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Home My WebLink About01-0875 PETITION FOR PROBATE and GRANT OF LETTERS No. To: 21-01-875 Estate of Myrtle B. Leedy also known as Register of Wills for the . Deceased. County of Cumberland in the Social Security No. 179-10-3957 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(~, who isJQf8: 18 years of age or older an the execut or in the last will of the above decedent, dated June 5 and codicil(s) dated none named ,~ 2001 (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h er last family or principal residence at 121 Walnut Bot tom Road, Shippensburg, Shippensburg Townshiv (list street, number and muncipality) Decendent, then ~_ years of age, died September 9 ~ 2001 , at Chambersburg Hospital. Chambersburg, PA 17201 Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: none-- Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ 173.000.00 $ $ $ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) '" 1:)' u c:: ~ ~3 4)'- ~~ c:: -00 c': cU":;: ~d:: 1:)',- 50 ~ c:: 00 i:/5 CJe~ Paul E. Hornbaker 309 Britton Road Shivvensburg. PA 17257 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA l ..coo COUNTY OF __C~BERLAND J S~ The petitioner{s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well ~d truR administer the est e ording to law. Sworn to or affirmed and subscribed ~ ~ ~ before me this 25th day of Paul E. Hornbaker ~. SEPTEMB R ~200 1 a ~ ~ ~ /?- 9- 9 ~o. 21-01-875 Estate of Myrtle B. Leedy , Deceased DECREE OF PROBATE A~D GRA~T OF LETTERS AND NOW SEPTEMBER 26 J}~2001 , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated June 5, 2001 described therein be admitted to probate and filed of record as the last will of Myrtle B. Leedy and Letters Testamentary are hereby granted to Paul E. Hornbaker FEES Weigle, Esquire ATTORNEY (Sup. Ct. I.D. N WEIGLE, PERKINS & ASSOCI 126 East King Street ADDRESS Shippensburg, PA 17257 (717) 532-7388 PHONE Probate, Letters, Etc. ......... Short Certificates( ).......... x-pag,es Ren'\mcration ................ JCP $ 235.00 $ 9.00 ~.OO $ $ 5 . 00 TOTAL _ $ 258.00 . . . . . . 9.-:Z~:-.2.QO~. . . . . . . . . . . . . . . . . . Filed ~~~~r \1 OS.80S REV 9/86 This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. .d: ~ p 7645947 ~~ Dat~ ~I' Fee for this certificate, $2.00 No. 21-01-875 1"V 2/17 COMMONWEALTH OF PENNSYLVAN'A . OEPARTMENT OF HEALTH · VITAL RECOROS CERTIFICATE OF DEATH STAI, '11.I NII.....A SOCIA~ S€CURtTY ~UIABER DATt or Of:ArH ,Mo";:"r-l;;' :';;,-- t.09/09/Z00J :=ll\olO RACE. A......IIl _. _. MI.. lllC (~I fl. Wh i tc ..., IRV1\'IHn "1f"'("M IV Iff....... "..,..".......,'"""Mt' - .~ 1720 I 2c. 0) -...ra~(F_ -...-. ..........~- '==.... :--- I I I ".,.,. t: 0Itw ......_conmlIultnQlO_...... ""'-..glft""'~__..""'""' ......................... b t..."........ -...... _,e-~_ . ~to-""'II"Y . ...-- ---- ! : .. AM AU1OI'SY M$I( AU10PSY I'lNOINOS - I't'AFOAMED7 ~PAlOIIlO COY'lETIONOFCIWISE -.. 0 OF DERH'I - 0 .....0 ...0 ....0 NoD - 0 OR! OF IH.IUllV (1Aonth. Coy, _, nw: OF IHJUtIIv /HJUAV J(f WOAIC7 DnCAI8E HOW INJURY OCCIIllflfD - ".... ........... o o o "LACIOPINJUAV...._._._.'-_ Y. -.,.... ~"'" _. ..... D NaD .-AHOca""IPYINCIPtfV8ICIAHIf'h,...,.....-"'_"'lI__<~IO<_oI_"'1 To ....-.."'Y k-..p. --......... "'" _. _. _ ........ _ _10 ......_.._ "'.n_ _ ....... CouIcf_ ......_ -. -. C8rT1'lIlt ~ only..... .CIJl1'Jn'M~~~CMJllIIoI___pI\YIC....hupr~deI'" IllClcompICMIG.-l31 -...-....,..--......___10............._"'__._....."'.".......,................................ .. a. MD. 'MaDICA&. UA_ItICOfIOHe,. On 1M........ .._....ton 1IftdI.. _.....Iton.... my oP"""". .1IIIl oe -.......................................... ............. .... 3'.. REG'STAAA'S SlONMURE ANa NU_A PA- I~tiol >> 12,/,2Jt 34. l. LAST WILL AND TEST AMENT I, MYRTLE B. LEEDY, presently residing at 201 East Burd Street, Apartment 203, Borough of Shippensburg, Cumberland County, Pennsylvania 17257, being of sound mind, memory and disposition, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void all wills by me at any time heretofore made. FIRST. I order and direct the payment of all my legally enforceable debts and funeral expenses as soon as may be convenient after my decease. SECOND. I direct my hereinafter named executor to liquidate all of my assets by public or private sale or otherwise as soon as may be practical and expedient and in the best interests of my estate and to distribute my estate as follows: A. I give, devise and bequeath fifty percent (50%) of my estate to my brother, AMBROSE Z. LEEDY. In the event that the said Ambrose Z. Leedy should predecease me or is not living on the thirtieth (30th) day following my death, I then direct that his share of my estate be given to his wife, MEDA LEEDY. In the further event that neither Ambrose Z. Leedy nor Meda Leedy survive me, I then give, devise and bequeath fifty percent (50%) of my estate to the children of Ambrose Z. Leedy and Meda Leedy, namely, LESTER LEEDY, LELAND LEEDY and KEVIN LEEDY, or to the survivor(s) of the said Lester Leedy, Leland Leedy and Kevin Leedy. B. I give, devise and bequeath thirty percent (30%) of my estate to my niece, BERTHA L. THOMPSON. In the event that the said Bertha L. Thompson should predecease me or is not living on the thirtieth (30th) day following my death, I then give, devise and bequeath thirty percent (30%) of my estate to her children, namely, TERRY THOMPSON, JERRY THOMPSON, and DIANE RICHARDSON, or to the survivor(s) of the said Terry Thompson, Jerry Thompson and Diane Richardson. C. I give, devise and bequeath ten percent (10%) of my estate to my