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HomeMy WebLinkAbout01-0956 PETITION FOR PROBATE and GRANT OF LETTERS f'/\Ow 0 I ~'- Estate of Bettyt.S~ Hatfield also known as No. To: 21-01-956 Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania Deceased. 168-26-3644 Social Security No. The petition of the undersigned respectfully represents that: Your petitioner is 18 years of age or olJer and the Executor named in the last will of the above decedent, dated August 24, 2001 and codicil(s) dated [none]. Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 61 Eastgate Dl'ivc, Camp Hill. Decedent, tben 70 years of age, died October 5, 2001, at 61 Eastgate Drive, Camp Hill, Pennsylvania. Except as follows, decedent did not ITJarry, was not divorced and did not have a child born or adopted after ~:xecution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: [none]. Decedent at de:ath 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: none $ unestimated $ $ $ WHEREFORE, petitioner respectfully requests the probate ofthe last will and codicil(s) presented herewith and the grant of letters testamentary thereon~ ~ John . Hatfield 61 Eastgate Drive Camp Hill, PA 17011 717-737-0612 ---------------------------------------------------------------------- ---------------------------------------------------------------------- OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA) : SS. COUNTY OF CUMBERLAND ) The petitioner above-named swears or affirms that the statements in the foregoing petition are true and correct to the best 0fthe knowledge and belief of petitioner and that as personal representative of the above decedent, petitioner will well and truly administer the tate accordin to law. Sworn to or affirmed and subscribed before me this 15th day of Joh . OCTOBER , 2001 . ~/~,ef[7nN/Se<'j,,()(' ~ ~4~ / RegIster " / '} ~ /.1'/- /:J.-.- No. 21-01-956 Estate of Betty W. Hatfield, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW, OCTOBER 16, 2001 , in consideration ofthe petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated August 24,2001 described therein be admitted to probate and filed of record as the last will of Betty W. Hatfield and Letters Testamentary are hereby granted to John G. Hatfield. Will Book # Page 17 14 '77 ~a ~LU"'V1?M/Pr)-"~/~1' / " , Re 'ster of V Ills ' FEES Probate, Letters, Etc. Short Certificates( ) Renunciation x-pages JCP 375.00 18.00 Ivo V. Otto III, Esquire (27763) ATTORNEY (Sup, Ct I.D. No.) MARTSON DEARDORFF WILLIAMS & OTTO 10 East High Street Carlisle, P A 17013 (717) 243-3341 TOTAL $ $ $ $ $ HLUU 5.00 416.00 Filed 10-15-2001 FIFILESIDA T AFILEIEST A TES\! 042S-petition.ltr . F:\FILES\DA T AFILE\ WILLS\I 0425-w. will 21-01-956 LAST WILL AND TESTAMENT I, BETTY W. HATFIELD, of Camp Hill, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. ITEM ONE I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and all inheritance taxes shall be paid to the extent possible from the assets held or passing under ITEM FOUR hereof as soon as practicable after my decease and as part of the administration of my estate. ITEM TWO Ifmy spouse, JOHN G. HATFIELD, is living thirty (30) days after my death, then I give, devise and bequeath all the rest, residue and remainder of my estate, both real and personal property, unto my said spouse, JOHN G. HATFIELD, absolutely. Ifmy said spouse does not so survive me, then I give, devise and bequeath all of my estate, both real and personal property, unto my Trustee to be held or distributed by such Trustee under ITEM FOUR hereof. ITEM THREE In the event my said spouse, JOHN G. HATFIELD, shall disclaim all or any portion of any devise or bequest made to my said spouse under the foregoing ITEM TWO, then the amount otherwise payable shall be held by my Trustee under ITEM FOUR hereof. For purposes of the Trust established under ITEM FOUR hereof, my said spouse shall not be deemed to have predeceased me by virtue of my spouse's exercise of the right to disclaim set forth herein. ITEM FOUR RESIDUARY AND DISCLAIMER TRUST My Trustee shall hold the assets received under ITEMS TWO and THREE hereof, if any, for the following purposes: a. My Trustee shall pay the net income, at least quarter-annually, to my spouse, JOHN G. HATFIELD, for life. In addition, my Trustee in my Trustee's sole discretion, may invade the principal of the Trust for the proper and adequate support of my said spouse, JOHN G. HATFIELD. didlJ B.W.H. Page 1 of 7 Pages b. My Trustee shall further pay to my said spouse, JOHN G. HATFIELD, annually, such sum from the principal of the Trust as my said spouse may request in writing, provided, however, that said sum may not exceed the greater of Five Thousand Dollars ($5,000.00) or five percent (5%) of the aggregate value, at the time of said request, of the principal of the Trust hereunder. c. Upon the death of my said spouse, JOHNG. HATFIELD, my Trustee shall distribute the principal of the Trust, in equal shares, to my children, JAMES W. HATFIELD, JOHN W. HATFIELD and JANE H. ERICKSON, absolutely. d. In the event that any of my said children shall fail to survive my spouse and me, but shall leave issue surviving, then such deceased child's share shall be heid by the surviving parent of such deceased child's issue and the net income therefrom shall be used, in equal shares, for the support, maintenance and education of the issue of such deceased child. The trustee shall use as much of the principal as he or she shall deem desirable, in equal shares, for said purposes. I direct that the issue of such deceased child shall have the right of withdrawal of his or her equal share of the principal and any accumulated income of said trust in the following manner: One-fifth (115) thereof as each attains the age of twenty-two (22) years, one-fourth (114) of the remainder of said share as each shall attain the age of twenty-five (25) years, one-third (113) ofthe remainder of said share as each shall attain the age of twenty-eight (28) years, one-half (1/2) ofthe remainder of said share as each shall attain the age of thirty-one (31) years, and the remainder of said share as each shall attain the age ofthirty-five (35) years. In the event that any of my children shall fail to survive my spouse and me and not leave issue surviving, then such deceased child's share shall be added to the shares of my other children as if originally a part thereof. e. To the extent that the same is permitted by law, none of the beneficiaries hereunder shall have any power to dispose of or to charge by way of anticipation any interest given to such beneficiary; and all sums payable to such beneficiaries hereunder shall be free and clear ofthe debts, contracts, alienations and anticipations of the beneficiaries, and all liabilities for levies and attachments and proceedings of whatsoever kind, at law or in equity. /3U-iYJ. B.W.H. Page 2 of 7 Pages ITEM FIVE POWERS OF EXECUTOR AND TRUSTEE In addition to the powers conferred by case law, by statute, and by other provisions hereof, my Executor and Trustee and their successors, shall have the following discretionary powers applicable to all property held by them which powers shall be effective without order of any court and shall exist until! final distribution. a. To retain any property of any nature received by them for whatever period they shall deem advisable; b. To invest and reinvest all or any part of said property in such stocks, bonds, securities or other property, real or personal, as in their discretion they shall deem proper, without regard to statutes limiting the property which a fiduciary may purchase; c. To sell, transfer, exchange or otherwise dispose of, any part of said property, for cash or on terms, publicly or privately, or to lease, even for a term exceeding five (5) years or the duration of any trust herein, without liability on the purchasers or lessees to see to the application of the proceeds, and to give options for these purchases without the obligation to repudiate them in favor of a higher offer; d. To execute and deliver any deeds, leases, assignments or other instruments as may be necessary to carry out the provisions of any trust hereunder; e. To borrow money, including the right to borrow money from any bank and to mortgage or pledge any asset of the estate as security; f. To assume continuance ofthe status of any beneficiary with regard to death, marriage, divorce, illness, incapacity and the like in the absence of information deemed reliable without liability for disbursements made on such assumption; g. To pay from the trust, or the income therefrom, all debts or claims against my estate, or any taxes or similar charges on my estate; h. To make any distribution hereunder either in kind or in money, or partially in kind and partially in money. Distribution in kind shall be made at the market value of the property distributed, (dull). B.W.H. Page 3 of 7 Pages and my Trustee, in its absolute discretion, may cause the share distributed to any distributee to be composed of property similar to or different from that distributed to any other distributee; 1. To exercise any subscription right in connection with any security held hereunder, to consent to or participate in any