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HomeMy WebLinkAbout01-0971 Estate of . \-\Gt"{(\ e+ C -:b(@.pe.r also known as PETITION FOR PROBATE and GRANT OF LETTERS ~;){ -01 -97/ No. To: Register of Wills for the Deceased. County of ~fYl~' ~ti in the Social Security No. ~~ I ' ~ - ~ 1 <34 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age~\ ?~ef an the execut.( IX in the last will of the above decedent, dated ~ and codicil(s) dated named ,19~ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ~mb-u \OI\d CountYh Pennsy~a~~1 with h t (' last amily or prin_cipal residence at ~ 5 e. L'6 b Uf'f\ a.d) ocr~m~~le. u ~ \\ T~j (list street, number and muncipality) Decendent, thell lP 5 years of jl,ge, die~:-=J q~\ . l'J:OlOCI , at ;;J.S E. Li ~ buq"\. It(j) ljQvJm~Q._ Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Fa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ iO) ~O() $ $ $ WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters of the last will and codicil(s) tion c.La.; administration d.b.n.c.La.) theron. ~ '-' ~ u I:: ~ :2~ ~'-' ~ ... ~~ I:: "00 1::''= cU.O 3~ ~'- 30 ~ I:: OIl V.i ~~~cct~ V ,.e.:CL.9a- l'f\. N\~ Ch)~~' Ie^. ~g~~jau~ ~',an~ I OATH OF' PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } ss COUNTY OF ~m~ \~ot'~ . The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will welA and truly administer the estate ac<:ording to law. Sworn to or affirmed and subscribed ~~ '(It. 'ra.~~ f!l . ~Qefore me thIS ?7nd day of ~ - . ~-- - -r.uas 0... tJ\. "^ ~ l..0 \ , . a ~ ~ ~ No. ?1-01-Q71 Estate of HARRIET E DRAPER , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW crrmRRR ::n+-20.0L_.___: 9__. in con~ideration c:' "I~!~ petitior~. Dn the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated Q-1 11-1 qqc; described therein be admitted to probate and filed of record as the last will of HARRIET E DRAPER and Letters testamentary are hereby granted to 'T'prp~~ M Mt""'T r.nl)11.1 ; tl 77/() ~<,u~-?",,<)40 . R~r of Wills /~ / FEES Probate, Letters, Etc. ......... Short Certificates( ).......... 1f~<e~~ion ................ JCP SO.OO n.OO 27.00 5.00 88.00 $ $ $ $ TOTAL _ $ AITORNEY (Sup. C:. LD. No.) ADDRESS Filed PHONE 1105.805 REV 9/86 h This is to certify that the information here given is correctly copied fro~ an original certificate of death duly filed wit me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. ?;~L> ;(~ ~ Local Registrar Fee for this certificate, $2.00 p 7691056 ~~~J I ~ oloCJ I ~ Date Item #- 3 ~,^/-J.d- - sho:.J I' b-L ~ 101 21-01-971 f./( HI05 ;4JR.. 2187 COMMONWEALTH Of PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH ,YPflPAINT IN PERMAIoEN r BLACK INK ~ @ ~ a ~ ~ z 4. Se tember 17 2001 NAME Of DeCEDENT If.~;'~.(;dj;~--- _u__.___._ OAIE Of OEArH.McnoIt. Ua,. ~, BIRTHPlACE (Co"_ 3ta.. Of fCftlql COUflh'VI 5. COUNTY OF OERH 65 Y.. ::;1Iy,D III. CUmber land RACE . Amencan Indian, 8lack, Wh.a. oIC tSpeao,I white DECEDENT'S USUAL OCCUMJION \~=: ::io"::'::::'.:2.:i' . .... Office Administrat Accoun i DECEDENT'S MAILING ADORESS (SI,.... Cllylbon. SIaIe.l"op COdeI 25 East Lisburn Road Bowmansdale PA 17008 SUflVIVING SPOUSE tY _. ill"" m-. '*""1 Pennsylvania 14. 17.n....__in Ttpp::>r Allpn 'T'wp - 1711. Did -- We in. Cwnberland --.,1 1711.0 :"'-':-.'::::01 MOTHER'S NAME ,F... ModdIe. _ Surname) Evel Hall a1y- II. lHFORMANT'S MAIlING AOllAESS (SIr.... CIlyITown. SIaM. Zop Code) 2011.25 East Lisburn Rd. Bowmansdale PA 17008 P1.ACE OF DISPOSITION, _ 01 ~..." C,.malOly lOCATION. CilyI1Owll. SI.... Zip CoclIl Of 01.... PIK. NoD l I -') co:( _ j . ) HJ H. , Apprcunmate . WervW betwMn :---- I l PART II: OllIe, "'IIi"llcanl c:andiIjona conlIobuling lO daalh. llUl noI ..lUllIng in IIle UIldefttlnQ __ given .. P>\RT I C,. [ : DUE 10(00 AS A CONSEOUENCE Of): OUEIOCOO"5ACoNstOUENCE~----'-- - .k- <} (J ~ ,J WERE AUTOPSY FINDINGS MANNER OF DEATH ~E PRIOR 10 COIoIPlETION OF CAUSE )(f 0 OF DEATH? ........el HomIClda Acelden( 0 Pending mvesuoauon 0 YaD No 0 Sutc:lde 0 COuld not: be determined 0 OATE OF INJURY (Moo'" Day. ......., TIME OF INJURY INJURY AI 'NORK? DESCRIBE HOW INJURY OCCURRED o NoD 3010 M. PlACE OF INJURY. AI home, 'arm, .,ee., ractory, office building, .tc ISpec.r....) ~ _ a ~ CERTIFIER IC._ oniy onel .CERTIFYING PIotYSICIAN (Ph.,.SIC..,.. cefldytng cause ~ de..... wnBn .:ulOlher pfl'Y~'0II1 t1dS prOOOtJOceo dedlh ana compleled tlem 231 To" beet of m,; knowledge, de.... occ~ du4 Ie the c.aUM'{a) and rn."".r .. ._atN. O-C0.~J!l~___ IJd IJ1/0 I ...AONOUNClNG AND CERTtFYlNG PHYStClAH (PhV5'Caan both j.)fOllOuflCIll9 OCdltl dud ~eflllYlfl9 10 Cduse of dedth) To 1M tM.. o. 1ftV' knowlH9A, deathoccuned.at at...llne. date,.and place, and due to thecaUH(a) and manne,.. st.ted.. 'MEDICAL EXAMINER/CORONER On the baaj. 01 ...minatlon andlot lnvestigAtion. in my opinion. death occulted a' the lime. dale, .nd place, and due to the c:ause(a) 1100 manne,.. stated.. " . . . . . . .. _ _ . _ _ . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . J'. REGIS T J4 .s:~fb It) b (lie I 9/ ~ (}o 2L-61~l LAST WILL AND TESTAMENT Of HARRIET E DRAPER It HARRIET E. DRAPER, now ofBowmansdale, Cumberland County, Pennsylvania, being of sound and disposing mind, do hereby make, publish, and declare this to be my Last Will and Testament, hereby revoking and making null and void all prior Wills and Codicils made by me at any time heretofore. ITEM 1- I direct that all my legally valid debts, funeral and administrative expenses) and debts incurred or payable because of my death, shall be paid by my Executor, hereinafter named, from my residuary estate as soon after my death as practicable. All death taxes) including federal, state, and other death taxes~ with respect to the property fonning my gross estate for tax purposes. whether or not passing under this Will~ including any interest or penalty imposed thereoot shall be considered an expense of administration of my estate, without apportionment or right of reimbursement. Taxes on future interests may be prepaid. ITEM II. I bequeath my household and personal effects, jewelry, automobiles, and other tanaible personalty oflike nature" in equal shares to the following persons who survive me by thirty (30) days: A. My daughter, TERESA M. McLOUGHI.JN; butt if she should not so survive me, then this bequest and its share sha111apse, and such property shall be distributed to the other beneficiaries designated under this Item of my Will. B, My daughter, ELIZABE1H A JACKSON; but, if she should not 80 survive me~ but leaves descendants who so survive me, such descendants shall receive, ~ sti(l)e.\ the share that she would have received bad she so survived me~ subject, however, to the trust provisions contained hereinafter if applicable to such descendants. Presently;, the descendants of my said daughter include Christina Michelle Jackson and Jessica Ann Jackson. C. My son, JOSEPH P. DRAPER; but, if he should not so survive me, but leaves descendants who 80 survive me. such descendants shall receive, ner stit:pes~ the share that he would have received bad SO survived me. subject. however, to the trust provisions contained hereinafter if applicable to such desamdants. Presently ~ the descendants of my said son include Kimberly Ann Draper:l Samantha Mary Draper) Christine Patricia Draper" and Kasey Lee Draper. Such property shall be divided by said beneficiaries as they shall agree. As to those items upon which they shall not agree, distribution shall be determined by my Executor. ITEM nT. J eive, devise and bequeath all of the residue ofmy estate, whether real) personal, or ~ and wherever situate, including any property subject to any power of appointment which I may now have or hereafter acquire, in equal shares to the following persons who survive me by thirty (30) days: A_ Mydaughter;o TERESAM. MclOUGHLIN; but, if she should not so survive me, then this bequest and its share sballlapse, and such property shall be distributed to the other