlement is reasonable. 7. Counsel has incurred the following expenses for which reimbursement is sought: The total for out of pocket expenses is $2,488.80. This includes medical records, deposition, filing fees, etc. fA copy of the accounting ledger and the receipts are attached hereto as Exhibit "C".) 8. Counsel's expense sheet shows a check that was paid to Cynthia Evans in an amount of $600.00 representing nurse consulting fees. The check stub for this fee is missing, however the check was cashed and deposited by Cynthia Evans. 9. Counsel requests counsel fees in the amount of$26,250.00, which represents 35 percent of the gross proceeds of settlement. (A true and correct copy of counsel's fee agreement is attached hereto as Exhibit "D"). 10. Petitioner requests allocation of the net proceeds of the settlement, after deduction of costs and attorney's fees as follows: Wrongful Death Action Survival Action 0% 100% II. The reason for the requested allocation is as follows: At the time of his death in February of 200 I, Mr. Radnor was 74 years old and his permanent residence was a nursing home. Therefore, at the time of his death Mr. Radnor had no dependents and his entire estate shall be deemed a survival action that will be divided according to his Last Will and Testament. 12. According to Chester Radnor's Last Will and Testament, his estate is to be divided as follows: Name Relationship Interest Chester J. Radnor, II Dale R. Radnor Son Son ](3 1/3 2 Stephen Radnor Michelle Radnor Chester J. Radnor, III Grandson Granddaughter Grandson 1/9 1/9 1/9 13. Pursuant to Chester Radnor's Last Will and Testament, the beneficiaries of the survival action and their respective monetary allowances are as follows: Name Relationship Allowance Chester Radnor, II Dale Radnor Stephen Radnor Michelle Radnor Chester Radnor, III Son Son Grandson Granddaughter Grandson TOTAL $15,420.40 $15,420.40 $ 5,140.13 $ 5,140.13 $ 5.140.14 $46,261.20 14. The three grandchildren listed above are receiving the appropriate allocation under the Last Will and Testament of Chester Radnor because they are all above the age of twenty-five (25) as required in the decedent's will. 15. In accordance with the above allocation, $46,261.20 will be allocated to the survival action. 16. The survival action beneficiaries are in agreement with the proposed distribution. 17. There are no known liens or claims against the proceeds of these actions or against the decedent's estate. WHEREFORE, Petitioners requests that they be permitted to enter into the settlement recited above and that the Court approves the proposed allocation and distribution of the settlement proceeds. Respectfully submitted, a, Esquire Att ey etitioner Attorney LD. #66856 3513 North Front Street Harrisburg, PA 17110 Date: / bo !o;) , I I 3 - EXIlIBI1' .. A.' - ,. , 'I \ \, ','. , , " . ..")\....., '\ ' ~'" I :t-'~: " il,), " "--1.-" :' .'- !v~r1:!,_"!,w,,~}"\~r~,,,{",'1 JI:'li~41: " ", I . ~~--, ".\ "",'j ,;.j Register of Wills of CUMBERLAND County, pennsylvania certificate of Grant of Letters , . :"./\/. '(" ;/ '/ ,. .. ",- .. ;-~ ,~"- ., :\ No. 2001-00924 PA No. 21-01-0924 ESTATE OF RADNOR CHESTER J \LA::i'l', !,'It(I:)'l, IVJ.l.LJULJ:.i) Late of CAMP HILL BOROUGH CUM~~KLANU CUUNiX, on the 25th Deceased Social Security No. day of October 193-16-8981 WHEREAS, dated April 8th 1996 2001 an instrument was admitted to probate as the last will of RADNOR CHESTER J (UA~l, ~~K~l, MiUULb) late of CAMP HILL BOROUGH CUMBERLAND County, who died on the 24th day of September 2001 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS , Register of Wills in and for the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to RADNOR CHESTER J II and RADNOR DALE R who have duly qualified as Executor {rix} and have agreed to administer the estate