recapitalization, reorganization, consolidation or merger of any corporation, company or association, the securities of which may be held hereunder, to delegate authority with respect thereto, to deposit investments under agreements, to pay assessments, and generally to exercise all rights of investors; J. To invest in endowment, insurance or annuity policies on the lives of beneficiaries of any trust herelmder; k. To continue in any partnership, joint venture, joint ownership or other business enterprise of which I am a part at the time of my death; 1. To compromise claims; m. To continue for whatever period of time as they shall deem necessary any ownership as a tenant in common or as a partner, in real estate or other property and to act as I could have done had I been living; n. To lend money to my estate or to any trust created hereunder or to purchase from the estate or from any trust created hereunder, at the market value thereof at the time of purchase, any securities or other property tendered to them by my estate or any trust created hereunder at any time and from time to time within a period of nine (9) months after my death; o. In the event that any amounts are payable hereunder or under any trust created hereunder to a minor, or to a person otherwise under legal disability, or to a person not adjudicated to be an incapacitated person, but who, by reason of illness or mental or physical disability is, in the opinion of the: fiduciary(ies) hereunder, unable to properly administer such amounts, such amounts may be paid by the fiduciary(ies) hereunder in his, her or their sole discretion in any of the following ways as he, she or they may deem best: 1. Directly to such beneficiary; 2. To a legally appointed guardian of such beneficiary for the benefit of such beneficiary; !kYJ. B.W.H. Page 4 of 7 Pages 3. To a person having custody of such beneficiary for the benefit of such beneficiary; 4. By the fiduciary(ies) hereunder using such amounts directly to the benefit of such beneficiary. Evidence of the application of payment of an amount in such a manner shall be a full and complete discharge ofthe fiduciary(ies) hereunder to the extent of such payment or application. This paragraph shall be applicable to payments of income as well as principal. p. To employ agents, attorneys and proxies and to delegate to them such power as my personal representatives and Trustees consider desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys and proxies; q. To conduct an inventory of any safe deposit box necessary to the administration of my estate. r. To do all other acts in their judgment necessary or desirable for the proper management, investment and distribution of my Estate. ITEM SIX PROTECTIVE PROVISIONS All income or principal held for the use and benefit ofthe beneficiaries of any trust hereunder shall not be in any way or manner subject to anticipation, assignment, pledge, sale or transfer, nor shall any such interest, while in the possession of my Trustee, be liable for or subject to the debts, contracts, obligations, liabilities or torts of any beneficiary, or to attachments, executions or sequestrations under process of law. ITEM SEVEN APPOINTMENT OF EXECUTORS I nominate, constitute and appoint my said spouse, JOHN G . HATFIELD, as Executor of my estate. In the event that my said spouse shall predecease me or fail to act as Executor, then I appoint my children, JAMES W. HATFIELD, JOHN W. HATFIELD and JANE H. ERICKSON, as Executors of my estate. I2Ilf/J B.W.H. Page 5 of 7 Pages ITEM EIGHT APPOINTMENT OF TRUSTEES I hereby appoint my said spouse, JOHN G. HATFIELD, as Trustee of the trust created under Item Four hereof. In the event that my said spouse shall fail or be unwilling to act or continue to act as Trustee, then I appoint my children, JAMES W. HATFIELD, JOHN W. HATFIELD and JANE H. ERICKSON, as Trustees of such trust, excepting any further trust for grandchildren under Item Four, d., hereof. ITEM NINE WAIVER OF BOND I direct that neither my Executor nor my Trustee or his successors shall be required to file any bond in any jurisdiction to secure the faithful performance of their duties, nor shall they be required to obtain any order or approval of any court for the exercise of any power or discretion set forth in this Will. IN WITNESS WHEREOF I have hereunto set my hand and seal this <9- L{ ~ day of Augu gf ,;;wt !M~/.{lIJdJ,~Jj) (SEAL) Betty W. atfield SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, have hereunto subscribed our names as witnesses thereto, in the presence of the said Testatrix and of each other. ~J (J~ /'-.-- . ~ -!~ 71lP11M&ll Page 6 of 7 Pages COMMONWEAL TH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) We, Betty W. 11M rt'ltifn',s{)r\ Hatfield, Tvo V. b4-~TIl and , the Testatrix and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her last Will and that the Testatrix has signed willingly, and that the Testatrix executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing ofthe Testatrix, signed the Will as a witness and that to the best of his /her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. 1 '~I . ~ .v.L~/~L,O. Tes tnx / Witness /)...- h ~/~m{~ Witness Subscribed, sworn to and acknowledged before me by Betty W. Hatfield, the Testatrix, and subscribed and sworn to before me by j V 0 \J. 0 t6 I1I and Ii rl "- 11J 0 f n S.cn , the witnesses, this ~tfday of 4.u .3u 501' , 2001. /~ 'V":~'1(J$>VV N~ Public NOTARIAL SEAL CORRINE L. MYERS, Notary Public Carlisle Boro, CumberlandCounty My Comr::i~~;l?~i)(r.~~'..~1ey 27, 2003 Page 7 of 7 Pages *' COMMON\'/EAL11i OF PENNSYLV",NI", DEPAATMENT OF REVENUE DEPT. 280601 HARRISBURG, P", 17128-0601 _._--_._~~--- - -- -T OECEDENT'S NAME (LAST, FIRST, AND MIDDlE INITIAL) I HATFIELD, BETTY W. 1 ~~~~;;;~~ ~MM-DD-YEAR) I ~A;~;~ ;I~~~(~M-D~YEAR) I (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST. FIRST AND MIDDLE INITIAL) HA TFIELD, JOHN G. --W - - ~ 1. Original Retum . -- 0 2. Supplemental Retum :0: ~ tn i 0 4. Limited Estate 181 4a. Future Interest Compromise (date of death u 0: :.: . after 12-12-82) !I! ~ 9 181 6. Decedent Died Testate (Attach copy 0 7, Decedent Maintained a Living Trust (Attach u,,- III of Will) copy of Trust) !:( 0 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) '..... REV: f_ EX" (HI) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I? 0 ,0(./; (If(j C- OFFICIAL USE ONL Y /7-. Jt/- 12- FILE NUMBER 21 01 ~ COUNTY COOE YEAR I SOCIAL SECURITY NUMBER 168-26-3644 00956 NUMBER ... z w o w u w o THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER .... tnz Ww 0:0 O:z 00 u"- lvo V. Otto, III, Esquire IRM NAME (If applicable) Martson Deardorff Williams & Otto o 3. Remainder Return (date of death plIor to 12-13-82) 181 5. Federal Estate Tax Retum Required 1 8. Total Number of Safe Deposit Boxes - :T+ k.JjspP u~e. 181 11. Election to tax under Sec. 9113(A) (Attach Sch 0) ELEPHONE NUMBER i 717/243-3341 --~:"'-=-:-':;':"'::"""=--~.- - OFFICIAL USE ONLY 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) z o ~ ::> ... ~ u w a:: 3. Closely Held Corporation. Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash. Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly OWned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities. & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 10 East High Street Carlisle, P A 17013 (1 ) None (2) 999,011.53 (3) 333,125.00 (4) None (5) 15,675.39 (6) None (7) 10,703.72 (9) 22,722.58 (10) 12. Net Value of Estate (Line 8 minus Line 11) (8) 1,358,515.64 (11 ) 22,722.58 1,335,793.06 (12) (13) 13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Vatue Subject to Tax (Line 12 minus Line 13) (14) 1,335,793.06 Copyright 2000 form software only The Lackner Group, Inc. SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) z o i= ~ ::> "- :E o U S 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 1 , 1 05,3 8 8 . 5 6 x .00 (15) 0.00 230,404.50 x .045 (16) 10,368.20 x .12 (17) x .15 (18) (19) 10,368.20 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Addres TREET ADDRESS 61 Eastgate Drive CITY Camp Hill isrATE FA IZIP--1-7011- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 10,368.20 9,850.00 518.41 Total Credits (A + 8 + C) (2) 10,368.41 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 + SA. This is the BALANCE DUE. (3) (4) (5) (SA) (58) 0.00 0.21 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;............................................................................. 0 181 b. retain the right to designate who shall use the property transferred or its income;................................ 0 181 c. retain a reversionary interest; or............................................................................................................ 0 181 d. receive the promise for life of either payments, benefits or care? .......................................................... 0 181 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?............................................................................................................... 0 181 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?..... 0 181 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?.............................................................................................................. 