beneficiaries designated under this Item ofmy Will. B. My daughter, ELIZABETIi A, IACKSON~ but, if she should not so survive me, but leaves descendants who so survive me, such descendants shall receive, ~ ~ the share that she would have received had she 80 survived me, subject, however, to the trust provisions contained hereinafter if applicable to such descendants. Presently, the descendants afmy said daughter include Christina Michelle Jackson and Jessica Ann Jackson. C. My son, JOSEPHP, DRAPER; but, ifhe should not 80 survive me7 but leaves descendants who so suryive me, such descendants shall receive, per stiq>e~, the share that he would have received had so survived me, subject, however, to the trust 3 provisions contained hereinafter if applicable to such descendants. Presently, the descendants of my said son include Kimberly Ann Draper, Samantha Mary Draper ~ Christine Patricia Draper;w and Kasey Lee Draper. ITEM IV. Any property }>Using hereunder to a beneficiary who, at the time of my death, is under the age of twenty-five (25) (the nBeneficiary")~ shall be held IN TRUST) NEVER TIiELESS, by my Trustee" hereinafter named1 for the benefit of such Beneficiary, upon the terms and for the purposes and uses, as follows: A. My Trustee shall hold and invest the principal of the Trost corpuS!I collect the income therefrom, and expend and apply 80 much of the net income (any income not so expended or applied to be accumulated and added to principalt and 80 much of the principal and accumulated income, as my Trustee shall deem necessary or advisable, in the sole and absolut.e discretion of my Trustee> for the support, maintenance, and education (inCluding college education, both graduate and undergraduate) of the Beneficiary~ after taking into consideration other r~y available assets and sources ofinOODle. Duling illne~~ or emergency. my Trustee may either pay a distribution to the Beneficiary!, or may make a distribution for the benefit of the Beneficiary. 4 B. At the time the Beneficiary attains the age of twenty-five (25), the Trust pertaining to the Beneficiary shall terminate, and my Trustee shall distribute the then. remaining principal and aooumulated or undistributed income to the Beneficiary. C. IftheBeneflciary should die during the existence of this Trust, it shall be divided and then continued for the benefit of any then-living issue of the Beneficiary, p.a: stU:pes. with such beneficiaries being substituted for the Beneficiary for all purposes including distribution at certain aae& as set forth above. D. If the Beneficiary should die before attaining the age of twenty-five (25) without leaving issue surviving as aforesaid, then that Trust shall terminate, and its assets shall be divided into as many equal shares as are created under Item ill hereof for the benefit of those children of mine~ or their issue, per stirpes, living at the time of the death of said Beneficiary, and then distributed to such beneficiaries; Provided, however~ that jf a Tnlst established hereunder for any such beneficiaries exists at the time of such distribution, then such distribution shall be made to that Trust for Bucb beneficiary. ITEM V. The interest of beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation. 5 \. ITEM VI. I hereby appoint my daughter, TERESA M. McLOUOlll.JN, to serve as the executrix (the "Executor..), ofthi&. my Last Will and Testament. In the event of her refusal or inability to so sene, I then nominate and appoint my daughter, ELIZABETH A JACKSON, and my 80~ JOSEPH P. DRAPER. or the survivor of them, to serve together in sucb capacity as Executor. ITEM 'VII. I hereby appoint TERESA M. McLOUGHLIN, to serve as the trustee (the 'trustee") ofany Trust created hereunder with regard to any Beneficiary. as defined herein. In the event of her refusal or inability to so serve, I then nominate and appoint my daughter, ELlZABETII A. JACKSON, and my son, JOSEPH P. DRAPER, or the survivor of them, to serve together in such capacity as Trustee. ITEM vm. I direct that my Executor and Trustee shaI1 not be required to give bond or post any other security for the faithful performance of duties in any jurisdiction. ITEM IX. My Executor and Ttustee shall have the following powers in addition to those invested in them by law and by other provisions of my Will applicable to all property, whether principal ofi11come. exercisable without Court approval, and effective until distribution of all property: A. To retain any investments I may have at my death so long as my Executor or Trustee may deem it advisable to my Estate or Trost so to do- 6 B. To vary investmentst when deemed desirable by my Executor or Trustee, and to invest in such bonds, cornmon trust funds controlled by my Executor or Trustee, stocks!' notes, real estate mortgages, or other securities or in such other property, real or personal, as my Executor or Tmstee deem wise, Vlithout being restricted to so-called legal investments. C. In order to etTecf"a division of the principal of my Estate or Trust or .- for any other purpoIIe, including any final distribution, my Executor or Trustee is authorized to make said divisions or distributioos of the personalty and realty partly or wholly in kind. If such division or distribution is made in kind, said assets are required to be divided or distributed at their respective values on the date or dates of their division or distribution. D. To sell either at public or private sale and upon such terms and c.onditiOI18 88 my Executor or Tmstee may deem advantageous to my Estate or Trust, any or aU real or personal estate or interests therein owned by my Estate or Trust severally or in conjunction with other persons or acquired after my death by my Executor or Trnstee, and to consummate said sale or sales by sufficient deeds or other inltrumentg to the purchaser or pW'Chasers, conveying a fee simple title, ftee and clear of all trust and without obligation or liability of the purchaser or purchasers to see to the application of the purcha..ae money or to make inquiry into the validity of said sale or sales; al80t to make, execute, aclmowledge, and deliver any and aD deeds, assignments, optiollB) or other writings which may be necessary or 7 desirable~ in carrying out any of the powers conferred upon my Executor or Trustee in this paragraph or elsewhere in my Will. E. To mortgage real estate, and to make leases of real estate for any period of time as is deemed reuonable by them. F. To borrow money from any party to pay indebtedness of mine, or of my Estate or Trust, expenses of administration, or inheritance:- legacy, estate or other taxes. G. To pay all costs, taxes, expensest and charges in connection with the administration of my Estate or Trust.. My Executor shall pay expenses of my last illness and funeral ~. H. To vote any shares of stock which form a part of my Estate or Trust, and to otherwise exercise all the powers incident to the o'Mlersmp of such stock. I. In the discretion ofmy Executor or Trustee, to unite with other owners of similar property in carrying out any plans for the reorganization of any corporation or company whose securities form a part ormy Estate or Trost. 8 ITEM X. Any person who shall have died at the mme time as me, or in a conunon disaster with me" or under such circumstances that it is difficult or irnpo8sible to determine who died first, shall be deemed to have predeceased me. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament, consisting of nine (9) typeWritten pages) this.6.. day of September, 1995. ~.ct!, ~ HARRlET E. DRAPE We, the undersigned, henby certifY that the foregoing Will was signtXL sealed, published and declared by the above-named Testatrix, HARRIET E. DRAPER, as and for her Last Will and Testament, in the presence of us, who at her request and in her presence and in the presence of each other> have hereunto set our hands and seals the day and year above written, and we certify that at the time of the execution thereof: the said Testa.trix was of sound and disposing mind and memory. J cmcl -Z i (/)~tU1 residing at )) ) eCyy;uU:c s k@ ( -P/J. ~ Ie-Sa.. r (VIe [Y) ( .11{-r i {' residing at w ~ II~ I e I :jJ 11 ~_________~_____..