according to law, all of which fully appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my Office the 8th day of October 2001. ~~~ . e ~s \: ~ ~ **NOTE** ALL NAMES ABOVE APPEAR {LAST, FIRST, MIDDLE} 8 /c: # evl9 vLL L~L~ X3HS ~3^V~VI 3NOLS~~V9~; ~ ~ ~vO-O€-~ ~ - EXHIBIT ttBU - LAST WILL AND TESTAMENT OF CHESTER J. RADNOR 21-2001-924 I, Chester 1. Radnor, of Enol a, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare as and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST I direct the payment of my debts and expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. SECOND I direct that all inheritance and estate taxes becoming due by reason of my death, whether such taxes may be payable by my estate or by any recipient of any property, shall be paid by my co-executors out of the property passing under this Will which is not specifically bequeathed or devised, as an expense and cost of administration of my estate. My co- executors shall have no duty or obligation to obtain reimbursement for any such tax paid, even though on proceeds ofinsurance or other property passing under this Will. 8 /8 # 81>~9 vLL L(L! ~3HS ~3^~~~1 3NO~S!~~9~: ~L!vO-O€-L~ THIRD I hereby exercise all powers of appointment which I may have at the time of my death in favor of my co-executors and all property subject to all such powers of appointment shall be included in my estate. FOURTH I give, devise and bequeath my entire estate be divided into three equal shares and be distributed as follows: one share to my beloved son Chester J. Radnor II, one share to my beloved son Dale R. Radnor, and one share to be distributed in equal portions to each of my beloved grandchildren who by name are Stephen Radnor, Michelle Radnor and Chester J. Radnor ill. The aforementioned grandchildren are to have their shares held in trust. Each grandchild will receive his or her share of the trust upon reaching his or her twenty fifth birthday . subject to the provisions of paragraph five. 2 e /1>' # €1>'~9 vLL L~L~ ~3HS ~3^~~~1 3NOLS:~V9t: ~L:vO-O€-LL FIFTH If at any time any grandchild named in Paragraph Four above has not reached the age of twenty-five at the time of my death, I appoint my' brother, Donald Radnor of 4 Hickory Drive, Mountaintop, P A as trustee of the assets payable to such grandchild or grandchildren, and shall have fuI] authority to use such assets in any manner such trustee shall deem advisable for the best interests of such child, including support, maintenance and education, including college, university, post-graduate or other education, without securing court order. Said trustee is specifically relieved of the obligation to file my bond. SIXTH I hereby nominate, constitute and appoint my beloved children, Chester 1. Radnor n and Dale R. Radnor as Co-Executors of this my Last Will and Testament. My Co-Executors are specifically relieved of the duty or obligation of filing any bond or bonds. IN WITNESS WHEREOF. I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding two (2) pages, this ~ day of April, 1996. ('?k.2Z:-' .1 A<.[ Chester rRadnor 3 6 /9 # EVL9 vLL L'L~ ~3HS ~3^~~~r 3NOLS~~V9L:,L:VO-O€-LL . . SIGNED, SEALED. PUBLISHED AND DECLARED by the above named testator, as and for his Will, in the presence of us, who, at his request, in this presence, and in the presence of each other, have hereunto subsCribed our names as witnesses in attestation thereof. ?ifC~ residing at ...vo 3 N. 2nd SI. /-/bfj .f?4 I =r10 S '71 ~ A'7-"",,,,g,, "/1 3 1( ~d .9 JjPt7 r/f /7/C>P tJ e /9 # S'1d9 t>LL .L~L~ ~3HS ~3^V~Vi 3NO~S:~V9~: LL~t>O-O€-L. ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPlDN I, Chester 1. Radnor, Testator, 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 Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ."J / "/ // L /tc7&=~ /1<-~cL~ Sworn or affirmed to and acknowledged before me, by Chester 1. Radnor, Testator, this ~ day of April, 1996. ~yj.