181 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 pi!~ury, I declare that I have examined this retum, including accompanying schedules and statements, and to the beSt-of my knowledge andbelief.lfiSinre.-C:QiTecl andcomPlele. Dedaralion of eparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNAl" E PERSON-REsPONIB FOR FlUNG RETURN---- ADDRESS -----~ ~ ~--- DATE 61 Eas!gate Drive Camp Hill, P A 170 II (,/Z~ / b z.. DATE SIGNA ----- ADORESS AN REPRESENtATIVE ADDRESS TIATE 10 East High Street Carlisle, PA 17013 ~/2..D I~-z. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. S9116 (a) (1.1) (i)). For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. S9116 (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. S9116 (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. S9116 1.2) [72 P.S. S9116 (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. S9116 (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. . SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER -------- 21 - 01 - 00956 ESTATE OF HATFIELD, BETTY W. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM I NUMBER I 1 200 shares, Lucent Technologies DESCRIPTION 2 200 shares, Microsoft Corp. 3 2200 shares, PPL Capital Funding Tr 1,7.75% Conv Pfd 4 I 300 shares, Tyco 30190.35 units, Select Ten Port 2001 J OAF 5 6 32,106.80 units, Select Ten 2001 Series A OAF 7 3955.28 units American Investment Cl A 8 18227 units ML Muni Bd Ins Pt A 9 355554 units ML Banking Advantage 10 I 16000 CD Chevy Chase Fed SB 7.0% Bond 11 50000 Pottstown PA SD 5.0% Bond 12 25000 Allegheny Co PA San Auth Swr Rev 5.5% Bond 13 20000 Dauphin Co PA Gen At Rev 5.3% Bond 14 90000 Phila PA Gas Wks Rev Ser B 5.375% Bond 15 20000 Wallingford-Swarthmore PA SO 5.25% Bond 16 Accrued dividend to No.1 above 17 Accrued interest to No.4 above 18 Accrued dividend to No.5 above 19 Accrued interest to No.6 above 20 I I Accrued interest to No.7 above I Total of Continuation Schedule{s) \ TOTAL (Also enter on line 2, Recapitulation) ______1-__________ UNIT VALUE VALUE AT DATE OF DEATH 6.49 1,298.00 57.72 11,544.00 19.39 42,658.00 47.43 14,229.00 .8809 26,594.68 .8776 28,176.93 27.51 108,809.75 7.891 143,811.03 1.00 355,554.00 105.0848 < 16,813 .57 I I 101.3260 50,663.00 103.8070 25,951.75 105.1220 21,024.40 105.3280 94,795.20 102.9780 20,595.60 136.80 556.50 3.75 67.71 I I i 35,407.04 ----1------ 999,011.53 I 66.14 ~~m'~. I INHERITANCE TAX RETURN ~ RESIDENT DECEDENT - - -~----_.------_.~-~-~-._--------~- -~-----------~~----~---~-~-~._._-- - ----------- .-- SCHEDULE B STOCKS & BONDS continued I FILE NUMBER ---- --- 21 - 01 - 00956 ESTATE OF HATFIELD, BEITY W. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION UNIT VALUE VALUE AT DATE NUMBER OF DEATH 21 Accrued interest to No. 11 above 254.68 22 I Accrued interest to No. 12 above 863.01 23 Accrued interest to No. 13 abovoe 474.66 24 Accrued interest to No. 14 above 365.92 25 Accrued interest to No. 15 above 1,272.33 26 Accrued interest to No. 16 above 411.37 27 855 shares, General Electric 37.45 32,019.75 , i -______1__- I _~l__._~ - ---- ---Page2ofScheduleB SCHEDULE C I CLOSELY-HELD CORPORATION, PARTNERSHIP or I SOLE-PROP~I=-T~~~_H~_____L___~________ __ I- FilE NUMBER---------- ___~__~~~ O~?~~________ *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIOENT DECEOENT I ESTATE OF HATFIELD, BETTY W. Schedule C-1 or C-2 (Including all sUPRorting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 333,125.00 10.25% interest in Hatfield Family Limited Partnership under agreement dated December 29, 1994, and from time to time amended, which partnership consists solely of approximately 126.09 acres situate in South Middleton Township, Cumberland County, Pennsylvania, being parcel no. 40-09-0527-016 and being more particularly described in Deed dated December 19, 1994, recorded in Cumberland County, P A, Deed Book 116, Page 1160. Copy of Deed and appraisal attached hereto ______ __ ____ ___________ __________ __ _ _ ________________ ____ _________ _______ _u_ __ ____ ____ TOTAL (Also enter on line 3, Recapitulation) 333,125.00 *' SCHEDULE C-2 PARTNERSHIP INFORMATION REPORT COMMONWEAl.TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER ___~~__ ~_2~_~ 01 - ~~~!n__ ESTATE OF HA TFIELD, BETIY W. 1. Name of Partnership The Hatfield Family Limited Partnership Address 61 Eastgate Drive City Camp Hill Federal Employer I.D. Number 25-1756043 Type of Business Limited Partnership Decedent was a ['gJ General ~ Limited Date Business Commenced 12/29/1994 -.----- Business Reporting Year Calendar State PA Zip Code 17011 2. 3. 4. Product/Service Real Estate $275,000.00 Partner. If decedent was a limited partner, provide initial investment. PERCENT OF INCOME 10.25% 10.25% 26.5% 26.5% 26.5% PERCENT OF OWNERSHIP -- 10.25% 10.25% 26.5% 26.5% 26.5% . -~----l BALANCE OF CAPITAL ACCOUNT 5. I ~~ G. Hatfield I ~tty W. Hatfield I ~ane H. Erickson ~~~~~~~~ei~~~d ______ PARTNER NAME i 6. Value of the decedent's interest $333,125.00 7. Was the Partnership indebted to the decedent? 0 Yes IllI No If yes, provide amount of indebtedness 8. Was there life insurance payable to the partnership upon the death of the decedent? 0 Yes IllI No If yes, Cash Surrender Value Net proceeds payable Owner of the poliCY 9. Did the decedent sell or transfer an interest in this partnership within one year prior to death or within two years if date of death was prior to 12-31-82? DYes a No If yes, 0 Transfer 0 Sale Percentage transferred/sold Transferee or Purchaser Consideration Date Attach a separate sheet for additional transfers and/or sales. 10. Was there a written partnership agreement in effect at the time of the decedent's death? IllI Yes 0 No If yes, provide a copy of the agreement. 11. Was the decedent's partnership interest sold? 0 Yes IllI No If yes, provide a copy of the agreement of sale, etc. 12. Was the partnership dissolved or liquidated after the decedent's death? 0 Yes IllI No If yes, provide a breakdown of distributions received by the estate, including dates and amounts received. 13. Was the decedent related to any of the partners? IllI Yes 0 No If yes, explain Spouse and mother 14. Did the partnership have an interest in other corporations or partnerships? 0 Yes IllI No If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest. A. Detailed calculations used in the valuation of the decedent's partnership interest. B. Complete copies of financial statements or Federal Partnership Income Tax returns (Form 1065) for the year of death and 4 preceding years. C. If the partnership owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have been secured, attach copies. D. Any other information relating to the valuation of the decedent's partnership interest. l I l_ *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER 21 - 01 - 00956 I ESTATE OF HATFIELD, BETTY W. Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. VALUE AT DATE OF DEATH 41.94 ITEM NUMBER I DESCRIPTION PSERS, prorated pension for October, 2001 2 Blue CrossIBlue Shield, premium refund 158.45 3 1995 Mercedes E320, sedan, appraised value 11,475.00 4 Diamond ring, appraised value 4,000.00 ___ u.n__ n __~__.~__~_ n._____ ___u_______ ._~__.nn_.___nu_~___u TOTAL (Also enter on Line 5, Recapitulation) 15,675.39 . L SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBA Tf PROPERTY I FILE NUMBER I 21 - 01 - 00956 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HA TFlELD, BETTY W. This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. -;-;;MI---- DESCRIPTION OF PROPERTY DATE OF DEATH % OF -~---- , Include the name of the transferee. their relationship to decedent and the date of transfer. DECO'S EXCLUSION TAXABLE VALUE NUMBER ALUE OF ASSET Attach a copy of the deed for real estate. INTEREST (IF APPLICABLE) 1 American Express IRA Account 0022435525500002, John G. Hatfield, spouse, beneficiary 5,747.91 100% -t--------- I 5,747.91 I I 4,955.81 2 Erie Family Life Insurance Company IRA Account 213932, John G. Hatfield, spouse, beneficiary 4,955.81 100% ~~- J I I n.' ,___ __n_'____-.l.-_~__ I TOTAL (Also enter on line 7, Recapitulation) I I 10,703.72 . SCH3JULE H RJNERALEXPENSES& ADIVNSIRAllVE cosrs COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HATFIELD, BETfY W. Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION FUNERAL EXPENSES: Myers-Hamer Funeral Home, Camp Hill, PA, funeral expense 2 Rolling Green Cemetery Corp., Mauseleum Interment Rights and Endowment Care 3 JDK Catering, Memorial service reception 4 Airfare, lodging and meals for children attending funeral service B. ADMINISTRATIVE COSTS: Personal Representative's Commissions 1. Social Security Number(s) J EIN Number of Personal Representative(s): Street Address City Year(s) Commission paid 2. Attomey's Fees State Zip 3. Family Exemption: (If d"ecedenU aaaress is not the same as claimant's, attach explanation) Claimant JOHN G. HATFIELD Street Address 61 Eastgate Drive City Camp Hill Relationship of Claimant to Decedent State P A Spouse 17011 Zip 4. Probate Fees 5. Accountant's Fees 6. Tax Retum Preparer's Fees 7. I 2 3 Other Administrative Costs The Sentinel, advertising Letters Testamentary Cumberland Law Journal, advertising Letters Testamentary Register of Wills, Inheritance Tax Return, filing fee _ n_ _L_ Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) I FILE NUMBER 21 - 01 - 00956 I AMOUNT 4,833.00 7,635.00 1,237.82 3,397.41 3,500.00 416.00 87.35 75.00 10.00 1,531.00 22,722.58 *' SchecUeH FlI1eraI ExpeIlSe5 & Adnir1istrc6IeCos1s ca1Ii'u!d COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HATFIELD, BETTY W. 4 Steven W. Barrett Real Estate & Appraisal Service, appraisal fee 5 6 7 Commonwealth of Pennsylvania, registration fee Merrill Lynch, account administration fee Reserved for additional probate fee, filing fees and miscellaneous expenses . __.