~ .......- 9 ---------------------------------------------------------------------------------------------------- . COMMONWEALTH OF PENNSYLVANIA COUN1Y OF BAlFnun Cv..mberwd SS.: . We, the Testatrix, and ~e+ 2: h'"'me~ . and ~_f\"\G 0\l.t..r~ r; e 5 the witnesses, respectively, whose names arc 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, that she had signed willingly, and that she executed it as her froo and voluntary act for the purposes therein expre8sed~ and that each of the witnesses, in the presence and heMing of the Testatrix, signed the Will as witness and that to the best ofherlher knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no oonstraint or undue influenQe, . ~ ~cr~ HARRIET E. DRAP ~*- ~1l.A1JM?uAU 1JWitn~s . F~J1 0 50 C'>.- In C iYl.l k 11=1l. L!L Witness Subscribed~ sworn to and acknowledged before me by the Testatrix, HARRIET E, DRAPER, and subscribed and sworn to before me by ~~-12+ '~~W"'\ecmG!O- a...id '-::rRf~ (Y)c.- IY\~~ e !) witnesses, this _ J'J day of September, 1995. Notarial Seat . Judith A. Walter, Notary PubHc ' I Upper Allen Twp., Cumberland County I My Commission Expires May12, 1998 Member, Pennsylvania Association of Notaries (SEAL) {NIUI:'WlU019:"'19\chpr-br.w~1 10 - -,~. 11,/5- ;f COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z8060l HARRISBURG, PA l71Z8-0601 *' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 01-0971 ACN 01153789 DATE 11-16-2001 C; qV/ REV-lS4S EX AFP <89-08) Reco:-ocd Office of Re[H~tA" \I"'" EST OF HARRIET E DRAPER ~!..1t__1 "vilIS . 5.5. NO. 221-22-8104 DATE OF DEATH 09-17-2001 .01 ole 12 P 2 :f9lUNTY CUMBERLAND TYPE OF ACCOUNT (i] SAVINGS o CHECKING D TRUST D CERTIF . TERESA L MCLOUGHLIN Cte-r'-- ,'- 25 E LISBURG RD 1 K. ,~.. ,- 'IT BOWMANSDALE PA 1700lC,urnberl.~,,_,'t-_-___j_- .'. i".")iJ I ..... .. Co., PA REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1ST FCU has provided the Depart.ent with the information listed below which has been used in calCUlating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this infor.ation is incorrect, please obtain written correction fro. the financial institution, attach a copy to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions .ay be answered by calling (717) 181-83Z7. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 139721-00 Date 04-26-1994 Established PART [!] Account Balance Percent Taxable A.ount Subiect to Tax Rate Potential Tax Due To insure proper credit to your account, two (Z) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". x x NOTE: If tax pay.ents are .ade within three (3) months of the decedent's date of death, you may deduct a 57. discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax [CHECK ] ONE BLOCK ONLY The above infor.ation and tax due is correct. I. You .ay choose to remit pay.ent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "An and return this notice to the Register of Wills and an official assessment will be issued by the PA Depart.ent of Revenue. B. c=J The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. c=J The above information is incorrect and/or debts and deductions were paid by you. You must co.plete PART ~ and/or PART ~ below. PART [!] TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subiect to Tax S. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due TAX ON JOINT/TRUST ACCOUNTS If you indicate a different tax rate, please state your relationship to decedent: OF 1 2 3 4 S 6 7 8 x x PART [!] DATE PAID PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line S of Tax COMputation) I $ Under penalties COMPlete to the best j. fit. me~ AXPAYER SIGNA of perjury, I declare that the facts I of my knowledge and belief. ~ have reported above are tru., correct HOME (-) 11 ) fJi(1. ft(s-(P WORK (1/7 ) fo17-t1J(jg TELEPHONE NUMBE and 1~~110 I D~ E )'.'~" ' '. ," > ..,:"'. ..1.;, COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG I PA l11Z8-0601 *' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 01-0971 ACN 01153790 DATE 11-16-2001 u j,K. REV-15~3 EX AFP (09- DO) Recora€c] Register of 'NiBs EST. OF HARRIET E DRAPER S.S. NO. 221-22-8104 DATE OF DEATH 09-17-2001 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS [Xl CHECKING o TRUST o CERTIF . .01 01 C 12 P 2 :30 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TERESA L MCLOUGHLIN ~~W~A~~g:~~G RD PA 1 CJlArj\b--{e~-\~'--. '_"_~.' C:ourt aifffl fJdrl\.i Co., PA MEMBERS 1ST FCU has provided the Department with the info....ation listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedentl yoU were a joint owner/beneficiary of this account. If you feel this information is incorrectl please obtain written correction from the financial institutionl attach a cOpy to this farm and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Co.monwealth of Pennsylvania. Questions may be answered by :a11ing (111) 181-83Z7. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 139721-11 Date 04-26-1994 Established Account Balance Percent Taxable A.ount Subiect to Tax Rate Potential Tax Due x 1,630.27 50.000 815.14 .045 .68 ESPONSE To insure proper credit to your account I two (Z) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Willsl Agent". PART [!] x NOTE: If tax payments are .ade within three (3) .onths of the decedent's date of deathl you ~y deduct a 57. discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax [CHECK ] ONE BLOCK ONLY The above information and tax due is correct. . You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest I or you may check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. B. E:J The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. c=J The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. PART [!J TAX RETURN - COMPUTATION OF LINE 1. Date Established 1 2. Account Balance 2 3. Percent Taxable 3 4. A.ount Subject to Tax 4 S. Debts and Deductions S 6. A.ount Taxable 6 7. Tax Rate 7 8. Tax Due 8 TAX ON JOINT'TRUST ACCOUNTS If you indicate a different tax rate, please state your relationship to decedent: x x PART [!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I $ I TOTAL (Enter on Line S of Tax Co.putationl that the facts I and belief. have reported above ~re ~ue, HOME ( 1 t1 ) (,11 / "I'r~5 ip WORK (1 f7 ) (Jq"7 - {J, () rz TELEPHON NUMB correct and /8/7/1)/ DATE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRIS8URG1 PA 17128-0601 '* INFORMATION NOTICE AND TAXPAVER RESPONSE FILE NO. 21 01-0971 ~~ ACN 01153791 DATE 11-16-2001 REY-1545 EX AFP <89-00> Recoraed Register of ~Vifls EST. OF HARRIET E DRAPER S.S. NO. 221-22-8104 DATE OF DEATH 09-17-2001 COUNTY CUMBERLAND TYPE OF ACCOUNT [Xl SAVINGS o CHECKING D TRUST o CERTIF . "OlDIe 12 P 2 :31 ** TERESA L MCLOUGHLINClerk-(i ~~W~A~~g:~~G RD PA 17Qtilbenand co,:uPA REHIT PAYHENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE~ PA 17013 "EHBERS 1ST FCU has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedentl you were a joint owner/beneficiary of this account. If you feel this infor~tion is incorrectl please obtain written correction from the financial institutionl attach a COpy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answared by ceIling (7171 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 139721-05 Date 05-04-2001 Established PART [!] x 2~003.16 100.00 2~003.16 .045 14 ESPONSE To insure proper credit to your accountl two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wil1s1 Agent". Account Balance Percent Taxable AMount Subject to Tax Rate Potential Tax Due x NOTE: If tax payments are made within three (3) months of the decedent.s date of deathl you may deduct a 5X discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax [CHECK ] ONE BLOCK ONLY The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interestl or you may check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. B. c=J The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent"s representative. C. ~ The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. PART ~ TAX RETURN - COMPUTATION lINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax S. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 S 6 7 X 8 If you indicate a different tax rate~ please state your relationship to decedent: PART ~ DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on line S of Tax COMputation) Under penalties of perjury~ I declare that the facts I complete to the best of .y knowledge and belief. ,J. (li. ()'lC~ ~l ~Lll,;U TAXPAY R SIGNATUR I $ and iei~dJ DA E . ....~M.~'. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 "'",,,,," '., "'~,.' ''', REV-1162 EX( 11-961 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MCLOUGHLIN TERESA M 25 E L1SBURN ROAD BOWMANSDALE, PA 17008 -------- fold ESTATE INFORMATION: SSN: 221-22-8104 FILE NUMBER: 21-2001- 0971 DECEDENT NAME: DRAPER HARRIET E DA TE OF PAYMENT: 12/12/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 09/17/2001 NO. CD 000637 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $129.63 I I I I I I I I TOTAL AMOUNT PAID: $129.63 REMARKS: TERESA M MCLOUGHLIN CHECK#102 SEAL INITIALS: DO RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS \ . ( ~ ~':~ ~ , r:/:) g t- ,....I ~. <( o 0.- ct 0> ~ ~ ~ ~ s .... ~ :- "'iil ee ~ ';i E :S , , o \,JJ 0 -d \t'l ~ ~ ~-- ~ :;:; --:. ... -S -::; ~ -: --:. ...-::. -: ~ - -: - ~ ~ ... ... -::::. -:. .::::; ~ - ~ ~ ~ S o <.) ~(<) ~b (/)Or- ~<.)-c- ~-o4 .......Sa- o ,,'" ... '- -s; Q) Q)woU; C;;~~ "c;, ~ ~ ~6<.) c-l o L"l ~ f. ~ .... r. ~ o ('" ~ '1 ""500P"'OOi' t ' W I- ~SUl UII:~ WD-U J:OO UII:..J D-ltl D- c( COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 INHERITANCE TAX RETURN RESIDENT DECEDENT I- Z W C w (.) w c DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Draper, Harriet E. REV-1500 ~ _,_~! 7=LS..___L(l,___,__,___..~ FILE NUMBER ~L-di __~2i COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 221 - 22 - 8104 DATE OF DEATH (MM-DD-YEAR) 9/17/2001 DATE OF BIRTH (MM-DD-YEAR) 2/19/1936 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) fX] 1. Original Return o 4. Limited Estate o 6, Decedent Died Testate (Attach ccpy of Will) o 9, Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-l2-82) o 7. Decedent Maintained a Living Trust (Attach copy ofTrust) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) o 3. Remainder Return (date ot death prior to 12-13-82) o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) I- Z W C Z o D- Ul W II: II: o U NAME Teresa M. FIRM NAME (If Applicable) COMPLETE MAILING ADDRESS 25 E. Lisburn Road Bowmansdale, PA 17008 ......... .... -' (1) ;- : ',- (2) " (3) (4) (5) 4320.36 2030.68 (6) (7) (8) 6351.04 (9) 5422.63 (10) (11) (12) (13) 5422.63 928.41 TELEPHONE NUMBER 717-697-1956 (14) q?8 41 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) z o ~ ..J :;) I:: Q" <C (.) w 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) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 928.41 x .0_ (15) x .0 45 (16) 41.78 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) 12. Net Value of Estate (Line 8 minus Line 11) z o ~ ~ :;) Q" :E o (.) >< ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due x .12 (17) x .15 (18) CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT (19) 41.78 20.0 REV-1508 EX + (1-97) , SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY " COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Harriet E. Draper 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. 1996 Dooge Neon (Kelly Blue Book) VALUE AT DATE OF DEATH $ 508.62 3800.00 ITEM NUMBER 1. DESCRIPTION Members 1st FCU Christmas Club (139721-02 Interest Income reported on 1099-INT 11.74 TOTAL (Also enter on line 5, Recapitulation) $ 4320 . 36 (If more space is needed, insert additional sheets of the same size) - REY.1:OOE,~+(1.97) ~. . . ..~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Harriet E. Draper If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Teresa M. McLoughlin 25 E. Lisburn Road Bowmansdale, PA 17008 Daughter B. c. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY 'Io0F DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed for joinUy.held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 1991 Members 1st FCU 500 Louise Drive Mechanicsburg, PA 17055 Savings 139721-00 $ 427.92 50% $ 213.96 Investment Savings 139721-05 2003.16 50% 1001.58 Checking 139721-11 1630.27 50% 815.14 TOTAL (Also enter on line 6, Recapitulation) $ 2030.68 (If more space is needed, insert additional sheets of the same size) ... ..I REV-1511 EX+ (12-99) . ., ~~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Harriet E. Draper Debts of decedent must be reported on Schedule 1. ITEM NUMBER A DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Malpezzi Funeral Home, Mechanicsburg, PA Grace Lawn Memorial Park, New Castle, DE Isaac's Restaurant - Mechanicsburg, PA Rothermel's Florist - Mechanicsburg, PA $4392.41 420.00 433.20 177.02 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Represenlative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City_ State __ Zip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City_ State _ Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ 5422. 63 (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER NUMBER I RELATIONSHIP TO DECEDENT NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not ListTrustee(s) TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 Teresa M. McLoughlin 25 E. Lisburn Road Bowmansdale, PA 17008 Elizabeth A. Jackson 137 Parma Court Newport News, VA 23608 Joseph P. Draper 202 Wordsworth Drive Wilmington, DE 19808 Daughter Daughter Son AMOUNT OR SHARE OF ESTATE 1/3 1/3 1/3 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV.1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) .~ 'l\1ell1bers 15T Hl)ERAL CREl)(T UNION Instructions for Recipient Box 1. Shows interest paid to you during the calendar year by the payer. This does not include interest shown in box 3. If you receive a Form 1 099-INT for interest paid on a tax- exempt obligation, see the instructions for your income tax return. Box 2. Shows Interest or principal forfeited because of early withdrawal of time savings. You may deduct this on the "Penalty on early withdrawal of savings" line of Form 1040. Box 3. Shows interest on U.S. Savings Bonds, Treasury bills, Treasury bonds, and Treasury notes. This mayor may not be all taxable. See Pub. 550, Investment Income and Expenses. This interest is exempt from state and local income taxes. This interest is not included in box 1. Box 4. Shows backup withholding. For example, persons not furnishing their taxpayer identification number to the payer become subject to backup withholding at a 31 % rate. See Form W-9, Request for Taxpayer Identification Number and Certification, for information on backup withholding. Include this amount on your income tax return as tax withheld. .......