~J~ Notary Public NolafIaiSeal SllnltaG. ~NdIlIyNic My~E>cpInls~l996 ...............dNo1aJieS 8 /L # ~td9 vLL L~L~ ~3HS ~3^~~~f 3NO~S:~~9L:LL~vO-O€-LL . . AFFIDAVIT We, j CD'/. LYNN C f24~-r. , and' rJO-.n~ r - ?6.rn1 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 CHESTER J. RADNOR sign and execute the instrument as his; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each ofus in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge, jnformation and belief, the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affinned to and subscribed to before me by ~ ~hI'"\ fl1"'~J. and l7a c. ~ witnesses, this .2S" day of April, 1996. j1~~ L~ f: >4r- ,\\.11\',- ~\\,,".". .,' .' ~ ~JAldta 11. Jy,~ii)~" NOTARY PUBLIC! ...... . , . NaenolSea. ~~~I'OO&J Mv<:omn&m.El/Pi8ss.,i.l6, 1996 -. . . , ........ 6 /8 # €1>'~9 VLL .L~L: ~3HS ~3^~~~1 3NOLS:~~9~: ~ ~ ~vo-o~-~ ~ - EXlJ1D1't t"C~t - () 0.. If) W f- e{_ () ... o 0 1f)Q. If) C1l e{a:~ o..ll::O ~.2 ~ w ;j :Jl o::O~ :::> - ~ ocf- (/) ;j < W 0 ~(.) -' (.) uJ<c N 0:: e{ :;; ..., ex: .. 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Q) - .. o cry C")('l')('f') O'<:tl,() NOOOC"')C"')OOQ ~OOOOOOC\JOO ....o~~~oor::~~ m~"-<Dr-~~..-Q')Q) .I::.~:c~:!:::t:::t::o~:C u..-(,<)-::I"t-COCOr-t--..-- '0 Q) 16 OJ "' w " ..: "(ij 0 a. c: ~C/)"O..:!l:::"y'.:::t:..Y."::'::::z:.~.Y..:::s:. 0..- <<!o(.,)oooo(,)()O .....:!a:(l)Q)Q)Q)Q)Q)Q)Q)Q) ~ri 686666600 (J Q) a. ~ ~ Q) u; Q) .c U o Q) 1i1 u; w o c " '" a: Cii (5 f- o CO <Xi co ... N o co <Xi co ... C\J If) :;:; ..., a: Cii - o f- - o CO <Xi co .... C\J o <0 <Xi co .... N Q) 0> l\l 0.. o ~ co co .... C\J a co cO co .... N '" " '(I; 0- III ct - c ,<!! <3 Cii a f- ..J <t b f- :::J CD .0 -. co "< 00 '<t N o o ~ '" ... '" [.LJ ~ o C "tJ '" eX Vi OJ OJ '" 1: 5 . OJ 0. :V'l >< .. [.LJ '- ~..c l.:t:-o ",.- OJ '" :co. . OJ , ~ --:0.. >-... 'c t.I.. .~ U ..; .~ i:"lei ,.; "-1, '.',., i \D '" 00 <t M CII 00 \0 M 6- <Xl ,-'I .'- ~ OJ ... '" OJ .<: U ..: o c. "tJ '" eX i:'r :..f;(:' ,:+;. it;};' 3: H\; t~;~ L;I["\~ ~ . ."~ ~ 11,1 {'.) 0 8 2'"'' )""'1" l!E.h. (: -------------------- ! \-,...,(;\::1; f>3.':,,,,: INVOICE .i '..', i} ij, :~ iJ G ,] Hei!e~:-,.:~Hc::;~~ #', ;,{;'3 .i;j:.~' ,It;-,, fJ9DJ. ..',' '5~ w'.er'I' ,~\...~X" 'I' .L-?:.2"4'If'J ./... '''3 i-'J,~: \:~ ~.:' 'k_UUU.j AMOUNT DUE ,-',;'; ',,,.'.,; ,.. ':0.:"'.:H "j ~, ).(ut-m~.:;F_;)l:~. 'let..:(.,_ '..\", ;: ;' ORIGiNAL ''i':;'' '-!.:i:"j{ N o;:~ he ~I ;.i, , ) j ; ) 0'\ / 0'\ "l "l 00 00 IJ'l IJ'l - M o o N -- - - -- M o o 0'\ " "" & ct:l , - '" ... '" "" ..: o c -0 OJ'" i::":': OJ '" '" OJ -C'" ... C -OJ "'n. OJ >< ::t:"" e--o O"ra un. ~ ~ 50.. 0'" "'c .~ U .ti:i.;~;n'.;i.': :.'L;:;~'n_' ~'H:"'i:" ..~''::C:.m ..i'.l{',' ~ --.~ ---'.~:(::' INVOICE '_._n.'..',.'.. :~_ 'T . .' :;"1't I .' :,.~ U 'J ~'~"::'~7':"':~C,"~~'~!.:;~:'~ J: .i.:~",} :.,;j;j:: ":>. ".j', :',0 "";"t VISA I MASTERCARD ACCEPTED ORIGINAL Time Sheet for Cynthia Evans Chester Radnor File Date 4/14/03 Hours Applied 1.2 1.7 2.6 2.5 2.1 0.7 1.6 0.4 3.5 0.3 1.4 1.5 0.3 0.3 4/15/03 4/16/03 Decription of Activity Put chart in chronological order Began medical summary Cominuedmeilicwsummary " " " Finished medical summary Put file back in Bate stamped order Wrote Facts portion of summary Research Computer work-Summary portion Printed & proofread summary Wrote Conclusions Computer work- conclusions Printed & proof read conclusions Time sheet Total Hours 20.1 R.J. MARZELLA ESQUIRE & ASSOCIATES. P.C. . ' . .,,- CYnthia Evans Client Prepaid Expenses:Radnor, Esta Fr~ 9302 411612003 703.50 703.50 Date'.. 81712003 . . 'Time: 03:30 PM .