-L__ --~ I FILE N~IM_BO~~-0095~----~.~- ---~-_._--- ----~----- Page 2 of Schedule H 900.00 6.00 125.00 500.00 '*' I COMMONWEALTH OF PENNSYLVANIA 11 INHERITANCE TAX RETURN RESIDENT DECEDENT ~ ~--- ~ ------ ~- - --- SCHEDULE J BENEFICIARIES NUMBE~I= NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 John G. Hatfield I I RELATIONSHIP TO DECEDENT I te AMOUNT OR SHARE OF ESTATE Spouse Estate residue Enter dollar amounts for distributions shown above on lines 15 through 17. as appropriate, on Rev 1500 cover she t II. NON-TAXABLE DISTRIBUTIONS; A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE I lB. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS I TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHE T __~_____.___~_._____~~____..~.____.__.______.__ -------.--1_ . SCHEDULE M ~ ~ FUllJRE NTERESTCONPROMSE (Cleek Box4aon Rev-1500CoYerSheet) I FILE NUMBER 21 - 01 - 00956 -fills.schedUle isappropriate only for Estates of decedents dying after Dece-mber1~982.------ This schedule is to be used for all future interests where the rate of tax which will be applicable when the future interest vests in possession and enjoyment cannot be established with certainty. Indicate below the type of instrument which created the future interest and attach a copy to the tax retum 1m Will 0 Trust 0 Other COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HATFIELD, BETTY W. I. I Beneficiaries i --1. John G. Hatfield-- 2. 3. 4. 5, pouse AGE TO i tEAREST8IRTlOAY i 71 ~ -=l ______~. __. _un! NAME OF BENEFICIARY RELATIONSHIP DATE OF BIRTH II,!' For decedents dying on or after July 1, 1994. if a surviving spouse exercised or intends to exercise a right of withdrawal within 9 months of the decedent's death, check the appropriate block and attach a copy of the document in which the surviving spouse exercises such withdrawal right.. ., . o Unlimited right of withdrawal 0 Limited right of Withdrawal -- .iii~~Explanation of Compromise Offer: DOD Value of Trust Age of Life Tenant at nearest Birthday Federal Section 7520 rate for October 2001 Spousal Principal Withdrawal Rate Total Interest Rate and Withdrawal Rate Remainder Factor Present value of Spousal Interest Remainder 675,000.00 71 5.60% 5.00% 10.60% 34.13% 444,595.50 230,404.50 see footnote (I) footnote (I) Federal Table S Single Life Remainder Factor - Life Interest Holder Age 71 and 10.6% Rate Internal Revenue Service Temp. Reg. Sec. 20.2031-7T I n_ I IV.i I I I I I Summary of Compromise Offer: 1. Amount of Future Interest: 2. Value of Line 1 exempt from tax as amount passing to charities, etc. (also include as part of total shown on Line 13 of Cover Sheet) 3. Value of Line 1 passing to spouse at appropriate tax rate Check One 0 60/0 0 3% 0 0% (also include as part of total shown on Line 15 of Cover Sheet) 4. Value of Line 1 Taxable at 6% Rate (also include as part of total shown on Line 16 of Cover Sheet) 5. Value of Line 1 Taxable at 15% Rate (also include as part of total shown on Une 17 of Cover Sheet) __ _J__6~._Total ".alue of Future Interest (sum of Lines 2 thru 5.must equal Line 1) 230,404.50 230,404.50 " I ~~-~~~- I FilE NUMBER 21 - 01 - 00956 I ~--D-o not complete this schedule unless the estate is making the election to tax assets under Section 9113(A) of the Inheritance & -Estate Tax Act. If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the Disclaimer Trust (marital, residual A, B, By-pass, Unified Credit, etc.). CO_~"E:VANIA_l_ INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 0 ELECllON UNOERSEC. 9113(A) (SPOUSALDISTRIBUTlONS) ESTATE OF HA TFIELD, BETTY W. If a trust or similar arrangement meets the requirements of Section 9113(A), and: a. The trust or similar arrangement is listed on Schedule 0, and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0, then the transferor's personal representative may specifically Identify the trust (all or a fractional portion or percentage) to be included in the election to have such trust or similar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule 0, the personal representative shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule O. The denominator is equal to the total value of the trust or similar arrangement. Part A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's surviving spouse under a Section 9113 (A) trust or similar arrangement. DESCRIPTION Assets listed in Disclaimer attached VAlUE--- 675,000.00 Part A Total 675,000.00 Part B: Enter the description and value of all interests included in Part A for which the Section 9113 (A) election to tax is being made. --~-~----~- DESCRIPTION VALUE I Assets listed in Disclaimer attached 675,000.00 Part B Total (If more space is needed, insert additional sheets of the same size) -675,000.00 INRE: ESTATEOFBEITYW. HATFIELD, DECEASED, LATE OF CAMP HILL BOROUGH, CUMBERLAND COUNTY, PA DISCLAIMER AND RENUNCIATION IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION : NO. 21-01-0956 I, JOHN G. HATFIELD, hereby exercise the rights granted to me in Chapter 62 ofthe Probate, Estates and Fiduciaries Code (the "PEF Code"), and I hereby disclaim and renounce any interest to which I may be entitled under Items THIRD and FOURTH of the Last Will and Testament of Betty W. Hatfield and under applicable law to the following assets: Date of Death Value Decedent's interest in The Hatfield Family Limited Partnership under Agreement dated December 29, 1994, as amended $ 333,125 3955.28 units American Investment Fund, Class A, together with accrued income (108,810 + 66) 108,876 18227 units ML Municipal Bond Fund Ins. Pt. A 143,811 2200 shares PPL Capital Funding Trust I, 7.75% Conv. Pfd 42,658 46530 shares ML Banking Advantage $ 46.530 TOTAL $ 675,000 IN WITNESS WHEREOF, intending to be legally bound hereby and intending that this Disclaimer and Renunciation shall be filed of record in the Office of the Clerk of the Orphans' Court Division of the Court of Common Pleas of Cumberland County, Pen~vania, as provided in Section 6204 of the PEF Code, I have hereQnto set my hand and seal this - day of ,2002. COMMONWEALTH OF PENNSYL VANIA ) SS. COUNTY OF CUMBERLAND ) F: IFILESIOA T AFlLEIEST A TESIl 04253 .disclaimer On this, the ~O~ day of cL~......" . , 2002, before me, a notary public, personally appeared John G. Hatfield, known to me to be ~ whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. ~~-:X~~~JJ Notary Public NOTARIAL SEAL CORRINE L. MYERS, Notary PubIie Carlisle Boro, CumberlandCountY M Commission Ex ires Ma 27,2003 f:\FlLES\DA T MIlE\ WILLS\ IO~25-w. will LAST WILL AND TESTAMENT I, BETTY W. HATFIELD, of Camp Hill, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. ITEM ONE I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and all inheritance taxes shall be paid to the extent possible from the assets held or passing under ITEM FOUR hereof as soon as practicable after my decease and as part ofthe administration of my estate. ITEM TWO ~~?::::J If my spouse, JOHN G. HATFIELD, is living thirty (30) days after my death, then I give, devise and bequeath all the rest, residue and remainder of my estate, both real and personal property, unto my said spouse, JOHN G. HATFIELD, absolutely. Ifmy said spouse does not so survive me, then I give, devise and bequeath all of my estate, both real and personal property, unto my Trustee to be held or distributed by such Trustee under ITEM FOUR hereof. ITEM THREE -,' -. ." In the event my said spouse, JOHN G. HATFIELD, shall disclaim all or any portion of any devise or bequest made to my said spouse under the foregoing ITEM TWO, then the amount otherwise payable shall be held by my Trustee under ITEM FOUR hereof. For purposes ofthe Trust established under ITEM FOUR hereof, my said spouse shall not be deemed to have predeceased me by virtue of my spouse's exercise of the right to disclaim set forth herein. ITEM FOUR RESIDUARY AND DISCLAIMER TRUST My Trustee shall hold the assets received under ITEMS TWO and THREE hereof, if any, for the following purposes: a. My Trustee shall pay the net income, at least quarter-annually, to my spouse, JOHN G. HATFIELD, for life. In addition, my Trustee in my Trustee's sole discretion, may invade the principal of the Trust for the proper and adequate support of my said spouse, JOHN G. HATFIELD. duff) B.W.H. Page 1 of 7 Pages b. My Trustee shall further pay to my said spouse, JOHN G. HATFIELD, annually, such sum from the principal of the Trust as my said spouse may request in writing, provided, however, that said sum may not exceed the greater of Five Thousand Dollars ($5,000.00) or five percent (5%) of the aggregate value, at the time of said request, of the principal of the