niece, CHLOE DUNCAN. In the event that the said Chloe Duncan should predecease me or is not living on the thirtieth (30th) day following my death, I then direct that this bequest shall lapse and shall be distributed prorata among the remaining beneficiaries named in Paragraph Second. "~ f2 ~- WEIGLE. PERKINS & ASSOCIATES - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 I~ ., . D. I give, devise and bequeath ten percent (10%) of my estate to my nephew, KENNETH LEEDY. In the event that Kenneth Leedy should predecease me or is not living on the thirtieth (30th) day following my death, I then direct that this bequest shall lapse and shall be distributed prorata among the remaining beneficiaries named in Paragraph Second. THIRD. I nominate, constitute and appoint PAUL E. HORNBAKER to be the Executor of this my Last Will and Testament; if he be unable to fulfill the duties of Executor, I then nominate, constitute and appoint GRACE M. HORNBAKER to be the Executrix of this my Last Will and Testament. In the further event, if neither Paul E. Hornbaker nor Grace M. Hornbaker be able to fulfill the duties of Executor or Executrix, I then nominate, constitute and appoint ALLFIRST BANK to be the Executor of this my Last Will and Testament. FOURTH. I direct that my personal representative shall not be required to give bond for the faithful performance of his duties in any jurisdiction. IN WITNESS WHEREOF, I, MYRTLE B. LEEDY, have hereunto set my hand and seal to this my Last ~iIl and Tes~.. ent, written on two pages, the first page signed for identification only, this 6 f'1t day of ,2001. }rA),~;P- h. ~~ MYRTLE B. LEEDY WEIGLE. PERKINS & ASSOCIATES - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 ... This instrument was by the Testatrix, on the date hereof, signed, published and declared by her to be her Last Will and Testament, in our presence, who at her request and in the presence of each other, we believing her to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. ./~_o 41r2#~ .:.' (1 _~k.r ~ COMMONWEAL TH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND I, MYRTLE B. LEEDY, the person whose name is signed to the 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. ~ 13. ~ ~ MYRTLE B. LEEDY ~ f Sworn or affirmed to and acknowledged before me by Myrtle B. Leedy, the Testatrix, this 5' ~ day of"':j' ","1\.~ , 2001. Q~ Q. (?~ Notarial Seal . David P. Perkins, Notary Public Shlppensburg Boro, Cumberland County My Commission Expires Oct. 28, 2001 Member, Pennsylvania AssociatIon of Notaries WEIGLE. PERKINS & ASSOCIATES - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG. PA 17257-1397 . . COMMONWEAL TH OF PENNSYL VANIA SS COUNTY OF CUMBERLAND We, G~Jt, J: B~nJer and ~el2.J-I?Llde E "r i-QJ/€-I(, the witnesses whose names are signed to the foregoing instrument, being duly qualified "according to law, do depose and say that we were present and saw Myrtle B. Leedy, the Testatrix, sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix, signed the will as witnesses; and that to the best of our knowledge the Testatrix was at the time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. -~ 9 P~dA--" ~~~ Sworn or affirmed to and subscribed before me by (;.[8--11,11. tT. Be.nder and ae {e'~R l1,{e E.. S+11 V~1t witnesses, this 5~ day of "J \J..\'\... ~ , 2001. G):A G O~ . Notarial Seal . DaVId P Perkins, Notary Public ~'Pcpensb~rg. 80m, Cumberland County y ommlSSlon Expires Oct. 28, 2001 Member, Pennsylvania Association of Notaries WEIGLE. PERKINS & ASSOCIATES - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 INRE: ESTATE OF MYRTLE B. LEEDY, late of the Township of Shippensburg, Cumberland County, Pennsylvania, deceased : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY : PENNSYLVANIA ORPHANS' COURT DIVISION : ESTATE NUMBER 21-01-0875 CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Myrtle B. Leedy Date of Death: September 9, 2001 Will No. 21-01-0875 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 October 8, 2001: Ambrose Z. Leedy 110 Middle Spring Road Shippensburg, P A 17257 Bertha L. Thompson 615 Britton Road Shippensburg, P A 17257 Chloe Duncan 201 West Springville Road Boiling Springs, P A 17007 Kenneth Leedy 5307 Cumberland Highway Chambersburg, P A 17201 WEIGLE. PERKINS & ASSOCIATES - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG. PA 17257-1397 ~ Notice has now been given to all persons entitled thereto under Rule 5.6(a) except NONE. Sign October 8, 2001 Name: Address: Weigle, Perkins & Associates 126 East King Street Shippensburg, P A 17257 Telephone: (717) 532-7388 Capacity: Personal Representative X Counsel for Personal Representative WEIGLE. PERKINS & ASSOCIATES - ATTORNEVS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 ESTATE OF MYRTLE B. LEEDY File No. 21-01-0875 F AMIL Y SETTLEMENT AGREEMENT TillS AGREEMENT made this J!!!Jday of ~ , 2002, BETWEEN: AMBROSE Z. LEEDY, BERTHA L. 40MPSON, CHLOE DUNCAN, and KENNETH LEEDY, being the legatees under the Last Will and Testament of Myrtle B. Leedy, late of the Township of Shippensburg, Cumberland County, Pennsylvania, AND PAUL E. HORNBAKER, Executor of the Estate under the Last Will and Testament of Myrtle B. Leedy, deceased, WHEREAS, Myrtle B. Leedy died September 9, 2001, testate, and under her Will left her estate to the parties herein; and WHEREAS, Letters Testamentary were granted to Paul E. Hornbaker on September 26, 2001, by the Register of Wills of Cumberland County, Pennsylvania; and WHEREAS, all assets of the late Myrtle B. Leedy have been liquidated or distributed and all her debts paid in full, and further the period of four months having been terminated since the first advertisement of the issuance of Letters to the said Executor, the said parties hereto desire to waive the duty of the Executor to file a First and Final Account with Proposed Schedule of Distribution for purposes of confirmation by the Court of Common Pleas of Cumberland County, Orphan's Court Division, AND FURTHER desire that a Family Settlement Agreement be executed, which Family Settlement will be duly recorded among the deed records in and for Cumberland County. WEIGLE & ASSOCIATES, RC. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 NOW, THEREFORE, WITNESSETH, that the parties hereto, in consideration of the premises above stated, and of the Accounting and Proposed Schedule of Distribution attached hereto and made a part hereof, and the receipt of their distributive shares as therein shown, do mutually bind themselves to the said Distribution and Accounting as set forth and further mutually release each other and in particular Paul E. Hornbaker, Executor, from all claims and demands whatsoever arising out of settlement of the Estate of Myrtle B. Leedy. The parties hereto do further agree that should any liability come due to the estate of the said decedent after the signing of this agreement, we and each of us do hereby covenant and agree with each other and the aforesaid personal representative that we will contribute pro rata our share of the estate to satisfy any and all claims, demands, suits, or causes of action which may be successfully prosecuted against the said estate or the aforesaid personal representative after the signing, sealing and delivery of this family settlement agreement and final release. IN WITNESS WHEREOF, the parties have hereunto set their hands and seals the day and year first above written. ~1~ Ambrose z. rLefAY ~~y~ B)rtha L. T;&SOn (!At ( ~~ Chloe Duncan (SEAL) (SEAL) (SEAL) (SEAL) WEIGLE & ASSOCIATES, P.c. - AT TO EYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 COMMONWEAL TH OF PENNSYL VANIA SS COUNTY OF CUMBERLAND On this, the / () !:: day of (VJ~ , 2002, before me, the undersigned officer, personally appeared AMBROSE Z. LEEDY, BERTHA L. THOMPSON, CHLOE DUNCAN, and KENNETH LEEDY, known to me (or satisfactorily proven) to be the persons whose names are subscribed to the within instrument, and acknowledged that they executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~~/c I(~ r f (SEAL) NotariaJ Seal Unda K Klein, Notary Public Shipper1Sburg, PA Cumberland County My Commission Expires August 151 2004 ! WEIGLE & ASSOCIATES. RC. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG. PA 17257-1397 EXECUTOR'S ACCOUNT FIRST AND FINAL ACCOUNT OF PAUL E. HORNBAKER, EXECUTOR FOR ESTATE OF MYRTLE B. LEEDY, DECEASED Date of Death: Date of Executor's Appointment: Dates of Advertisement of Letters: News Chronicle Cumberland Law Journal Accounting for the Period: September 9, 2001 September 26, 2001 October 12, 19, 26, 2001 October 19,26, November 2,2001 September 26, 2001, to May 7, 2002 Purpose of Account: Paul E. Hornbaker, Executor, offers this account to acquaint interested parties with the transactions that have occurred during his administration. The account also indicates the proposed distribution of the estate. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with: Jerry A. Weigle, Esquire Weigle & Associates, P.C. 126 East King Street Shippensburg, PA 17257 717-532-7388 WEIGLE & ASSOCIATES, P.c. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 SUMJIARY OF ACCOUNT Estate of ~le B. Leedy For Period 09/09/01 Through 5/7/02 Page PDqposed Distribution to Beneficiaries 10 Principal Receipts Net Gain (or loss) on Sales or other Dispositions Other Receipts 1-2 3 less Disbursements: Administration Expenses (Prin) Fees and Carmissions (Prin) Funeral Expenses (Prin) Other Expenses (Prin) 4 4 5 5 $20,638.89 17,411.84 185.50 7,640.49 Balance before Distributions Distributions to Beneficiaries 6 Principal Balance on Hand 7 Incane Receipts less Disbursements: Incare Taxes 8 9 Balance before Distributions Distributions to Beneficiaries Incane Balance on Hand Canbined Balance on Hand Fiduciary Acquisition Value $ 37,007.76 ----------- ----------- $182,353.78 454.82 0.00 $182,808.60 45,876.72 $136,931.88 100,000.00 $ 36,931.88 $ 78.00 2.12 $ 75.88 0.00 $ 75.88 $ 37,007.76 ----------- ----------- RECEIPTS OF PRINCIPAL Estate of MYrtle B. Leedy As of 5/7/02 Assets Listed in Inventory (Valued as of date of death) Cash on Hand Cash on hand at date of death Check on hand at date of death - Blue Cross/Blue Shield benefit payrrent 09/05/01 American Express Travelers Checks on hand at date of death Checking Acconnts Allfirst Bank Checking Account #0038474778 $6.65 Accrued Interest Money Market Accounts American Express Mutual Fund Account #011528512574002 American Express Annuity Account #930067418812004 Refunds Public Opinion - refund at cancellation 09/13/01 Lititz Mutual Insurance COrrpany - refund of unused premium 09/19/01 Episcopal Towers - security deposit refund 09/20/01 State Fann Mutual Autarobile Insurance - refund of premium at cancellation 10/30/01 Sprint - refund at cancellation 11/09/01 $ 157.00 1,287.00 70.00 $ 95,899.14 52,145.73 $ 76.63 41.00 203.40 31.34 0.57 Page 1 Fiduciary Acquisition Value $ 1,514.00 29,306.32 148,044.87 352.94 RECEIPrS OF PRINCIPAL Estate of Myrtle B. Leedy As of 5/7/02 Assets Listed in Inventory (Valued as of date of death) Miscellaneous Property Travelers Insurance - 09/30/01 monthly annuity benefit Blue Cross/Blue Shield - benefit payment 10/12/01 American legion Auxiliary - death benefit 