~ Received of: Marzella, Robin J (attorney for Radnor, Chester II Dauphin County Receipt NO. 0039880 Page 1 of 1 $ 105.00 One Hundred Five and 00/100 Dollars Case: 2003-CV-3428-CV Complaint Total: Plaintiff: Radnor, Chester II Amount 105.00 105.00 / / , ,It Check: 09532 Payment Method: Check Amount Tendered: Stephen E Farina / Lowell Witmer, Prothonotary / Clerk of Cou 105.00 By: Deputy Clerk Clerk: NCAHILL Duplicate / P;:::C'-1~ST":-;T ~ The jvlilwTJ ;). HersiJe" . J,ledi::al Cemer . <;1' \ ~~ ~ 0 ~~ RE:Account # P~(ient Narne:G~s~,,- Enclosed are the copies of the bills you requested. B Checks should he made payable to: Hershey Medical Center P.O. Box 853 Hershey Pa 17033 Atrn: Cindy Frantz OurPederal Tax LD. #'s are: Physician 25 1857035, I If the patient was eligible for Medical Assistance Benel Assistance Recovery Board. Deparnnent of Public Welfare Bureau of Financial OperatioDS TPL section Casualty Unit P.O. Box 8486 Harrisburg PA 17105. Please contact The medical Asistance Recovery Board di Sincerely, ~~~~~~ Patient Financial Services 717-531-5984 o (J) CfJ (J) o o ~ If) .- ~ o C:I. r-- .- 25 .- U 0.: vi '" !;( Li o III lJ) c( <i:l '" a:: ::> ~ c( ::l '" N a:: c( ::E .... o C -0 co '" ~ CC J, ... '" C ... ~ -0 ';;j c:>. ... ....; u 6: 0:: ::2:~ ::c .~ D \ o ~ Ll> .- <Xl "" '"' 1.0 1.0 .- ~ Cii .... o c -0 ~ .... ... ~ '" <lJ 6 u Ii: Manor Care Client Prepaid Expenses-RjM:Radnor '----- ' FTC Chester Radnor .l..l.U~4 7/2912004 97.90 97.90 (lDpLQof tp1- ~!-(~~ h <.,$ /)/1/7 ~l.. ) LJ-J!- 91. CZ () ( r/u~~ /lJt~ (;/LJ:bCfI'(/ ~/YJ}CVl~~i Ml~@~n\W~1ii1 I JUl 2 3 2004 1!)J BY: _'_.m. ......---------- An HeR Manor Care Company Page 1 of 1 . Robin Marzella .~.__._---~-~.....".----_._~---_._'- "- -~,----- From: Chris Carlisle [c-dcorral@prodigy.net] Sent: Wednesday, January 19, 2005 12:24 PM To: Robin Marzella Cc: foresightservices@comcast.net Subject: Chester Radnor Robin, Jack emailed me with the totals so you can submit them with your setllement costs. He will foliow later with a hard copy invoice. 5.25 investigative hours for Data searches $472.50 $240.95 $71345 Tolai Due Pav to Foresight Service, Inc. P.O. Box 1886 Doylestown, Pa. 18901 Thanks for the assignment! Chris 1/19/05 - 0- ~. '"'r1 :0 ;J, ~g \- -0'" , n '"" .'e. ~ ~ ~~ ~ ~.f-T 'j;!, 0 0- if' \ V> '" ~ 7>< ~_. . ~\i % ~ if'v> " :;:0-- c ~ eJ.';:) - o-r> ?l. ::> 0 ~ ;' fi, rrl 'A '8 ~ n '" ~ ~ ; "" " f> ~ , \ \ ..... -;;. \D . 'g . <}l -' .... ~ vJ ~ 't{. Ct:l -' (J1 ..... (0 <.oJ ~ \ - - EXIIIBIT till'. - ~' . POWER OF ATIORNEY AND CONTINGENCY FEE AGREjJMENT I (We), Dale and Chester Radnor, the undersigned, hereinafter called "client(s)" hereby retain, appoint, and nominate R. J. Marzella and Associates, P.C., its members and associates, hereinafter called "attorney" to represent client(s) as legal counsel for all purposes in connection with our father's death. Client(s) and attorney hereby agree as follows: 1. Initial Evaluation - Attorney will undertake an initial investigation and evaluate the merits of this case. No attorney fee will be charged for attorney work in connection with the evaluation. Client(s) shall provide in advance a retainer of 0 to be used for the purposes of paying the costs associated with the initial investigation. Attorney will review the pertinent records and will advise the client(s) concerning the probable merits of the case. If the initial evaluation of the merits of the claim is favorable, attorney will advance the costs of prosecuting the case. These costs shall be repaid by client(s) as specified in paragraph 5 below. Attorney reserves the right to terminate the agreement after the initial evaluation ifthe case is determined not to have merit, at which time any balance remaining in the trust account after payment of expenses shall be returned to dient(s). 