Trust hereunder. c. Upon the death of my said spouse, JOHN G. HATFIELD, my Trustee shall distribute the principal of the Trust, in equal shares, to my children, JAMES W. HATFIELD, JOHN W. HATFIELD and JANE H. ERICKSON, absolutely. d. In the event that any of my said children shall fail to survive my spouse and me, but shall leave issue surviving, then such deceased child's share shall be held by the surviving parent of such deceased child's issue and the net income therefrom shall be used, in equal shares, for the support, maintenance and education of the issue of such deceased child. The trustee shall use as much of the principal as he or she shall deem desirable, in equal shares, for said purposes. I direct that the issue of such deceased child shall have the right of withdrawal of his or her equal share of the principal and any accumulated income of said trust in the following manner: One-fifth (l/5) thereof as each attains the age of twenty-two (22) years, one-fourth (1/4) of the remainder of said share as each shall attain the age of twenty-five (25) years, one-third (113) ofthe remainder of said share as each shall attain the age of twenty-eight (28) years, one-half (1/2) of the remainder of said share as each shall attain the age of thirty-one (31) years, and the remainder of said share as each shall attain the age of thirty-five (35) years. In the event that any of my children shall fail to survive my spouse and me and not leave issue surviving, then such deceased child's share shall be added to the shares of my other children as if originally a part thereof. e. To the extent that the same is permitted by law, none ofthe beneficiaries hereunder shall have any power to dispose of or to charge by way of anticipation any interest given to such beneficiary; and all sums payable to such beneficiaries hereunder shall be free and clear ofthe debts, contracts, alienations and anticipations of the beneficiaries, and all liabilities for levies and attachments and proceedings of whatsoever kind, at law or in equity. 13~~J. B.W.H. Page 2 of 7 Pages " ITEM FIVE POWERS OF EXECUTOR AND TRUSTEE In addition to the powers conferred by case law, by statute, and by other provisions hereof, my Executor and Trustee and their successors, shall have the following discretionary powers applicable to all property held by them which powers shall be effective without order of any court and shall exist until final distribution. a. To retain any property of any nature received by them for whatever period they shall deem advisable; b. To invest and reinvest all or any part of said property in such stocks, bonds, securities or other property, real or personal, as in their discretion they shall deem proper, without regard to statutes limiting the property which a fiduciary may purchase; c. To sell, transfer, exchange or otherwise dispose of, any part of said property, for cash or on terms, publicly or privately, or to lease, even for a term exceeding five (5) years or the duration of any trust herein, without liability on the purchasers or lessees to see to the application of the proceeds, and to give options for these purchases without the obligation to repudiate them in favor of a higher offer; d'. To execute and deliver any deeds, leases, assignments or other instruments as may be necessary to carry out the provisions of any trust hereunder; e. To borrow money, including the right to borrow money from any bank and to mortgage or pledge any asset of the estate as security; f. To assume continuance of the status of any beneficiary with regard to death, marriage, divorce, illness, incapacity and the like in the absence of in formation deemed reliable without liability for disbursements made on such assumption; g. To pay from the trust, or the income therefrom, all debts or claims against my estate, or any taxes or similar charges on my estate; h. To make any distribution hereunder either in kind or in money, or partially in kind and partially in money. Distribution in kind shall be made at the market value of the property distributed, (j (oY). B.W.H. Page 3 of 7 Pages and my Trustee, in its absolute discretion, may cause the share distributed to any distributee to be composed of property similar to or different from that distributed to any other distributee; 1. To exercise any subscription right in connection with any security held hereunder, to consent to or participate in any recapitalization, reorganization, consolidation or merger of any corporation, company or association, the securities of which may be held hereunder, to delegate authority with respect thereto, to deposit investments under agreements, to pay assessments, and generally to exercise all rights of investors; J. To invest in endowment, insurance or annuity policies on the lives of beneficiaries of any trust hereunder; k. To continue in any partnership, joint venture, joint ownership or other business enterprise of which I am a part at the time of my death; 1. To compromise claims; m. To continue for whatever period oftime as they shall deem necessary any ownership as a tenant in common or as a partner, in real estate or other property and to act as I could have done had I been living; n. To lend money to my estate or to any trust created hereunder or to purchase from the estate or from any trust created hereunder, at the market value thereof at the time of purchase, any securities or other property tendered to them by my estate or any trust created hereunder at any time and from time to time within a period of nine (9) months after my death; o. In the event that any amounts are payable hereunder or under any trust created hereunder to a minor, or to a person otherwise under legal disability, or to a person not adjudicated to be an incapacitated person, but who, by reason of illness or mental or physical disability is, in the opinion of the fiduciary(ies) hereunder, unable to properly administer such amounts, such amounts may be paid by the fiduciary(ies) hereunder in his, her or their sole discretion in any of the following ways as he, she or they may deem best: 1. Directly to such beneficiary; 2. To a legally appointed guardian of such beneficiary for the benefit of such beneficiary; /d-UrY). B.W.H. Page 4 of 7 Pages : 3. To a person having custody of such beneficiary for the benefit of such beneficiary; 4. By the fiduciary(ies) hereunder using such amounts directly to the benefit of such beneficiary. Evidence of the application of payment of an amount in such a manner shall be a full and complete discharge ofthe fiduciary(ies) hereunder to the extent of such payment or application. This paragraph shall be applicable to payments of income as well as principal. p. To employ agents, attorneys and proxies and to delegate to them such power as my personal representatives and Trustees consider desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys and proxies; q. To conduct an inventory of any safe deposit box necessary to the administration of my estate. r. To do all other acts in their judgment necessary or desirable for the proper management, investment and distribution of my Estate. ITEM SIX PROTECTIVE PROVISIONS All income or principal held for the use and benefit of the beneficiaries of any trust hereunder shall not be in any way or manner subject to anticipation, assignment, pledge, sale or transfer, nor shall any such interest, while in the possession of my Trustee, be liable for or subject to the debts, contracts, obligations, liabilities or torts of any beneficiary, or to attachments, executions or sequestrations under process of law. ITEM SEVEN APPOINTMENT OF EXECUTORS I nominate, constitute and appoint my said spouse, JOHN G. HATFIELD, as Executor of my estate. In the event that my said spouse shall predecease me or fail to act as Executor, then I appoint my children, JAMES W. HATFIELD, JOHN W. HATFIELD and JANE H. ERICKSON, as Executors of my estate. laaVj, B.W.H. Page 5 of 7 Pages ITEM EIGHT APPOINTMENT OF TRUSTEES I hereby appoint my said spouse, JOHN G. HATFIELD, as Trustee of the trust created under Item Four hereof. In the event that my said spouse shall fail or be unwilling to act or continue to act as Trustee, then I appoint my children, JAMES W. HATFIELD, JOHN W. HATFIELD and JANE H. ERICKSON, as Trustees of such trust, excepting any further trust for grandchildren under Item Four, d., hereof. ITEM NINE WAIVER OF BOND I direct that neither my Executor nor my Trustee or his successors shall be required to file any bond in any jurisdiction to secure the faithful performance of their duties, nor shall they be required to obtain any order or approval of any court for the exercise of any power or discretion set forth in this Will. IN WITNESS WHEREOF I have hereunto set my hand and seal this Jl L(..J"h.. day of A ug<< t1 ,;; tp{ l&t~ (././ MJ"d,fJ (SEAL) Betty W 'atfield ,? SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, have hereunto subscribed our names as witnesses thereto, in the presence of the said Testatrix and of each other. ~~\- /~.~ . '.!MfC... I n1M6-?