- Box 5. Any amount shown is your share of investment expenses of a single-class REMIC. If you file Form 1040, you may deduct these expenses on the "Other expenses" line of Schedule A (Form 1040) subject to the 2% limit. This amount is included in box 1. Box 6. Shows foreign tax paid. You may be able to claim this tax as a deduction or a credit on your Form 1040. See your Form 1040 instructions. Nominees. If this form includes amounts belonging to another person, you are considered a nominee recipient. You must file Form 1 099-INT for each of the other owners showing the income allocable to each. You must also furnish a Form 1 099-INT to each of the other owners. File Form(s) 1099-INT with Form 1096, Annual Summary and Transmittal of U.S. Information Returns, with the Internal Revenue Service Center for your area. On each Form 1099-INT, list yourself as the "payer" and the other owner as the "recipient." On Form 1096, list yourself as the "filer." A husband or wife is not required to file a nominee return to show amounts owned by the other. IMPORTANT - TAX DOCUMENT ENCLOSED ~s.). k A-f'tOV nf n I , CORl=IECTED (if checked) PAYER'S name, street address, city, state, ZIP code, and telephone no. Paye(s RTN (optional) OMB No. 1545-0112 MEMBERS 1ST FEDERAL CREDIT UNION 5000 LOUISE DRIVE ~@O1 Interest Income MECHANICSBURG PA 17055 Form 1099-INT PAYER'S Federal identification number I RECIPIENTS identification number 1 Interest Income not Included in box 3 Copy B 23-1360906 22-1228104 $ 11.74 For Recipient RECIPIENT'S name.S1reel oddre.. (Including apt. nc).City. slate, and ZIP code 2 Early withdrawal penalty 3 Interest on U.S. Savings This is important tax Bonds end Trees. obligations information and is ESTATE OF HARRIET E DRAPER $ .00 $ .00 being furnished to the Internal Revenue C/O TERESA M MCLOUGHLIN 4 Federal Income tax withheld 5 Investment expenses Service. If you are 25 E LISBURN ROAD $ .00 $ required to file II return, a negligence penalty or BOWMANSDALE PA 17008 6 Foreign tax paid 7 Foreign country or U.S. other slInctlon may be possession imposed on you If this income is taxable and Account number- (optional) the IRS determines that 210567 $ It has not been reported. Form 1099-INT (Keep for your records.) Department of the Treasury - Internal Revenue Service 34174 Send Inquires to' 5000 Louise Drive , .. '.., , . PO Box 40 "l\If/e""'tnberslST Mechanicsburg, PA 17055 .1 ~ ... www,members1sl.org FEDERAL CREDIT UNION Main Switchboard: (717) 697.1161 or (800) 283.2328 Call-24: (717) 697 -4372 or (800) 283-4372 TOO: (717) 697-5312 or (800) 283-2328 ex!. 5312 TeleBranch: (717) 795.6049 or (800) 237-7288 Member's Statement of Account Account Number From TO Page 139721 10-01-01 10-31-01 1 of 2 SIMPLIFY YOUR BILL PAYING ROUTINE WITH BILL PAYER. SEE THE ENCLOSED INSERT FOR MORE INFORMATION. 1703 I\\l "LItu..OV {J)\ HARRIET E DRAPER Cia TERESA M MCLOUGHLIN 25 E LISBURN RD BOWMANSDALE PA 17008-0000 SUFFIX:OO SAVINGS 100101 141700008 100101 141700008 100101 HOLIDAY CLUB TRANS 102401 TFR TO SHARES 210567-00 103101 DIVIDEND JOINT OWNERS: TERESA M MCLOUGHLIN Y-T-D DIVIDENDS: TRUTH IN SAVINGS INFORMATION ANNUAL PERCENTAGE YIELD I 2.25% ANNUAL PERCENTAGE YIELD EARNED I 2.26% 437.00 -437.00 508.62 -936.95 1. 32 20.33 SUFFIX:02 HOLIDAY CLUB 100101 HOLIDAY CLUB TRANS -508.62 Y-T-D DIVIDENDS: 8.62 TRUTH IN SAVINGS INFORMATION ANNUAL PERCENTAGE YIELD I 2.30% SUFFIX:05 INVESTMENT SAVINGS 101601 SHARE WITHDRAWAL 102401 SHARE DIVIDEND '10240 I SHARE wi THuRAWAL -4392.41 5.80 -622.42 JOINT OWNERS: TERESA MCLOUGHLIN Y-T-D DIVIDENDS: TRUTH IN SAVINGS INFORMATION ANNUAL PERCENTAGE YIELD I. 0% ANNUAL PERCENTAGE YIELD EARNED I 2.68% 64.66 SUFFIX:ll CHECKING BEGINNING BALANCE DEPOSITS DRAFTS DEB I TS/F EES MAINT/SERVICE CHGS ENDING BALANCE 694.99 437.00 177 .02 954.97 .00 .00 TOTAL NUMBER DRAF S CLEARED YOUR AVG DAILY BA ANCE WAS YOUR LOW MONTH BA ANCE WAS 1100101 PAYROLL ALLOCATION FROM I 13972 1-00 437.00 NOTICE; SEE REVERSE SIDE FOR IMPORTANT INFORMATION. 508.62 .00 481 .38 .00 1131.99 SEND ALL INQUIRES TO THE CREDIT UNION AT THE ADDRESS SHOWN ON PAGE # 1 1704 "" mberslST d, CREOlT UNION 1 3972 1 1 0 - 0 1 - 0 1 1 0 - 3 1 - 0 1 2 of 2 <AN$l/E:Ff, OA rEOATE/ 100101 1019 101801 102401 ........fAANSACTIONOESCRIPTION DIRECT DEPOSIT REG-E TRANSACTION 141700008 SHARE DRAFT # 681 TFR TO SHARES 210567-11 1018015703 ...AMOUNT........... -437.00 -177.02 -517.97 13At...J,\.t4CE 694.99 ~_.--- \ 517.21.D .uu * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ~ * * * * NO. 681 AMOUNT 177 .02 JOINT OWNERS: TERESA M MCLOUGHLIN Y-T-D DIVIDENDS: .00 NO. AMOUNT NO. AMOUNT NO. TOTAL: AMOUNT 177 .02 TRUTH IN SAVINGS INFORMATION ANNUAL PERCENTAGE YIELD I 1.50% --- ------------------------------------------------------------- ------------ --- FOR 2001 * IRA YTD * OTHER YTD * TOTAL YTD * TOT~L YTD * TOT~L YTD * DIVIDENDS DIVIDENDS DIVIDENDS WITH~OLDING FOR EITURES .00 93.61 93.61 .00 .00 ... COMMONWEALTH OF PENNSYLVANIA DEPARTMENI OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 0 1 - 0971 01153791 11-16-2001 REV-1545 EX AFP (09-00) EST. OF HARRIET E DRAPER S.S. NO. 221-22-8104 DATE OF DEATH 09-17-2001 COUNTY CUMBERLAND TVPE OF ACCOUNT [iI SAVINGS D CHECKING D TRUST D CERTIF . ** TERESA L MCLOUGHLIN 25 E LISBURG RD BOWMANSDALE PA 17008 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1ST FCU has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If yoU feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of PennS'Ilvdnid. Questions md'l be answered b'l calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 139721-05 Date 05-04-2001 Established t\> I 'f'l-\'4.fcount Balance \' \S:'!" P~rcent Taxable ~ Amount Subject to \ '(\lJ Tax Rate ~' Potential Tax Due x 2,003.16 100.00 2,003.16 .045 ~,:: "/ 90.,14 .~~ \>I.) . TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice must accompany 'lour payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". x NOTE: If tax payments are made within three (3) months of the decedent's date of death, yoU may deduct a 51. discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax PART [!J above information and tax due is correct. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. [CHECK ] ONE BLOCK ONLY B. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. If you indicate a different tax rate, please state your relationship to decedent: PART [!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED PART ~ TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 4 5 6 7 8 x x PAVEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) I $ Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knOWledge and belief. HOME ( WORK ( TELEPHONE ) ) NUMBER ';1+' I.' J TAXPAVER SIGNATURE ,j ~nMMONWE4LTH OF PENNSYLVANIA DEPARTMENT 'OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 0 1 - 0971 01153790 11-16-2001 REV-154l EX AFP (09-00> EST. OF HARRIET E DRAPER S.S. NO. 221-22-8104 DATE OF'DEATH 09-17-2001 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS [i] CHECKING D TRUST D CERTIF. TERESA L MCLOUGHLIN 25 E LISBURG RD BOWMANSDALE PA 17008 (, JA Iv" \u\~\~l ~ l c:f REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1ST FCU has provided the Department with the information listed below which has been used in calCUlating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a COpy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answer'ed by calling (717) 787-11327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Accouni No. 139721-11 Daie 04-26-1994 Esiablished " S";l Accouni Balance ~...~, "\) Perceni Taxable ~;~~~ Amouni Subjeci io l(~ Tax Raie Poieniial Tax Due x 1,630.27 50.000 815.14 .045 36.68 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". PART [!] x NOTE: If tax payments are made within three (3) months of the decedent.s date of death, you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax [CHECK ] ONE BLOCK ONLY The above information and tax due is correct. ~. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or yoU may check box nA" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. B. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent.s representative. C. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. If you indicaie a differeni iax raie, please siaie your relaiionship io decedeni: PART ~ TAX RETURN - COMPUTATION LINE 1. Daie Esiablished 2. Accouni Balance 3. Perceni Taxable Q. Amouni Subjeci io Tax 5. Debis and Deduciions 6. Amouni Tax~ble 7. Tax Raie 8. Tax Due PART @J DATE PAID DEBTS AND DEDUCTIONS CLAIMED OF 1 2 3 Q 5 6 7 8 x TAX ON JOINT/TRUST ACCOUNTS x PAYEE DESCRIPTION AMOUNT PAID TOTAL IEnier on Line 5 of Tax Compuiaiionl $ Under penaliies of perjury, I declare ihai ihe facis I compleie io ihe besi of my knowledge and belief. \ -0. r'll rfl c ':fi (~-(/t{~J\ Q 'l/l~.J TAXPAYER SIGNATURE have reporied HOME (111 WORK c7H TELEPHONE correci and I(){~/ ~ t. j DAT " 'CoMMQNWE~lTH OF PENNSYLVANIA oEPARTMENT'oF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 0 1 - 0971 01153789 11-16-2001 REV-1545 EX IFP 'D9-DDl EST. OF HARRIET E DRAPER S.S. NO. 221-22-8104 DATE OF DEATH 09-17-2001 COUNTY CUMBERLAND TYPE OF ACCOUNT !il SAVINGS o CHECKING o TRUST o CERTIF . TERESA L MCLOUGHLIN 25 E LISBURG RD BOWMANSDALE PA 17008 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1ST FCU has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a COpy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Quastiorts may be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 139721-00 Date 04-26-1994 Established . J\ ,,'~ '\ 't' Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 427.92 50.000 213.96 .045 .tl,IS ~63 , TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". x NOTE: If tax payments are made within three (3) months of the decedent's date of death, you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax PART IT] A. "[/{'The above information and tax due is correct. M, 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box uAu and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. [CHECK ] ONE BLOCK ONLY B. [J The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. [J The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. If you indicate a different tax rate, please state your relationship to decedent: PART ~ DATE PAID DEBTS AND DEDUCTIONS CLAIMED PART ~ TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF 1 2 3 4 5 6 7 8 x TAX ON JOINT/TRUST ACCOUNTS x PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) I $ Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME ( WORK ( TELEPHONE ) ) NUMBER DATE TAXPAYER SIGNATURE COMMONWEALTH OF PENNSYLVANIA DEPARTMI'NT OF REVENUE BUHEA:U OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: /) ^ t.,')(,::) /,) l11;' (;...:J PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MCLOUGHLIN TERESA M 25 E L1SBURN ROAD BOWMANSDALE, PA 17008 ----~--- lold ESTATE INFORMATION: SSN: 221-22-8104 FILE NUMBER: 21-2001- 0971 DECEDENT NAME: DRAPER HARRIET E DATE OF PAYMENT: 12/12/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 09/17/2001 NO. CD 000637 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $129.63 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: TERESA M MCLOUGHLIN CHECK#102 SEAL INITIALS: DO RECEIVED BY: TAXPAYER $129.63 MARY C. LEWIS REGISTER OF WILLS Kelley Blue Book Used Car Values . New Car Pricing Build a Car Incentives My Car's Value Used Car Retail Buy a New Car Buy a Used Car Sell Your Car Motorcycles Financing Insurance Lemon Check Warranties Accessories Car Reviews Car Previews Decision Guides Advice Aboutkbb Home Page 1 of2 K.eUq Blue Book The Trusted Resource kbb COrry AutoNatlon~com Get an instant "^" fi price on your dream or. rnc Click on the image above to visit this advertiser Blue Book Private Party Report Pennsylvania' May 5, 2002 1996 Dodge Neon Sedan 40 /: o 0 '"' >o;l-~:: ~, Buy a New Car Buy a Used Car List Your Car For Sale Online Financing Quote Insurance Quote Warranty Quote Payment Calculator Engine: 4-Cyl. 2.0 Liter Trans: Automatic Drive: Front Wheel Drive Mileage: 8,320 Equipment Air Conditioning Power Steering AM/FM Stereo Dual Front Air Bags Consumer Rated Condition: Good "Good" condition means that the vehicle is free of any major defects. The paint, body and interior have only minor (if any) blemishes, and there are no major mechanical problems. In states where rust is a problem, this should be very minimal, and a deduction should be made to correct it. The tires match and have substantial tread wear left. A clean title history is assumed. A "good" vehicle will need some reconditioning to be sold at retail; however major reconditioning should be deducted from the value. Most recent model cars owned by consumers fall into this category. Private Party Value $3,745 Private Party value represents what you might expect to pay for a used car when purchasing from a private party. It may also represent the value you might expect to receive when selling your own used car to another private party. '::;et a Used Car Trade-In Value Get Invoice & MSRP on New Cars http://www.kbb.comlkb/ki.dl1/kw .kc.ur?kbb;7 50896&;p&722;Dodge; 1996%20Neon&7 ;DO:... 5/5/2002 I ~ ',,"' ~...... "'.....'...........-........ '-- . '\ -....-,;..... .~ ~:,~;~~~/>._-" , - - '{- ,.'-~(? .,~ -' ~. \>\ . -. L \ (,- ,. i i < ~4-- t: -'-"- :: '. .'~......~ ~~'!- I _ . 3ft t' ~ n _,~~:.~;.~''\..te _..... 0 "\ ..-\.~..' "'~........:w:.'<2.."- WHEREAS, on the 23rd dated September 15th 1995 was admitted to probate as Register of Wills of CUMBERLAND County, Pennsylvania Certificate of Grant of Letters No. 2001-00971 PA No. 21-01-0971 I ESTATE OF DRAPER HARRIET E (LAo'l' , Fl~o'l', jVlllJlJLt;) Late of UPPER ALLEN TOWNSHIP CUIVjJ:)t;~LA1\1lJ CUUNT'f., Deceased Social Security No. 221-22-8104 day of October 2001 an instrument the last will of DRAPER HARRIET E (LAo'l' , Fl~oT, jVlluULt;) late of UPPER ALLEN TOWNSHIP CUMBERLAND County, who died on the 17th day of September 2001 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS , Register of Wills in and for the County of CUMBERLAND in the Commonwealth of pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to MCLOUGHLIN TERESA M who has duly qualified as Executor (rix) and has agreed to administer the estate according to law, all of which fully appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my Office the 23rd day of October 2001. 7'N/~'suf~yJ ~~{~"'l **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) " LAST WILL AND TESTAMENT Of HARRIET E. DRAPER I, HARRIET E. DRAP~ now of Bowmansdale, Cumberland County, Pennsylvania, being of sound and disposing mind, do hereby make, publish, and declare this to be my Last Will and Testament. hereby revoking and making null and void all prior Wills and Codicils made by me at any time heretofore. ITEM I I direct that all my legally valid debts, funeral and administrative exp~n8es) and debts incurred or payable because of my death, shall be paid by my Executor, hereinafter named, from my residuary estate as soon after my death as practicable. All death taxes, including federal, state, and other death taxes, with respect to the property forming my gross estate for tax purposes. whether or not passing under this Will, including any interest or penalty imposed thereon, shall be considered an expense of administration of my estate, without apportionment or right of reimbursement. Taxes on future interests may be prepaid ... i. ,... ....".,;;..,'1;':"...., .a "<'V.:jt,: .,..:,,*.~. ',"..~. ';,;1, .,~ '.. ....". _....."..~~~-,...._,--.,...---,......~._""'......._<..."""'-"""'<._-,._.~..~,...., ITEM II. I bequeath my household and personal effects, jewelry, automobiles, and other tangible personalty of like nature. in equal shares to the following persons who liUrvivc me by thirty (30) days: A. My daughter, TERESA M, McLOUGHLIN~ but, if she should not so survive me, then this bequest and its share shall lapse, and such property shall be distributed to the other beneficiaries designated under this Item of my Will. B. My daughter. ELIZABETH A JACKSON; but, if she should not so survive me, but leaves descendants who so survive me, such descendants shall receive, ~ sticw, the share that she would have received had she so survived me, subject, however, to the trust provisions contained hereinafter if applicable to such descendants. Presently. the descendants of my said daughter include Christina Michelle Jackson and Jessica Ann Jackson. C. My son, JOSEPH P. DRAPER; but, if he should not so survive me, but leaves descendants who so survive me) such descendants shall receive, per stit:pes, the share that he would have received had SO survived me. subject. however. to the trust provisions contained hereinafter if applicable to such descendants. Presently, the descendants of my said son include Kimberly Ann Draper, Samantha Mary Draper, Christine Patricia Draper) and Kasey Lee Draper. ~ ... . ....,.,-' ""''''''~'''.