2. Attornevs Fees - In payment for the services performed by the attorney, client(s) hereby agree that attorneys fees shall be paid as follows: (a) Prior to preparation for trial or arbitration, payment for services shall be (35%) contingency fee on the total amount paid in settlement of the claim; and (b) After preparation for trial or arbitration begins, payment for services shall be (40%) contingency fee on the total amount paid by either settlement or verdict. (c) In the event of a settlement in the form of a structured settlement, it is agreed that attorney fees shall be paid according to the above terms based on the cost of the structured settlement to the settling party(s). It is further understood and agreed that the amount to be paid as the attorney fees on the structured settlement shall be paid on a lump sum basis at the time the structured settlement is entered into by the client(s). . 3. Settlement - No settlement of this case shall be made without the c1ient(s) prior approval. 4. Distribution of Proceeds - Client(s) further agrees that from the proceeds of any recovery, whether by settlement, judgment or otherwise, the attorney may deduct the attorneys fees to which it is entitled, together with all costs and expenses which have been advanced or remain unpaid; and c1ient(s) further agree that the attorney may deduct the amount of all unpaid bills for professional services and make disbursements of such funds directly to the creditors involved. 5. Cost Advance - Attorney shall have the authority to make advances and to incur such costs as the attorney determines necessary in the processing of the c1ient(s) case. Such advances and costs include but are not limited to: (a) Fees for physicians, psychologists, accountants and other experts which attorney deems necessary to assist in handling of c1ient(s) case; (b) Copying charges, travel expenses, court costs, deposition expenses, long distance telephone calls, postage. In the event of a monetary recovery, c1ient(s) agree to reimburse attorney for the above-referenced expenses incurred. After the attorneys fees are deducted from the settlement and/or verdict, the expenses shall be repaid to attorney out of the remaining balance of the settlement and/or verdict. If c1ient(s) rejects a settlement offer that attorney believes is reasonable and equitable under the circumstances, c1ient(s) agree to be responsible for any and all out-of-pocket expenses incurred during the pursuit of their claim, irrespective of a monetary recovery. 6. Withdrawal - If, during the pursuit of this case, the attorney determines that, under the existing circumstances, it is not feasible or practicable to prosecute this case, upon notification to the c1ient(s) of such facts, the attorney may withdraw from representation under this agreement. 7. Appeal -If the c1ient(s) authorizes an appeal of this case, the attorneys fees shall be increased by 5% more than the fee set forth above to cover the additional work involved in handling of of the appeal. . 8. Fee Division - In the event that client(s) were referred to R. J. Marzella and Associates, P.c. by a referring attorney, client(s) do not object to the division of the attorneys fees being charged the c1ient(s) between the attorney and the referring attorney. Client(s) understand that they will not pay any additional fee as a result of the division of the fee between attorney and referring attorney. 9. Termination of Al!"reement bv Client(s) - In the event that the c1ient(s) make the decision to seek legal representation elsewhere regarding the incident described herein, c1ient(s) agree to immediately reimburse attorney for all expenses incurred to date. Moreover, for the work performed to date by the attorney, c1ient(s) agrees that in the event of an ultimate monetary recovery, attorney is entitled to reasonable compensation (quantum merit) from any verdict or settlement. 