10/19/01 Blue Cross/Blue Shield - benefit payment 10/19/01 'IDI'AL INVEN'IORY $ 269.96 2,376.00 150.00 339.69 Page 2 Fiduciary Acquisition Value $ 3,135.65 $182,353.78 ----------- ----------- GAINS AND IDSSES ON SALES OR OTHER DISrosITIONS Estate of Myrtle B. Leedy For Period 09/09/01 Through 5/7/02 Gain 11/20/01 American Express Annuity acct proceeds Net Proceeds Fiduciary Acquisition Value $ 52,979.83 52,145.73 Net Gain $ 834.10 11/20/01 American Express Mutual F\m.d proceeds Net Proceeds Fiduciary Acquisition Value $ 95,519.86 95,899.14 Net loss Total Gains and losses $834.10 (379.28) less IDss Net Gain $ 454.82 ----------- ----------- Page 3 loss $ 379.28 $379.28 DISBURSEMENTS OF PRINCIPAL Estate of Myrtle B. Leedy For Period 09/09/01 Through S/7/02 Administration Expenses (Prin) 10/09/01 Register of Wills, Cumberland Ccunty - Letters Testamentary and Short Certificates 10/09/01 Cumberland law Journal - advertising letters TestaI'Cel1.tary 10/17/01 Allfirst Bank - estate checks 11/13/01 News Chronicle - advertising Letters Testamentary 11/14/01 Allfirst Bank - estate account service charge 11/27/01 Register of Wills, CUmberland Oounty - PA Inheritance Tax payment at discount 03/04/02 Register of Wills, CUmberland Cbunty - filing PA Inheritance Tax Retum 03/04/02 Register of Wills, CUmberland County - PA Inheritance Tax :balance due OS/07/02 Register of Wills, CUmberland Cbunty - filing Family Settlement Agreement OS/07/02 Weigle & Associates, P.C. - reimbursement for postage, xerox copies, and long distance telephone calls OS/07/02 Linda K. Klein - notary fee Fees and corrmissions (Prin) 12/26/01 Weigle & Associates, P.C. - partial attorney fee 03/04/02 Paul E. Hornbaker - Executor Carmission 03/04/02 Weigle & Associates, P.C. - balance of attorney fee $ 258.00 75.00 7.00 76.88 7.S0 20,000.00 IS.00 83.01 7S.00 2S.S0 16.00 $ 3,000.00 8,294.15 6,117.69 Page 4 $ 20,638.89 17,411.84 DISBURSEMENTS OF PRINCIPAL Estate of Myrtle B. Leedy For Period 09/09/01 Through 5/7/02 Funeral Expenses (Prin) 10/09/01 Fisher's Florist Other Expenses (Prin) 10/09/01 Shippensburg Health Care Genter - 09/20/01 statement 10/09/01 Pharmacare Pharma.cy - 09/29/01 statement 10/24/01 Sprint - final billing 11/15/01 Pharmacare Pharmacy - 10/31/01 statement 11/27/01 Shippensburg Health Care Genter - 11/20/01 statement 'TOTAL DISBURSEMENTS OF PRINCIPAL $ 2,328.92 684.65 45.00 27.92 4,554.00 Page 5 $ 185.50 7,640.49 $ 45,876.72 ----------- ----------- DIS'IRIBillIONS OF PRINCIPAL 'ill BENEFICIARIES Estate of Myrtle B. Leedy For Period 09/09/01 Through 5/7/02 Page 6 To: Ambrose Z. Leedy Cash 11/27/01 Cash To: Bertha L. Tharpson Cash 11/27/01 Cash To: Chloe Duncan Cash 11/27/01 Cash To: Kenneth Leedy Cash 11/27/01 Cash $ 50,000.00 30,000.00 10,000.00 10,000.00 'IDrAL DISIRIBurIONS OF PRINCIPAL 'ID BENEFICIARIES $100,000.00 ----------- ----------- Checking Accounts PRINCIPAL BAlANCE ON HAND Estate of Myrtle B. Leedy As of 5/7/02 Allfirst Bank Estate Checking Account 950288503 Less: Income balance on hand PRINCIPAL BALANCE ON HAND Page 7 Current Value Carrying Value $ 37,007.76 $ 37,007.76 $ 37,007.76 75.88 $ 37,007.76 75.88 $ 36,931.88 $ 36,931.88 ----------- ----------- ----------- ----------- Interest RECEIPT'S OF INCQIIIE Estate of MYrtle B. Leedy For Period 09/09/01 Through 5/7/02 Allfirst Bank Checking Account 10/09/01 final interest Allfirst Bank Estate Checking 11/15/01 interest 12/05/01 interest 01/04/02 interest 02/05/02 interest 03/05/02 interest 04/03/02 interest Total Interest ~ RECEIPT'S OF INo:ME $ 10.-80 9.88 17.01 11.03 11.31 9.90 8.07 67.20 Page 8 $ 78.00 $ 78.00 ----------- ----------- DISBURSEMENTS OF INCCME Estate of ~le B. Leedy For Period 09/09/01 Through 5/7/02 Incane Taxes 02/12/02 PA Department of Revenue - 2001 PA41 fiduciary incane tax 'IOrAL DISBURSEMENTS OF INCCt'v'IE Page 9 $ 2.12 $ 2.12 ----------- ----------- PROPOSED DISTRIBUTIONS 'TO BENEFICIARIES Estate of MYrtle B. Leedy For Period 09/09/01 Through 5/7/02 Page 10 To: Ambrose Z. Leedy Cash 5/7/02 The beneficiary will receive a 50% interest in the estate / s residue, representing a portion of the following assets: Cash $ 18,503.88 Total $ 18/503.88 To: Bertha L. Tharpson Cash 5/7/02 The beneficiary will receive a 30% interest in the estate / s residue, representing a portion of the following assets: Cash 11,102.32 Total $ 11,102.32 To: Chloe Duncan Cash 5/7/02 The beneficiary will receive a 10% interest in the estate's residue / representing a portion of the following assets: Cash 3/700.77 Total $ 3/700.77 To: Kenneth Leedy Cash 5/7/02 The beneficiary will receive a 10% interest in the estate / s residue / representing a portion of the following assets: Cash 3,700.79 Total $ 3/700.79 'IDI'AL PROrosED DISTRIBUTIONS 'ill BENEFICIARIES $ 37,007.76 PAUL E. HORNBAKER, Executor of the Estate of Myrtle B. Leedy, deceased, hereby declares under oath (penalties of perjury) that he has fully and faithfully discharged the duties of his office; that the foregoing First and Final Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the estate have been paid in full; that, to his knowledge, there are no claims now outstanding against the estate; and that all taxes presently due from the estate have been paid. ~e.~'t Paul E. Hornbaker, Executor Subscribed and sworn to by PAUL E. HORNBAKER, before me this / 0 ~ day of M~ ' 2002. ;t~ rl{~tM- Notarial Seal Unda K. Klein, Notary Public Shippensburg, PA Cumberland County My Commission Expires Augu.st 15, 2004 WEIGLE & ASSOCIATES. P.c. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG. PA 17257-1397 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 WEIGLE JERRY A 126 E KING STREET SHIPPENSBURG, PA 17257 -------- fold ESTATE INFORMATION: SSN: 179-10-3957 FILE NUMBER: 21-2001- 0875 DECEDENT NAME: LEEDY MYRTLE B DA TE OF PAYMENT: 11/29/2001 POSTMARK DATE: 11/28/2001 COUNTY: CUMBERLAND DATE OF DEATH: 09/09/2001 NO. CD 000570 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $20,000.00 I I I I I I I I TOTAL AMOUNT PAID: $20,000.00 REMARKS: PAUL E HORNBAKER C/O JERRY A WEIGLE ESQUIRE CHECK# 101 SEAL INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS 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 WEIGLE JERRY A 126 E KING STREET SHIPPENSBURG, PA 17257 ____u__ fold ESTATE INFORMATION: SSN: 179-10-3957 FILE NUMBER: 2101-0875 DECEDENT NAME: LEEDY MYRTLE B DATE OF PAYMENT: 03/15/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 09/09/2001 NO. CD 000959 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $83.01 I I I I I I I I TOTAL AMOUNT PAID: $83.01 REMARKS: PAUL E HORNBAKER C/O JERRY A WEIGLE ESQ CHECK# 110 SEAL INITIALS: DO RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS \., 1'7-/?&- 7> BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG1 PA 171Z8-D6Dl COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT1 ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX '02 flAY -3 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-29-2002 LEEDY 09-09-2001 21 01-0875 CUMBERLAND 101 I'"I1 .'~! i ::c:o JERRY A WEIGLE ESQ WEIGLE & ASSOCIATES 126 EKING ST l;,:: SHIPPENSBURG p~lt11257 *' REV-1S47 EX AFP tOl-02> MYRTLE B Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE1 PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=is47-E3f-AFP--('OY:ozi--NOTici-OF-YNHEifiTAifci-TAX-APPRAisEi'-EN~-"ALioWAiici-bR-""---------""--- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF LEEDY MYRTLE B FILE NO. 21 01-0875 ACN 101 DATE 04-29-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED I~ an assessment was issued previously, lines 14, lS and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 11. Allount of Line 14 at Sibling rate (11) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due 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) 1. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (1) .00 .00 .00 .00 182~353.78 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 181153.22 7.640.49 (11) (12) (13) (14) NOTE: .00 X 00 = .00 X 045 = 781280.02 X 12 = 781280.05 X 15 = NOTE: To insure proper credit to your accountl subllit the upper portion of this forll with your tax paYllent. 1821353.78 '5.793 71 1561560.07 .00 1561560.07 (19)= .00 .00 91393.60 11,742.01 211135.61 TAX CREDITS: ,""",nl::n. .n........... . I. l + J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 11-28-2001 CDOO0570 11052.63 201000.00 03-15-2002 CDOO0959 .00 83.01 TOTAL TAX CREDIT 211135.64 BALANCE OF TAX DUE .03CR INTEREST AND PEN. .00 TOTAL DUE .03CR . 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 HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) Recc.1ed..Offict. Re\) "'y of 'NiUs ~ ~ .... ~ r.I2 ~ e: ~ -= ~ "g ~ '"'= =O\t~ &~Q~ s;=~~ !C ~~ 2 ~ =" > C/':J (JQ....~ ~ r.I2 ~ fG"" N=r>>> ~g~C/':J ~.... C/':J toN 0 ::s ~ ~ ~ C/':J .01 NOV 29 P 1 :08 ~ Cfen,\,'. Gutnbe: iei REGISTER OF WILLS, CUMBERLAND COUNTY STATUS REPORT UNDER RULE 6.12 Name of Decedent: Myrtle B. Leedy Da te 0 f Death: September 9, 2001 Will No. 21-01-0875 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completiol the administration of the above-captioned estate: 1. State whether administration of the estate is cc Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration wi] complete: 3. If the answer to No. 1 is Yes, state the followi a. Did the personal representative file a fin2 account with the Court? Yes No X b. The separate Orphans' Court No. (if any) fc 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 ~he :::::Of;h~;;:a;s~ourt and m~aChe~~p t. s~natu~ -----r, J- w'l Jerry A. Weigle, ESq~_ire_lL___ ~ Name (Please type orjrint) WEIGLE & ASSOCIA~ES,P.C. 12~~t King Street Address Shippensburg, PA 17257 ( 717) 532-7388 Tel. No. V'I ~ ;~ N P - ~:; Capacity: Personal Represent X Counsel for person representative (MAH:rmf/AM3) 6 REV-1500 EX + (6-00) OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA REV-1500 I 1- 'l- eI DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 2001 0875 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Leedy , Myrtle B. 179-10-3957 DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 09/09/01 04/26/1916 WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 3. Remainder Return CHECK r Original Return W Supplemental Return B (date of death prior to 12-13-82) APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required (date of death after 12-12-82) PRIATE 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach copy of Will) (Attach a copy of Trust) BLOCKS 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death between D 11. Election to tax under Sec. 91 t3(A) 12-31-91 and 1-1-95) (Attach Sch 0) fijJj~rb\m$ii'WQQMij~pfmQQijijlRiWt;ije.Wj@Q.ijElektlAt.t.AXW\~fQRMAfiQij$ijQqmmO:#Rij&ripf.9.~ NAME COMPLETE MAILING ADDRESS COR- Jerry A. Weigle, Esquire 126 East King Street RE- FIRM NAME (If Applicable) Shippensburg , PA 17257 SPON DENT Weigle & Associates, P.c. TELEPHONE NUMBER (717) 532-7388 ':-;.t".,; ~FFICIA~.Use ONLY 1. Real Estate (Schedule A) (1) N~e': i"-J 2. Stocks and Bonds (Schedule B) (2) Nqne 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) None -..., -. 4. Mortgages & Notes Receivable (Schedule D) (4) None ......'.- ---' 5. Cash, Bank Deposits & Miscellaneous Personal \.