( Page 6 of 7 Pages COMMONWEAL TH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) We, Betty W. 17M f'/10(nSbr\ Hatfield, TVD V. ~~TIL and , the Testatrix and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her last Will and that the Testatrix has signed willingly, and that the Testatrix executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as a witness and that to the best of his /her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ~'-IJ" 1~'^ / Tes tox ,I Witness ~ ~ ~/~trI~ Witness Subscribed, sworn to and acknowledged before me by Betty W. Hatfield, the Testatrix, and subscribed and sworn to before me by Iv L: \l c tbYST and Ii n Ii- 111 Dr 'f"1.5.cn , the witnesses, this ~z.f-day of Aifjt-iST ,2001. (l . .\ ~... LL/ 'u.~---x' )'1'(J.91-"v NOraiy Public NOTARIAL SEAL CORRINE L. MYERS, Notary Public Carlisle Boro. CumberlandCountv My Co~i~si~f.1Xxp1re~~lpy 27, 2003 Page 7 of 7 Pages F,iL /(_ (J. /... . ~ -- F: IFILESIDA T AFILEIEST A TESI 1 0425-notice.cert CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: BETTY W. HATFIELD Date of Death: October 5, 2001 File No. 21-01-00956 To the Register: I certify that notice of estate administration 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 or about January 4,2002. John G. Hatfield 61 Eastgate Drive Camp Hill, PA 17011 Jane H. Erickson 342 Forest Avenue Reservoir Forest, IL 60305 James W. Hatfield 536 Daventry Road Berwyn, PA 19312 John W. Hatfield c/o Urban Veterinary Care 2930 North Lincoln Avenue Chicago, IL 60657 Notic~: has now been given to all persons entitled thereto under Rule 5.6(a) except: N/A Date: January 4,2002 Signature Name ~\},~ U:S-. Ivo V. Otto III, Esquire MARTSON DEARDORFF WILLIAMS & OTTO Ten East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Personal Representative "':::I' ~r) "::;j I :;::: <::t:: -, () a;: :;V a: 0: r'-l p :1._ :.;-2 (I) = GG MARTSON DEARDORff WILLIAMS & OTTO MDW&'O INFORMATION' ADVICE' ADVOCN:Y ATTORNEYS & COCNSELLORS AT LAw TEN EAST HIGH STREET CARLISLE, PENNSYLVANIA 17013 WILLI^'\,1 F. MARTSON JOHN B. FOWLER III EDWARD L. SCHORPI' DANIEL K. DEARDORFF THOMAS J. WILLIAMS' I VO V. OTTO III GEORGE B. FALLER JR.' CARL C. RISCH MARK A. DENLINGER DAVID R. GALLOWAY TELEPHONE (717) 243-3341 F ACSIM I LE (717) 243-1850 INTERNET www.mdwo.com January 2, 2002 'BOARD CERTifiED CiVIL TRIAL SPECIALIST Mrs. Mary C. Lewis Register of Wills Cumberland County Courthouse Carlisle, P A 17013 RE: Estate of Betty W. Hatfield Estate No. 21-01-00956 Date of Death: October 5,2001 Dear Mrs. Lewis: Enclosed with this letter is estate check number 102 in the amount of$9 ,850. 00 representing payment ofP€mnsylvania Inheritance Tax in the above-referenced estate. Will you please issue the appropriate receipt and forward it to me at the above address. I thank you in advance for your prompt attention to this matter. ro..J ~';l P'1 CL Very truly yours, MARTSON DEARDORFF WILLIAMS & OTTO r'--J I ...; (c. &tJ: r'-oJ p ~~! -:~ .@ \~-~) = '-'. ...; (J c..; ~r~~ Ivo V. Otto III -". ~c -...., IVO/clm Enclosure HAND DELIVERED F:\FILESIDA T AFILEIEST A TESlI0425-row.1 I N FOR MAT ION · A D V ICE · A 0 v 0 CAe y SM 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 OTTO IVO VICTOR III 10 E HIGH STREET CARLISLE, PA 17013 ___n_n fold ESTATE INFORMATION: SSN: 168-26-3644 FILE NUMBER: 21-2001- 0956 DECEDENT NAME: HA TFI ElD BETTY W DATE OF PAYMENT: 01/02/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 10/05/2001 NO. CD 000708 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $9,850.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: JOHN G HATFIELD C/O IVO V OTTO III CHECK#102 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS $9,850.00 MARY C. lEWIS REGISTER OF WillS J ~ INRE: ESTATEOFBETTYW. HATFIELD, DECEASED, LATE OF CAMP HILL BOROUGH, CUMBERLAND COUNTY, PA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA ORPHANS' COURT DIVISION : NO. 21-01-0956 DISCLAIMER AND RENUNCIA nON I, JOHN G. HATFIELD, hereby exercise the rights granted to me in Chapter 62 ofthe Probate, Estates and Fiduciaries Code (the "PEF Code"), and I hereby disclaim and renounce any interest to which I may b(~ entitled under Items THIRD and FOURTH ofthe Last Will and Testament of Betty W. Hatfield and under applicable law to the following assets: Date of Death Value Decedent's interest in The Hatfield Family Limited Partnership under Agreement dated December 29, 1994, as amended $ 333,125 3955.28 units American Investment Fund, Class A, together with accrued income (108,810 + 66) 108,876 18227 units ML Municipal Bond Fund Ins. Pt. A 143,811 2200 shares PPL Capital Funding Trust I, 7.75% Conv. Pfd 42,658 46530 shares ML Banking Advantage $ 46,530 TOTAL $ 675,000 IN WITNESS WHEREOF, intending to be legally bound hereby and intending that this Disclaimer and Renunciation shall be filed of record in the Office of the Clerk of the Orphans' Court Division of the Court of Common Pleas of Cumberland Coun~, Pennszlvania, as provided in Section 6204 ofthe PEF Code, I have here~nto set my hand and seal thIs' L- day of / , 2002. COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) On this, the (;;(o~ day of c.L.......... D . , 2002, before me, a notary public, personally appeared John G. Hatfield, known to me to be ~ whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. ~=~X~P4-' I Notary Public NOTARIAL SEAL CORRINE L. MYERS, Notary Public Carlisle Bora, CumberlandCounty My Commission Expires May 27, 2003 F: IFILES\DA T AFILEIEST ATES\ I 04253 .disclaimer /_"" I~__/~:!..:v , aUREA.U OF INDIVIDUA.L T A.)(.ES \. IN\-IERITI".NCE TI".X DIVISION DEPT. 280601 \-II".RRISBURG, PI". 17128-0601 COMMONWEALiH Of PENNS'fLVAN\A OEPARiMENi Of REVENUE N01ICE Of INHERIl ANCE 1 A.X APPRAISEMEN1, ALLOWANCE OR DISALLOW ANCE OF DEDUC1IONS AND ASSESSMENl Of lA.X OA iE 8_23-2002 ESi A iE Of Betty W. Hatfield OAiE Of OEAiH 10-5-2001 fILE NO. 2101-0956 COUNiY cumberland ACN 101 MAKE CHECK PAYABLE AND REMli PAYMENi iO: Register of Wills cumberland County courthouse Carlisle, PA '\7013 CUT ALONG THIS LINE _c) _ _ "E:r~IIlI,()Y/"R- Pg"TI()N-"O_R_yg~" "E_C()"Dll_ - (0_ - - - -- - - -- -- - - - - - - - - - - - - -- - -- - - - - -- _ REV:' 547 .,no"''') pc - - - -- - - - -- -- - -tio TlCE OF INH ERIT ANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF Botly W _ Ha"e'd F.LE NO. 2101-0956 AeN 101 DATE 8-23-2002 TAX RETURN WI>S' 0) ACCEPTED AS FILED 1811 CHANGED see attached RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1'110 V. otto,\\\ Esq. Martson Deardorff Williams & otto 10 East High street Carlisle pa 17013 Amount Remitted 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closelv Held Stock/Partnership Interest (Schedule C) 4. MortQaQes/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/ Misc. Personal Property (Schedule E) 6. Jointlv Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED D'EDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 22,722.58 10. Debts/MortQaQe Liabilities/Liens (Schedule I) (10) 0.00 11. Total Ded"ctio", (11\ 22.722.50 12_ Net Va'"e ofT ax Ret"" (12\ 1.335.793.06 13. Charitable/Go,e"me,ta' Beo"est. Noo-e_d 9113 Trusts (S",",,"1e J\ (13\ 0.00 14 Net Va'"e of Estate S"biect to Tax (14\ 1.335.793.06 NOTE' If 00 assessment was is"ed .,e'ioOSI" lI,es 14, 15 ood/o' 16, 17 ood I. wil i ,e"eet fi9"os that include the total of ALL returns assessed to date. (1 ) (2) (3) (4) (5) (6) (7) 0.00 999.011.53 333.125.00 0.00 15,675.39 0.00 10,703.72 (8) NOTE: To insure propel credit to your account, submit the upper portio of this form with your tax payment. 1.358,515.64 1,105,388.56 X .00 X.045 X .12 X .15 (19) 0.00 ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 taxable at SiblinQ rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: (15) (16) (17) (18) 0.00 PAYMEN'T RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-\ 0.00 TOTAL TAX CREDIT 0.0 BALANCE OF TAX DUE 0.0 INTEREST O.C TOTAL DUE O.C * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR C1\.LCULATION 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 B' A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTI< RESERVATION: ......, of '-'''''' d.o, 00 '" "'.,,, """""" 12, 1982 - " '"' M"~ 'me"", '0 '''' ""Ie " "'o~'"'" '0 """~'oo '" '"~""""" C',~ B ("""'~') -.,,,',, 'fl'" """"'"' "",,'" ""''''00 of '"' ""'Ie "" 'If, '" '''' "'., "" C""""on...., "'~b, ~"'~" ~,~" '''' Og'" '" appraise and assess transfer Inheritance Taxes at the lawful Class B (COllateral) rate on any such future interest. PURPOSE OF NOTICE: PAYMENT: 0,."" ~, "'" """,00 '" ~. Noooo ''''' ,"bmll wIlh "of """"0' " '''' R".,oe of '",. ""'''' 00 ~, -."do "'.. ""'" '" moo" """ payable to: REGISTER OF WILLS, AGENT. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 21 of 1995. (72 PS. Section 9140). 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 '""'..~ oed E'"", T", (REV-1313) Aoolloo",",,~ M'.b" " ., Olf"" of~, R",,,,, of ,",. '" '"' of 'h, " R,,,,,", 0',,,,,, Offioo', '" by calling the Special 24-hour answering service numbers for forms ordering: In Pennsylvania 1-800-362-2050, outside Pennsylvania and within local Harrisburg area (717) 787-8094, TDD# (717) 772-2252 (Hearing Impaired Only). OBJECTIONS: Ao, "''' '0 'ole~" "" ~""'" ,"'h '''' 'PP~'_'"', '",""000" ,,~"""ooo of '''''''''"', '" ,"""_, of "'" ('0""0' """,", " """,,) " shown on this Notice must object within sixty (60) days of receipt of this Notice by: \DMINISTRA TIVE 'ORRECTtONS, F,",,, ,~. d"""""" 00 .. -"""moo, ""'," b""~",, '0 wrilio, '" PA "'''''''m,", of R,~ouo, B,~," of '''''','''',,' T""" A ITN Poo' A",,,,o,,", R,"_ UM, Oopt, 280601 H"<i,",~, P A 171 28.otlO1 Ph"", ~ 17) ?aT -8505 S~ "''' 3 of '''' boo"oI "'0",""""' "" '0"'".000 T '" Return for a Resident Decedent" (REV-1501) for an explanation of administratively COrrectable errors. --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. 