~''';,"''''' ""'.~,' ...."'-..:...""'~~~._.,."'.",',~.\fl3"'.<).............'~<,'.._........... ,. ",,,. ""~ ~'."-'~ - '''''-'''''.'''''''''- "."",_,i_""_..,....,.......,,,.,~,,..'" ,.~,~ ~".'..,.' "~".," """"','_,,, ~_ '., Such property shall be divided by said beneficiaries as they shall agree. As to those items upon which they shall not agree, distribution shall be determined by my Executor. ITEM nT I ewe, devise and bequeath all of the residue of my estate, whether real, personal, or mixed, and wherever situate, including any property subject to any power of appointment which I may now have or hereafter acquire, in equal shares to the following persons who survive me by thirty (30) days: A My daughter, TERESA M. McLOUGHLIN; but, if she should not so sw-vive me, then this bequest and its share shall lapse, and such property shall be distributed to the other beneficiaries designated under this Item of my Will. B. My daughter, ELIZABETIi A. JACKSON~ but, if she should not so survive me, but }e,aves descendants who so survive me, such descendants shall receive, ~ ~, the share that she would have received had she so survived me, subject, however, to the trust provisions contained hereinafter if applicable to such descendants. Presently, the descendants of my said daughter include Christina Michelle Jackson and Jessica Ann Jackson. C. My son, JOSEPH P. DRAPER; but, if he should not RO survive me, but leaves descendants who so survive me, such descendants shall receive, (let sticpes, the share that he would have received had so survived me, subject, however, to the trust 3 "" <\;.)t;-' ,'(:I'",~,;,~.M"l<t>l~ w provisions contained hereinafter if applicable to such descendants. Presently, the descendants of my said son include Kimberly Ann Draper, Samantha Mary Draper, Christine Patricia Draper, and Kasey Lee Draper. ITEM IV. Any property passing hereunder to a beneficiary who, at the time of my death, is under the age of twenty-five (25) (the "Beneficiary"), shall be held IN TRUST, NEVERTHELESS, by my Trustee, hereinafter named, for the benefit of such Beneficiary, upon the terms and fOf the purposes and uses, as follows: A. My Trustee shall hold and invest the principal of the Trost COrpUB~ collect the income therefrom, and expend and apply so much of the net income (any income not so expended or applied to be accumulated and added to principal), and so much of the principal and accumulated income, as my Trustee shall deem necessary or advisable, in the sole and absolute discretion of my Trustee, for the support, maintenance, and education (inCluding college education, both graduate and undergraduate) of the Beneficiary, after taking into consideration other readily available assets and sources of income. Duling illness or emergency, my Trustee may either pay a distribution to the Beneficiary, or may make a distribution for the benefit of the Beneficiary. 4 .. I ,~""~,""N,.....~,;,_,..____."..~...,, .j\(!, .. I __~~r""""""""~.~~""""''''''''';'''~ B. At the time the Beneficiary attains the age of twenty-five (25), the Trust pertaining to the Beneficiary shall terminate, and my Trustee shall distribute the then- remaining principal and accumulated or undistIiibuted income to the Beneficiary. C. If the Beneficiary should die during the existence of this Trust, it shall be divided and then continued for the benefit of any then-living issue of the Beneficiary~ nm: ~ with such beneficiaries being substituted for the Beneficiary for all purposes including distribution at certain ages as set forth above. D. If the Beneficiary should die before attaini.ng the age of twenty-five (25) wtthout leaving issue surviving as aforesaid~ then that Trust shaH temrinate, and its assets shall be divided into as many equal shares as are created under Item ill hereof for the benefit of those children of mine, or their issue, per stirpes, living at the time of the death of said Beneficiary, and then distributed to such beneficiaries; Provided, however, that jf a Tmst established hereunder for any such beneficiaries exists at the time of such distribution., then such distribution shall be made to that Trust for such beneficiary. ITEM V. The interest of beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation. 5 . .. ....' .' ITEM VI. I hereby appoint my daughter, TERESA M. McLOUGHLIN, to serve as the executrix (the "Executor"), of this, my Last Will and Testament. In the event of her refusal or inability to so serve, I then nominate and appoint my daughter, ELIZABETH A JACKSON, and my BOn, JOSEPH P. DRAPER, or the survivor of them, to serve together in such capacity as Executor. ITEM VII. I hereby appoint TERESA M. McLOUGHLIN, to serve as the trustee (the "Trustee") of any Trust created hereunder with regard to any Beneficiary, as defintld herein. In the event of her refusal or inability to so serve, I then nominate and appoint my daugbter, ELIZABETII A. JACKSON, and my son, JOSEPH P. DRAPER, or the survivor of them, to serve together in such capacity as Trustee. ITEM Vlll. I direct that my Executor and Trustee shall not be required to give bond or post any other security for the faithful performance of duties in any jurisdiction. ITEM IX. My Executor and Trustee shall have the followin8 powers in addition to those invested in them by law and by other provisions of my Will applicable to all property, whether principal of income, exercisable without Court approval. and effective until distribution of all property: A To retain any investments I may have at my death so long as my Executor or Trustee may deem it advisable to my Estate or Trust so to do. 6 . B. To vary investments, when deemed desirable by my Executor or Trustee, and to invest in such bonds, common trust funds controlled by my Executor or Trustee, stocks. notes, real estate mortgages, or other securities or in such other property, real or personal, as my Executor or Trustee deem wise, without being restricted to so-called legal investments. C. In order to effect-a division of the principal of my Estate or Trust or for any other purpose, including any final distribution, my Executor or Trustee is authorized to make said divisions or distributions of the personalty and realty partly or whoUy in kind. If such division or distribution is made in kind, said assets are required to be divided or distributed at their respective values on the date or dates of their division or clistribution. D. To sell either at public or private sale and upon such terms and conditions as my Executor or Trustee may deem advantageous to my Estate or Trust, any or all real or personal estate or interests therein owned by my Estate or Trust severally or in conjunction with other persons or acquired after my death by my Executor or Trustee, and to consummate said sale or sales by sufficient deeds or other instruments to the purchaser or purchasers, conveying a fee simple title, free and clear of all trust and without obligation or liability of the purchaser or purchasers to see to the application ofllie purcha..~ money Of to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge, and deliver any and an deeds, assignments, options, or other writings which may be necessary or 7 . . ~ ~ desirable, in carrying out any of the powers conferred upon my Executor or Trustee in this paragraph or elsewhere in my Will. E. To mortgage real estate, and to make leases of real e~1ate for any period of time as is deemed rcaaonable by them. F. To borrow moncy from any party to pay indebtedness of mine) or of my Estate or Trust, f..'Xpenses of administration. or inheritance, legacy, estate or other taxes. G. To pay all costs, taxes, expenses, and charges in connection with the administration of my Estate or Trust. My Executor shall pay expenses of my last illness and funeral expenses. H. To vote any shares of stock which fOITIl a pfU1 of my Estate or Trust, and to otherwise exercise all the powers incident to the ownership of such stock. 