}l Property (Schedule E) (5) 182,353.78 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested (6) None t,,,..:l RECA- hJ PITULA- 7. Inter-Vivos Transfers & Miscellaneous TION Non-Probate Property (Schedule G or L) (7) None 8. Total Gross Assets (total Lines 1-7) (8) 182,353.78 9. Funeral Expenses & Administrative Costs (Schedule H)(9) 18,153.22 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule i) (10) 7,640.49 11. Total Deductions (total Lines 9 & 10) (11) 25,793.71 12. Net Value of Estate (Line 8 minus Line 11) (12) 156,560.07 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax (13) None has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 156,560.07 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of Line t4 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0 (15) - TAX 16. Amount of Line 14 taxable at lineal rate 0.00 X .0 45 (16) 0.00 78,280.02 - COMPU- 17. Amount of Line t4 taxable at sibling rate X .12 (17) 9,393.60 TATION 18. Amount of Line 14 taxabie at collateral rate 78,280.05 x.15 (18) 11,742.01 19. Tax Due (19) 21,135.61 20. D leHec.l<ije~~JFY(itAijJ;l]~~e..m~AJ:t~jp:Q~ti.p.WR~iYMJ;lkltl :::}~aJ;SQ!':\!;TQANs,we3AU;QQeS:IIQNSQSRAGe:~ANPP;eGHl;GKMATH"<'<. ............................ ............................. ............................ ............................. ............................ ............................. ............................ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . o PA15001 NTF 29755 Copyright 2000 Greatland/Nelco LP - Forms Software Only Estate of: Myrtle B. Leedy Sl:MllARY OF ALlOCATIONS 'ID BENEFICIARIES Taxable at sibling rate Ambrose Z. Leedy 78,280.02 Taxable at collateral rate Bertha L. 'Ihatpson Chloe Duncan Kenneth Leedy 46,968.03 15,656.01 15,656.01 78,280.05 21-2001-0875 PA REV-1500 EX (6-00) D d t' C I t Add Page 2 ece en s omDle e ress: STREET ADDRESS 121 Walnut Bottom Road CITY I STATE I ZIP 8hi . PA 17257 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 21,135.61 20,000.00 1,052.60 Total Credits (A + B + C) (2) 21,052.60 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. 6. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (3) 0.00 (4) (5) 83.01 (5A) 0.00 (56) 83.01 ......p[EAse.ANSWER.iHE.i=oLL6WIN<iQUESTioNS.BY.PLAciNG.AN.;;j(;;..iN.THe.APPROPRIAie..BLOCKS.. Yes No ~ I B ~ 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on information of which preparer has any knowledqe. SIGN lURE . ~RS RESPONS E F R FILING RETURN -COATE . r') c... a ,/'- 2- - L-.. ~ DA~ )- r L -02-- , PA 17257 on on spouse [72 P.S. Ii 9116 (a)(1.1)(i)]. For dates of death on or after January 1, 1995, the tax rate is imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)]. The statute dne~ not ellempt 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 jf 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 at transfers tram a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, ora stepparent of the chiid is 0% [72 P.S. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineai beneficiaries is 4.5%, except as noted in 72. P.S. 9 9116(1.2) [72 P.S. 9 9116(a)(1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedent's si blings is 12% [72 P.S. 9 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. o PA15002 NTF 29756 Copyright 2000 Greatland/Nelco LP - Forms Software Only Estate of: Myrtle B. Leedy 21-2001-0875 The following person (s) are signing the retUTIl as representative (s) of the estate: Paul E. Hornbaker 309 Britton Road Shippensburg, PA 17257 REV-15G8 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Myrtle B. Leedy SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-2001-0875 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 NO. DESCRIPTION VALUE AT DATE OF DEATH 1 Cash on hand at date of death 157.00 2 Check on hand at date of death - Blue Cross/Blue Shield :benefit payment 09/05/01 1,287.00 3 American Express Travelers Checks on hand at date of death 70.00 4 Allfirst Bank Checking Account #0038474778 29,299.67 Interest on above item acc:rued as of decedent's death 6.65 5 American Express Mutual Fund Account #011528512574002 95,899.14 6 American Express Annuity Account #930067418812004 7 Public Opinion - refund at cancellation 09/13/01 52,145.73 76.63 8 Lititz Mutual Insurance Canpany - refund of unused premium 09/19/01 41.00 9 Episcopal Towers - security deposit refund 09/20/01 203.40 10 State Farm Mutual Autarobile Insurance - refund of premium at cancellation 10/30/01 31.34 11 Sprint - refund at cancellation 11/09/01 12 Travelers Insurance - 09/30/01 rronthly annuity :benefit 0.57 269.96 13 Blue Cross/Blue Shield - :benefit payment 10/12/01 14 American Legion Auxiliary - death :benefit 10/19/01 15 Blue Cross/Blue Shield - :benefit payment 10/19/01 2,376.00 150.00 339.69 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 182,353.78 7 CPA81 NTF 10908 Copyright Forms Software Only, 1997 Nelco, Inc. REV-1511EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Myrtle B. Leedy SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-2001-0875 Debts of decedent must be reported on Schedule I. ITEM NO. DESCRIPTION A. FUNERAL EXPENSES: AMOUNT 1 Fisher's Florist 185.50 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Paul E. Hornbaker Social Security Number(s)/EIN No. of Personal Representative(s) Street Address 309 Britton Road City Shippensburg State 8,294.15 171-28-2248 PA Zip 17257 Year(s) Commission Paid: 2002 2. 3. Attorney Fees Name : Weigle & Associates, P. C. 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 9,117.69 0.00 4. Probate Fees 258.