'ISCOUNT " '"' Ie, duo " "''' ..." .", (3) 00''''''" m"",", "",~, '-''"'' d". , "uo '''00", (5%) """,", of '''' "'" 'old" ,,"'.... ENAL TY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before Joeuo~ 18,1996, "" "M d" ,", ., ,"d of ., "'" 'mo"" porioo, Th', OOO-",rt"'_o "Mtty " '''''''"', '0 ~, ~"" m,""" oed '0 '''' ~m, time period as you would appeal the tax and interest that has been assessed as indicated on this notice. TEREST' 'ole"" " d"~,,, b",o",,,, "fufl;" d" of d.,"q~"", 010'00 (0) ~_ ,,'" 00' (1) ",,"'" ,"",,, of d,""" '" "'''''Ie of """"0' T,,,,, 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 2001 are: YEAR 1982 1983 1984 1985 1986 1987 1988-1991 INTEREST RATE 20% 16% 11% 13% 10% 9% 11% DAILY INTEREST FACTOR 000548 000438 .000301 000356 000274 .000247 .000301 YEAR 1992 1993-1994 1995-1998 1999 2000 2001 2002 INTEREST RATE 9% 7% 9% 7% 8% 9% 6% DAIL Y INTEREST FACTOR 000247 .000192 .000247 .000192 .000219 000247 000164 --Interest is calculated as follows: --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. INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR . (. .... :~EV-1470 EX (6-66) . INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL. TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME Betty W. Hatfield FILE NUMBER Harry A. Herr ACN 2101-0956 101 REVIEWED BY SCHEDULE ITEM NO. EXPLANATION OF CHANGES The tax due on all current interests is reflected on the attached Inheritance Tax Assessment. The tax due on all future interest uncertainties is covered on the attached compromise tax assessment,(ACN 102). ROW Page 1 ~ ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPARTMENT 280601 HARRISBURG, PA 17128-0601 8-23-2002 Telephone 717 783-6070 Ivo V. Otto, III Esq. Martson Deardorff Williams & Otto 10 East High Street Carlisle, Pa 1'7013 Re: Estate of Betty W. Hatfield File Number 2101-0956 Date of Death: 10-5-2001 Dear Mr. Otto,"I: Enclosed is a "Notice of Inheritance Tax Appraisement, Allowance or Disallowance of Deductions and Assessment of Tax," (REV-1547 EX), ACN 101 establishing the tax applicable to all present interests in the above estate. Also enclosed is a "Notice of Inheritance Tax Appraisement, Allowance or Disallowance of Deductions and Assessment of Tax," (REV-1547 EX), ACN 102 establishing the tax applicable to future interests where the rate of tax is uncertain. Based on the provisions of the above decedent's Will, Deed of Trust and the information reported on Schedule M by the estate representative, the Department concurs with the estate representative's compromise proposal, and the tax on the future interests have been assessed as shown on the ACN 102 assessment notice. All existing inheritance and/or estate tax payments have been appropriately applied. Any changes which become necessary as a result of a protest de!cision or an order of court will be reflected in adjustments to both ACN 101 and ACN 102. Please contact me at the telephone number above if you have any questions. Sincerely, #~~AI~ Harry A. Herr Trust Valuation Specialist Inheritance Tax Division Enclosure .. .... BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE Ivo V. Otto,1II Esq. Martson Deardorff Williams & Otto 10 East High Street Carlisle Pa 17013 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NO. COUNTY ACN REV.1547 EX (12.97) PC 8-23-2002 Betty W. Hatfield 10-5-2001 2101-0956 Cumberland 102 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: Register of Wills Cumberland County Courthouse Carlisle, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ - "i'feV=1547 e)("(oif-97'YPC -" .. -"". -"". - "No-tic"e-OF -fNi=fERIT M~Cln'A5f APprfAUfeMENt~'AnOWANCE" off' -". -" - -". --" - -"" - -- -"". --" --. -" DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF Betty W, Hatfield FILE NO. 2101-0956 ACN 102 DATE 8-23-2002 TAX RETURN WAS: (D) ACCEPTED AS FILED (D) 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. Mortoaoes/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 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 0.00 10. Debts/Mortoaoe Liabilities/Liens (Schedule I) (10) 0.00 11. Total Deductions (11) 0.00 12. Net Value ofTax Return (12) 230.404.50 13. Charitable/Governmental Bequests: Non-elected 9113 Trusts (Schedule J) (13) 0.00 14. Net Value of Estate Subiect to Tax (14) 230.404.50 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16,17 and 18 will reflect figures that include the total of ALL returns assessed to date. (1 ) (2) (3) (4) (5) (6) (7) 0.00 0.00 0.00 0.00 0.00 0.00 230.404.50 (8) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 230.404.50 ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 taxable at Siblino rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: (15) X .00 (16) 230.404.50 X .045 10.368.50 (17) X .12 (18) X .15 (19) 10,368.50 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 1-2-2002 CDOO0708 518.42(+) 9,850.00 TOTAL TAX CREDIT 10,368.42 BALANCE OF TAX DUE 0.08 INTEREST TOTAL DUE .08 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF AIlDITIONAL 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: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 21 of 1995. (72 P.S. Section 9140). PAYMENT: 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 WILLS, AGENT. 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-1313). Applications are available at the Office of the Register of Wills or any of the 23 Revenue District Offices, or by calling the special 24-hour answering service numbers for forms ordering: In Pennsylvania 1-800-362-2050, outside Pennsylvania and within iocai Harrisburg area (717) 787-8094, TDD# (717) 772-2252 (Hearing Impaired Only). OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance or disallowance of deductions, or assessment of tax (inciuding 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 17126-1021, OR --election to have the matter determined at audit of the account of the personal representative OR --appeal to the Orphans' Court. ADMINISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, A TIN: Post Assessment Review Unit, Dept. 280601 Harrisburg, PA 17126-0601 Phone (717) 787-6505. See page 3 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors DISCOUNT: 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. PENALTY: 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 same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. 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 1,1962 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 1962 through 2001 are: YEAR INTEREST RATE DAILY INTEREST FACTOR YEAR INTEREST RATE DAILY INTEREST FACTOR 1962 20% .000546 1992 9% .000247 1983 16% .000436 1993-1994 7% .000192 1984 11% .000301 1995-1996 9% .000247 1985 13% .000356 1999 7% .000192 1966 10% .000274 2000 8% .000219 1967 9% .000247 2001 9% .000247 1966-1991 11% .000301 2002 6% .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER 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. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT * REV-1U7 EX AFP 101-02) IVO V OTTO III MARTSON EHIL 10 E HIGH SiT CARLISLE ESQ DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-26-2002 HATFIElD 10-05-2001 21 01-0956 CUMBERLAND 102 BETTY W Allount Rellitted PA .17013 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 =i6ifj-Ex--AFP--foY:02y------...--zNirERITANCE--TAX--STA-fEMENT-cfF'-AcrcoUi.ff--...---------------- - - --- ESTATE OF HATFIELII BETTY W FILE NO.21 01-0956 ACN 102 DATE 08-26-2002 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-16-2002 P R I N C I PAL T A X DUE: .......................................................................................................................................................................................... 10,368.50 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-02-2002 CDOO0708 518.42 9,850.00 TOTAL TAX CREDIT 10,368.42 BALANCE OF TAX DUE .08 INTEREST AND PEN. .00 If IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .08 SIDE FOR CALCULATII)N OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REI'LECTED AS A "CREDIT" ICRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J PAYMENT: 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 lIake check or money order payable to: REGISTER OF WILLS, AGENT. If NDN-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 cOllpleting an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-13l3). Applications are available at the Dffice of the Register of Wills, any of the 23 Revenue District Offices or froll 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 (Tl only). REPLY TD: Questions regarding errors contained on this notice should be addressed to: PA Departllent of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, phone (7l]) 787-6505. DISCDUNT: 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. PENALTY: 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. 