10. Arbitration. Any dispute between the attorney and the client(s) shall be resolved by arbitration. The arbitrators shall be members of the Pennsylvania Bar Association. The attorney shall select one arbitrator. The client(s) shall select one arbitrator. The two arbitrators shall select a third arbitrator. The arbitrators shall, by majority vote, establish all rules pertaining to the arbitration, including determining how the cost of arbitration shall be paid. If the dispute is not resolved, the rules of the American Arbitration Association in effect at the time shall apply and control. I (We), Dale and Chester Radnor, have read the above agreement and understand and agree to its terms. There are no oth~reements between (:he parties hereto. This agreement is entered into this / -j( day of A1 P A. J I , 2001. cJ9i~ R ;gJffV Dale Radnor Chester Radnor, II 4-/ s~ 6 2- Date Date . CERTIFICATE OF SERVICE I, Adam G. Reedy, hereby certifY that a true and correct copy of the foregoing document was served upon all counsel of record this 20th day of January 2005, by depositing said copy in the United States Mail at Harrisburg, Pennsylvania, postage prepaid, first class delivery, and addressed as follows: Grant Fleming, Esquire McQuaide, Blasko, Schwartz, Fleming & Faulkner, Inc. 600 Centerview Drive Suite 5103 Hershey, PA 17033 R. J. MARZELLA & ASSOCIATES, P.c. By: Adam G. Reedy 08-08-2005 RADNOR 09-24-2001 21 01-0924 CUMBERLAND 501 APPEAL DATE: 10-07-2005 ( See reverse side under Objections) Amount R~ittedl I 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:is47-Ex-AFP-ioi:osi-NOTICE-OF-INHERITANCE-TAX-APPRAIsEMENT:-ALLOWANCE-OR--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX CHESTER J FILE NO. 21 01-0924 ACN 501 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PD BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE P[('(1 - ;-\I\l^;tC~,.!IF INHERITANCE TAX 'LuJR~~Ell!>!!~),'ALLOWANCE DR DISALLOWANCE R~r::c iYf :D~D~T~S AND ASSESSMENT DF TAX , - ',. '-" .," '.-' ' ~ ;....... 2005 MiG -5 MIll: 53 DATE ESTATE OF DATE DF DEATH FILE NUMBER COUNTY ACN GERALD J SHEKLETSKIC: 414 BRIDGE ST PO BOX E NEW CUMBERLAND 01 i:R'/ "'F V_I.- 11\ I.j . CF'j:-'-'i';,":, I' ,...." i;.)T ,. PA 17070 ESTATE OF RADNOR *' REV-1547 EX AFP (06-05) CHESTER J TAX RETURN WAS: I X) ACCEPTED AS FILED ) CHANGED DATE 08-08-2005 I~ an assess.ent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will r~1ect ~igures that include the total ~ abb returns assessed to date. ASSESSMENT DF TAX: 15. AltOunt of Line 14 at Spousal rate (15) 16. ~unt of Line 14 taxable at Lineal/Class A rat. (16) 17. ADount of Lin. 1~ .t Sibling rat. (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due T X CT. RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: LITIGATION RETURN 1. R.a1 Est.t. ISchedu1e A) (1) 2. Stocks and Bonds ISchedu1e B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) (5) 6. .Jointly Owned Prop.rty ISchedu1. f) (6) 7. Transfers (Schedule G) (7) 8. Total Assets .00 .00 .00 .00 75.000.00 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Tot.1 DaducUons 12. Net Value of Tax Return 13. Charitabl./Gov.rn..ntal Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 29,853.80 .00 Ill) (12) (13) 11~) NOTE: .00 45,146.20 .00 .00 X 00 = X 045 = X 12 = X 15 = AMOUNT PAID 2,031. 00 DATE 05-27-2005 NUllBER CD005370 INTEREST/PEN PAID 1-) .00 ~. TOTAL TAX CREDIT BALANCE DF TAX DUE INTEREST AND PEN. TOTAL DUE IF PAID AFTER DATE INDICATED, SEE REVERSE FDR CALCULATION OF ADDITIONAL INTEREST. (19)= NOTE: To insure proper credit to your account, sub.i t the upper portion of this for. with your tax pa)'llent. 75,000.00 ?Q 8'i::-i Rn 45,146.20 .00 45,146.20 .00 2,031.58 .00 .00 2,031. 58 2,031.00 .58 .01 .59 IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FDR INSTRUCTIONS.)