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 See Schedule attached Total from continuation page (s) 297.88 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 18,153.22 7 CPA11 NTF10911 Copyright Forms Software Only, 1997 Nelco. Inc. Estate of: Myrtle B. leedy SCHEDULE H, PART B - - Administrative Costs Item No. Description 7 CUmberland law JOUITlal - advertising letters Testamentary 8 News Chronicle - advertising letters Testamentary 9 Allfirst Bank - estate checks 10 Allfirst Bank - estate account service charge 11 Register of Wills, CUmberland County - filing PA Inheritance Tax Retu:rn 12 Register of Wills, CUmberland County - filing Family Settlem=nt Agreem=nt 13 Weigle & Associates, P.C. - reimbursem=nt for postage, xerox copies, and long distance telephone calls 14 Linda K. Klein - notary fee TOTAL. (Carry forward to ma.in schedule) . . . . . . Page 2 21-2001-0875 Arrount 75.00 76.88 7.00 7.50 15.00 75.00 25.50 16.00 297.88 REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Myrtle B. Leedy Include unreimbursed medical expenses. ITEM NO. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-2001-0875 DESCRIPTION AMOUNT 1 Shippensburg Health Care Center - 09/20/01 statement 2 Pharma.care Pharma.cy - 09/29/01 statement 3 Sprint - final billing 4 Pharmacare Pharmacy - 10/31/01 statement 5 Shippensburg Health Care Center - 11/20/01 statement 2,328.92 684.65 45.00 27.92 4,554.00 7 CPA12 NTF 10912 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 7,640.49 Copyright Forms Software Only, 1997 Nelco, Inc. REV-1513 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES Mvr Ie B. Leedv No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Ambrose Z. Leedy 110 Middle Spring Road Shippensburg, PA 17257 2 Bertha L. Tharpson 615 Britton Road Shippensburg, PA 17257 3 d1loe Duncan 201 West Springville Road Boiling Springs, PA 17007 4 Kenneth Leedy 5307 Cumberland Highway Chambersburg, PA 17201 FILE NUMBER RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Brother Niece Niece Nephew 21-2001-0875 AMOUNT OR SHARE OF ESTATE 78,280.02 46,968.03 15,656.01 15,656.01 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 7 CPA13 NTF 10913 TOTAL OF PART 11-- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 Copyright Forms Software Only, 1997 Nelco, Inc. (If more space is needed, insert additional sheets of the same size) i 01 02: 40p ALLFIRST CIS 3029342955' p.2 !l allflrst AIlJirsl Financial Ccnb:r N.A. PO flox 900 Millboro, De 19966 October 15, 2001 Weigle, Perkins & Associates Attorneys At Law 126 East King Street Shippensburg, rA 17257-1397 Re: Estate ofMvrtle B. Leedv Social Security: 179-/0-3957 Date of Dealh: Semember 9. 2001 Dear Sir or Madam: Per your inquiry dated September 17,2001 please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: l. Type of Account Relationship Checking Hf/fnleresl Account Nllmber 0038474778 Ownership (Names oj) Myrtle B. Leedy, Owner Opening Date 03/06/95 Balance 0/1 Date of Death $29,299.67 Accrued Interest $ 6.65 Total 'Ti9)Oif.J2" This leller does /l01 include allY aCCO/tn/s in which Ihe decca"ed may have been listel{ as Po",er oj AtlOrney. Custodian of Uniform Trans}ers. Representative Payee. or Trustee under a WrillenAgreemenl. For fllrther accallnr irifarmullOl1. closures andlor rei/llblWSemerrl uffi,"ds refit to below brunc/" SHlPPEI\SBURC OFI'ICE 35-39 EAST KI:'IIG ~TREET SlllPPI~l\snURC, I'A 17257 717.532.4132 S}1cereIY, / ~/ {I ~ / ' c Sue KlI'l'I Ie Assistant l Cis Services, (302) 934-2909 ~ Financial Advisors IDS LIFE INSURANCE COMPANY AMERICAN EXPRESS FUNDS AMERICAN EXPRESS CERTIFICATE COMPANY AMERICAN EXPRESS BROKERAGE 70100 AXP Financial Center Minneapolis, MN 55474 October 22, 2001 WEIGLE, PERKINS AND ASSOCIATES 126 EAST KING STREET SHIPPENSHBURG, P A 17257-1397 Dear JERRY A WEIGLE: Thank you for your recent inquiry regarding MYRTLE B LEEDY's accounts. These are the values of the accounts as of 09/09/2001. Mutual Funds Account Number 011528512574002 Total Value $95899.14 # of shares 21277.016 Asset Value Per Share 4.500 Annuities - Post 1985 Account Number 93006741881 2004 Total Value $52145.73 Please note that the values indicated for any Life Insurance product(s) reflect the gross death benefit at date of death, not the cash value. We appreciate the opportunity to be of service to you. Please contact us if you have any questions. Sincerely, 1 , ~ ~ Seipel Death Settlements Processing Team 70310 AXP Financial Center Minneapolis, MN 55474 888-723-8476 Enter 18656 . ","'1"- ~' r d : .~.,>' ~,,-: - 2Din Insurance and annuities are issued by IDS Life Insurance Company, an American Express company. lq: _ v:-= SHIPPENSBURG HEALTH CARE eTR 121 WALNUT BOTTOM ROAD SHIPPENSBURG. PA 17257 PAUL HORNBAKER 309 BRITTON RD SHIPPENSBURG. PA 17257 RESIDENT: LEEDY. MYRTLE B DATE 08/31/01 09/09/01 09/20/01 09/20/01 09/20/01 DESCRIPTION DAYS PREVIOUS BALANCE 09/01/01 - 09/09/01 8 PATIENT COMFORT MEDICAL SUPPLIES TV CABLE 09/20/01 (717) 530-8300 (717) 532-2601 DAILY RATE: 149.00 RESIDENT NUMBER: 06291 AMOUNT BALANCE 1103.00 1192.00 9.38 17.54 7.00 1103.00 2295.00 2304.38 2321.92 2328.92 V ( 0 ,-cr ~o { '~. . - i \' $ ~1 rt 'J, ~ NEW BALANCE 2328.92 PLEASE PAY WITHIN 10 DAYS...THANK YOU! SHIPPENSBURG HEALTH CARE CENTER 121 WALNUT BOTTOM RD SHIPPENSBURG, PA 17257 (717)530-8300 DATE: RESIDENT NAME: AMOUNT OWED: RESIDENT INSURANCE COMPANY 6 t t3S THIS IS A COPAY PLEASE SEND AMOUNT. - ~x..\. 6c. ~ /vle't\\ Wil.~ ~(bC(SSe..:.~ ~~\rQL~\ r~ (ct;.h~;uJ ~ {lIS> &At>~( THANK YOU, l C; 'c:tKQ ~ S8:c-C. -WCvJ(" ~ 4~'t~Lh.. ; BUSINESS OFFICE SHCC 1-,,0 ( I 1./ q ) " ( cl D'>o . .,A . ~ I 0 (ff rR lf0 VJv. .)