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 becalle 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: Daily Interest Factor Year Interest Rate Daily Interest Factor Vear Interest Rate 1982 20% .000548 1992 9% .000247 1983 16% .000438 1993-1994 7% .000192 1984 11% .000301 1995-1998 9% .000247 1985 13% .000356 1999 7% .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. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REV-liD7 EX AFP (Dl-D2l IVO V OTTO III MARTSON ETAL 10 E HIGH ST CARLISLE ESQ DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-26-2002 HATFIELD 10-05-2001 21 01-0956 CUMBERLAND 101 BETTY W Allount Rellitted PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure p.roper 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'(fj-Ex--AFP--coY:02Y------...--fNifERITANCE--TAX-STA"fEHE-NT-'(fJ:-AC-CO[jtff--.-..---------------- - - --- ESTATE OF HATFIELD BETTY W FILE NO.21 01-0956 ACN 101 DATE 08-26-2002 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST F.IGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-16-2002 P R I NC I PAL TAX DU E :: ........................................................................................................................................................................................................................... .00 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 If IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUJ:RED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J PAYMENT: 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 1I0ney 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 cOllpleting 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 Offices 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). REPLY 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 (57-) discount of the tax paid is allowed. PENALTY: The 157- tax amnesty non-participation penalty is cOllputed 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) 1I0nths and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January I, 1982 bear interest at the rate of six (67-) percent per annum calculated at a dailY rate of .000164. All taxes which became delinquent on and after January I, 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 Daily Interest Factor 1982 207- .000548 1992 97- .000247 1983 167- .000438 1993-1994 n .000192 1984 117- .000301 1995-1998 97- .000247 1985 137- .000356 1999 n .000192 1986 107- .000274 2000 87- .000219 1987 97- .000247 2001 97- .000247 1988-1991 117- .000301 2002 67- .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 paYllent is made after the interest computation date shown on the Notice, additional interest must be calculated. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN '* REY-485 EX iFP (01-021 IVO V OTTO III MARTSON ETAL 10 E HIGH ST CARLISLE ESQ DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-02-2002 HATFIELD 10-05-2001 21 01-0956 CUMBERLAND 201 BETTY W Allount Rellitted PA 17.0.13 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure pr"oper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~ REV = 483--Ex--A'FP-Tor--02r----.-.-NcfficE--oi=--liETE-RMiifA'Ti'ejti-ANIi-AS-SESS-MENT----------------------- - ---- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN .. ESTATE OF HATFIELD BETTY W FILE NO.21 01-0956 ESTATE TAX DETERMINATION ACN 201 DATE 09-02-2002 1. Credit For State Death Taxes as Verified 3,645.00 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 9,850.08 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed 9,850.08 5. Pennsylvania Estate Tax Due .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 -IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) PURPOSE OF NOTICE: PAYMENT: To fulfill the requirements of Section 2140 (b) 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 KILLS I AGENT. REFUND (CR): A refund of a tax credit 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 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). OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: PENALTY: INTEREST: Any party in interest not satisfied with the assessment of tax as shown on this notice may object within sixty (60) days of receipt of this Notice by: --written protest to the PA Depertment of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --electing to have the matter determined at audit 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. 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. For dates of death on or after 10-3-91, Pennsylvania Estate Tax based on the Federal Estate Tax return becomes delinquent at the expiration of nine (09) months from the date of death. For dates of death prior to 10-3-91, Pennsylvania Estate Tax based on the Federal Estate Tax return becomes delinquent at the expiration of eighteen (18) months from the date of death. Taxes which became delinquent before January I, 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 or after January I, 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 Daily Interest Factor 1982 20% .000548 1992 9% .000247 1983 16% .000438 1993-1994 7% .000192 1984 Ill.: .000301 1995-1998 91.: .000247 1985 131.: .000356 1999 7% .000192 1986 101.: .000274 2000 81.: .000219 1987 91.: .000247 2001 91.: .000247 1988-1991 Ill.: .000301 2002 61.: .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. ~<iiil Internal Revenue Service WP Cincinnati, OH 45999 Contact Person: Brian Kaufmann Badge Number: 17-14026 Telephone: 1-866-699-4083 (Toll Free Number) ~ / - tJ 1-095'- ,-< J February 5, 200:~ Estate Tax Closing Document (Not a bill for tax due) IVO V OTTO III ESQ 10 E HIGH ST CARLISLE PA 17013 Estate Name: BETTY HATFIELD Social Security Number: 168-26-3644V Date of Death: 10/5/01 We have determined the following: NET ESTATE TAX: $ 0.00 STATE DEATH TAX CREDIT: $ 3,645.00 GENERATION-SKIPPING TAX: $ 0.00 These figures do not include any interest and penalties that may be charged. Please keep this document in your permanent records. You may need it to complete administration of the estate, such as: close probate proceedings, transfer title to property, and settle state taxes. Keep it with your cancelled check(s) to show that you have met the estate tax obligation. Proof of payment in the amount shown above releases you of personal liability (IRe 2204). If the time for payment in the amount shown above is extended under section 6161, 6163, or 6166, personal liability is not released until full payment has been received. We will not reopen this return unless you notify us of changes to the return, or there is evidence of misrepresentation of a material fact, a clearly defined substantial error based upon an established Service position or a serious administrative omission. (See IRC 7121). 'I! . Field Director, Cincinnati Compliance Service Center ,'-' i J , .I i,,--j ~Y r, REGISTER OF WILLS OF CUMBERLAND COUNTY STATUS REPORT UNDER RULE 6.12 (For Resident Decedents Dying After July 1, 1992) Name of Decedent: BETTY W. HATFIELD Date of Death: October 5, 2001 File No. : 2001-00956 Social Security No.: 168-26-3644 Pursuant to Rule 6.12 ofthe Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes x No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state thefollowing: a. Did the personal representative file afinal account with the Court? Yes No x b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes x No d. Copies of receipts, releases, joinders and approvals offormal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. co Y."j Signature: Name: Address: ~~s- Ivo V. Otto III, Esquire MARTSON DEARDORFF WILLIAMS & OTTO Ten East High Street Carlisle, P A 17013 (717) 243-3341 Counsel for personal representative Date: May 2:9, 2003 r-.,j 0... D'\ ':'>..I '>- ':::c ;c . FIFl~I~r AFILEIEST A TESI I 0425:3~ ,;}? Cr.: ~~ .: E '.,.L.. .--' .J) - ..... -'* ::;0 /"7_/.</_ /.2- BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. ZS06Dl HARRISBUR&, PA 171Z8-06Dl IVO V OTTO III ESQ MARTSON ETAL 10 E HIGH ST CARLISLE PA 17013 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN '* REY-1UEXJoFP (II-II) 11-24-2003 HATFIELD 10-05-2001 21 01-0956 CUMBERLAND 202 BETTY W AlIOunt R_i tted 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, subnit the upper portion of this form with your tax pay..nt. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ..... RE-v:73rEx-iiWTiii:.-02'-----..-NoficE'-iiF--uE"ERMINAiiiiN-;.NU-;.ssEliSMENy---------------------------- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER .. ESTATE OF HATFIELD BETTY W FILE NO.2l 01-0956 ACN 202 DATE 11-24-2003 ESTATE TAX DETERMrNATrON 1. Credit For State Death Taxes as Verified 3,645.00 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 9,850.08 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) .00 5. Pennsylvania Estate Tax Due 9.850.08 .00 4. Total Inheritance Tax Assessed 6. Amount of Pennsylvania Estate Tax Previously Assessed Based on Federal Estate Tax Return .00 7. Additional Pennsylvania Estate Tax Due .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 I TOTAL DUE .00 -IF PAID AFTER THIS DATE, SEE REVERSE SIDE IIF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YDU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FDRH FOR INSTRUCTIONS.)