~ 1f~ ~ .,. LAST WILL AND TEST AMENT I, MYRTLE B. LEEDY, presently residing at 201 East Burd Street, Apartment 203, Borough of Shippensburg, Cumberland County, Pennsylvania 17257, being of sound mind, memory and disposition, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void all wills by me at any time heretofore made. FIRST. I order and direct the payment of all my legally enforceable debts and funeral expenses as soon as may be convenient after my decease. SECOND. I direct my hereir.after named executor to liquidate all of my assets by public or private sale or otherwise as soon as may be practical and expedient and in the best interests of my estate and to distribute my estate as follows: A. I give, devise and bequeath fifty percent (50%) of my estate to my brother, AMBROSE Z. LEEDY. In the event that the said Ambrose Z. Leedy should predecease me or is not living on the thirtieth (30th) day following my death, I then direct that his share of my estate be given to his wife, MEDA LEEDY. In the further event that neither Ambrose Z. Leedy nor Meda Leedy survive me, I then give, devise and bequeath fifty percent (50%) of my estate to the children of Ambrose Z. Leedy and Meda Leedy, namely, LESTER LEEDY, LELAND LEEDY and KEVIN LEEDY, or to the survivor(s) of the said Lester Leedy, Leland Leedy and Kevin Leedy. B. I give, devise and bequeath thirty percent (30%) of my estate to my niece, BERTHA L. THOMPSON. In the event that the said Bertha 1. Thompson should predecease me or is not living on the thirtieth (30th) day following my death, I then give, devise and bequeath thirty percent (30%) of my estate to her children, namely, TERRY THOMPSON, JERRY THOMPSON, and DIANE RICHARDSON, or to the survivor(s) of the said Terry Thompson, Jerry Thompson and Dia!'.e Richardson. C. I give, devise and bequeath ten percent (10%) of my estate to my niece, CHLOE DUNCAN. In the event that the said Chloe Duncan should predecease me or is not living on the thirtieth (30th) day following my death, I then direct that this bequest shall lapse and shall be distributed prorata among the remaining beneficiaries named in Paragraph Second. '.JJ4,u ^- -i' {J i/) ''t" . r:-;1' V'c-<...JL- 15 ..:....Cl-'<r.t'\~. WEIGLE. PERKINS & ASSOCIATES - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG. PA 17257-1397 . '"" D. I give, devise and bequeath ten percent (10%) of my estate to my nephew, KENNETH LEEDY. In the event that Kenneth Leedy should predecease me or is not living on the thirtieth (30th) day following my death, I then direct that this bequest shall lapse and shall be distributed pro rata among the remaining beneficiaries named in Paragraph Second. THIRD. I nominate, constitute and appoint PAUL E. HORNBAKER to be the Executor of this my Last Will and Testament; if he be unable to fulfill the duties of Executor, I then nominate, constitute and appoint GRACE M. HORNBAKER to be the Executrix of this my Last Will and Testament. In the further event, if neither Paul E. Hornbaker nor Grace M. Hornbaker be able to fulfill the duties of Executor or Executrix, I then nominate, constitute and appoint ALLFIRST BANK to be the Executor of this my Last Will and Testament. FOURTH. I direct that my personal representative shall not be required to give bond for the faithful performance of his duties in any jurisdiction. IN WITNESS WHEREOF, I, MYRTLE B. LEEDY, have hereunto set my hand and seal to this my Last~i~l and Testa~ent, written on two pages, the first page signed for identification only, this (J t,vl day of_ ~,.&~ ,2001. & ~c , c-), }"" }y,,:J,-" / -- _. r::r. ~ "a~t{ ""~ '<:::\-Y-y ~ MYRTLE B. LEEDY WEIGLE, PERKINS & ASSOCIATES - ATTORNEVS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 - .. This instrument was by the Testatrix, on the date hereof, signed, published and declared by her to be her Last Will and Testament, in our presence, who at her request and in the presence of each other, we believing her to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. /~ ~ Q~ / ./ '::'?;!~f7' ;,.'4/'i.~/J'--- _~ciL. f;~ -YM~ COMMONWEAL TH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND I, MYRTLE B. LEEDY, the person whose name is signed to the 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. frr-.fz-t:&_ /3 ~<"~" MYRTLE B. LEEDY Sworn or affirmed to and acknowledged before me by Myrtle B. Leedy, the Testatrix, this 5'.}L day of.:1l).....~.. , 2001. ~)~G.~ Notarial Seal . David P Perkins, Notary Public Shlppensburg Bora, Cumberland County My Commission Expires Oct. 28, 2001 Member. Pennsylvania Association of Notaries WEIGLE. PERKINS & ASSOCIATES - ATTORNEYS AT LAW - 126 EAST KING STREET ~ SHIPPEN5BURG, PA 17257.1397 - .. COMMONWEAL TH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND We, G &4r~ J: lic?/)2 de-r and G- e R I- R u de f. ,,-r;;' .f-IJ- if e Ie ' the witnesses whose names are signed to the foregoing instrument, being duly qualified 'according to law, do depose and say that we were present and saw Myrtle B. Leedy, the Testatrix, sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix, signed the will as witnesses; and that to the best of our knowledge the Testatrix was at the time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. _~/h P b'~{~/v-' ~.h-. r)ffi~d Sworn or affirmed to and subscribed before me by GLe-nJ1- tT, Bend&T and (J-e 1?~R Ll rl e E, ,Sf-It tieR witnesses, this 5~ day of . ~ \J.-I"L \...., , 2001. GJ~ G U~ . Notarial Seal . David P Perkins, Notary Public Shlppensburg.8oro, Cumberland Count My CommiSSion Expires Oct. 28, 200l Member, Pennsylvania Association of Notaries WEIGLE, PERKINS & ASSOCIATES - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 --