1. In the discretion ofmy Exerotor or Tru&tee, to unite with other owner& of similar property in carrying out any plans for the reorganization of any corporation or company whose securities form a part ofmy Estate or Trust. 8 . . . .. ITEM X. Any person who shall have died a.t the <mme time as me, or in a conunon disaster with me, or under such circumstances that it is difficult or impossible to determine who died first, shall be deemed to have predeceased me. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Telrtament, oonsistin.g of nine (9) typewritten pages, this J6.- day of September, 1995. ~o:I, W~ HARRIET E. DRAPE We, the undersigned, ~ e<<tifY that the foregoing Will was signed, sealed, published and declared by the above-named Testatrix, HARRIET E. DRAPER. as and for her Last Will and Testament, in the presence of us, who at her request and in her presence and in the presence of each other, have hereunto set our hands and seals the day and year above written, and we certify that at the time of the ex~tion thereof, the said Testatrix was of sound and disposing mind and memory. :](tnct-Z i (n~maf1 residing at &echculA'c .s: ~@ ( fJA- ~~le.SQ r (VlCmurtrie.residing at LJ ej/ ~/I e I ;P/1_~_~__ 4~"""" 9 --------------------------------------- ----------------------------------------- -- COMMONWEALTH OF PENNSYLVANIA COUNTY OFDA1J1?nli'~ Clkffiber!ord '\ .. 88.: - We, the Testatrix, and ~P+:2 tY\i"e~ , and -r-e&~Li!\c 0\L-Lr'\- r; e > the v.,i.tncssca, respectively, whose names arc sig...'1.cd to t.1C 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, that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesse:s, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best ofherlher knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence, -~c.~~ HARRIET E. DRAPE Caw ct ~n..rnlli~ ~tnes . rl0J1Qj)t\'-- /Y)c m 1 k J. tfl ~ Witness Subscribed, sworn to and acknowledged before me by the Testa.trix, HARRIET R DRAPER. and subscribed and sworn to before me by ~t.l-p pi- ~. rt'\1In~r I'T'\~ and '-=r~re~ Me fY\...v1-r~ e . witnesses, this _ 1'7 day of September, 1995. < vtJk (SEAL) Notarial Seal Judith A. Walter, Notary Public Upper Allen ~wp., Cl!mberland County My COlnmisslon Expires May 12. 1998 Member, Pennsylvania Association of Notaries [NIiH:Wll.#() 19 .'Rill~pr-br.w~l 10 ~. , ~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: \-\ Q((;~+ ~, 'J)("QPR-r q\ \~\QI Date of Death: Will No. dl-Ol-C!t-" Admin. No. To the Register: I certify that notice of (beneficial interest) 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 q \. 0 ~ Name Address Q34.08 Pol PQfrno..Q.-t, Ne~f'o(t- rJews, VA JaGer\--. p, 'D(~p-tL aO:l WOrdSWort-l-) Dr, \N:\/Yl:~tO('.1)E 1'1~o~ -,- eus a.. N\ - t\I\ e.l 00~ ~ \ I'''' g.s E' - L; 5 bV( ,.., Rcl, BQVo/I'N.).,sd o"lt \ {'A Il 0 0 ~ C\ ,'-za.be,+V\ (\, nc."kRc-n Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: t \ d 9 \ O~ LJ.rfl - I Yl eot ~-.! Signature 0'1 ..... -:q Q: ,~ /'1 .....- 8: 0 (V) :z: ,'.1 c:::x:: .., -., '1> 1._. .j......, W ..:'l:.. .0 . " ~ E CD a:: $ :;; CC ,., U ...., ~ Name leCeso... M._ Me;. Lou t h \ .{}.' Address ~ 5 E, L \'sh0rt"\ rz d BOWMQjlsdaLt PA l,CO% Telephone 111,) liS 1 - 'C\6 G, Capacity: X Personal Representative _Counsel for personal representative \. /:/-/t..S-=- /~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 11128-0601 '* NOTICE OF INHERITANCE TAX APPRAISEKENT~ ALLONANCE OR DISALLONANCE OF DEDUCTION~, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-l!i41 EX iFP U2-00) Recore<:.': Ref)st;, L; ot TERESA L MCLoUGHLI~2 25 E LISBURG RD BoWMANSDALE FEB -1 P 1 :42 PA~8 Curnberk.:, PA DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 02-04-2002 DRAPER 09-17-2001 21 01-0971 CUMBERLAND 221-22-8104 01153789 Allount Rellitted HARRIET E MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-V:is~i-EX--AFP--(i]f:oO)------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 02-04-2002 ESTATE OF DRAPER HARRIET COUNTY CUMBERLAND E DATE OF DEATH 09-17-2001 FILE NO. 21 01-0971 TAX RETURN WAS: S.S/D.C. NO. 221-22-8104 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACN 01153789 ACCOUNT NO. 139721-00 TYPE OF ACCOUNT: (~SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 04-26-1994 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 427.92 0.500 213.96 .00 213.96 .45 9.63 TAX CREDITS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) PAYMENT MUST BE MADE BY 06-18-2002~. TOTAL TAX CREDIT .00 BALANCE OF TAX DUE 9.63 INTEREST AND PEN. .00 TOTAL DUE 9.63 · IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRl, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. l COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLOWANCE OR DISALLOWANCE OF DEDUCTION~, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1541 EX AFP (12-80) 113 02-04-2002 DRAPER 09-17-2001 21 01-0971 CUMBERLAND 221-22-8104 01153791 AIIaunt Rellitted HARRIET E Recorn2t ReQi::;t ,'. of DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY P 1 :42 SSN/DC ACN TERESA L MCLOUGHLIN .02 FES-1 25 E LISBURG RD BOWMANSDALE PA 17~k(. CurnbBi 1 FA MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~ iifv=is4-i-E)f-AFP--fi1f:ooi------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 02-04-2002 ESTATE OF DRAPER HARRIET E DATE OF DEATH 09-17-2001 COUNTY CUMBERLAND FILE NO. 21 01-0971 TAX RETURN WAS: S.S/D.C. NO. 221-22-8104 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01153791 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 139721-05 TYPE OF ACCOUNT: (~SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 05-04-2001 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 2,003.16 1.000 2,003.16 .00 2,003.16 .45 90.14 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) PAYMENT MUST BE MADE BY o6-18-2oo2~. TOTAL TAX CREDIT .00 BALANCE OF TAX DUE 90.14 INTEREST AND PEN. .00 TOTAL DUE 90.14 . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. · ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISEKENT~ ALLONANCE OR DISALLONANCE OF DEDUCTION~, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS Recore;,,' of Recbtf': REV-1548 EX AFP (12-001 -02 FEB -1 DATE ESTATE OF DATE OF DEATH FILE NUMBER P 1 :42cOUNTY SSNI'DC ACN 02-04-2002 DRAPER 09-17-2001 21 01-0971 CUMBERLAND 221-22-8104 01153790 HARRIET E TERESA L MCLOUGHLIN 25 E LISBURG RD ",CLerk," BOWMANSDALE PA 17uefUYlbenc:", . ! I r! 'L; ~ .. Allount Rellitted PJ\ MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-V=is4-i-ix--AFP--ri2-:ooi------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 02-04-2002 ESTATE OF DRAPER HARRIET E DATE OF DEATH 09-17-2001 COUNTY CUMBERLAND FILE NO. 21 01-0971 TAX RETURN WAS: S.S/D.C. NO. 221-22-8104 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01153790 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 139721-11 TYPE OF ACCOUNT: () SAVINGS (>0 CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 04-26-1994 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 1,630.27 0.500 815.14 .00 815.14 .45 36.68 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) PAYMENT MUST BE MADE BY 06-18-2002*. TOTAL TAX CREDIT .00 BALANCE OF TAX DUE 36.68 INTEREST AND PEN. .00 TOTAL DUE 36.68 · IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT-- ( CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE (l/{S/1'1 *C/ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEKENT~ ALLONANCE OR DISALLONANCE OF DEDUCTION~, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS IEY-1541 EX AFP 112-00> PA 17008 DATE ESTATILJloF . itA TI'. 0 [OF DEATH FILE NUMBER COUNTY -02 FEB -~:~~C:S6 ~~~~b0'JS;. HA~l JAtK PA::: :::t::MIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 02-04-2002 DRAPER 09-17-2001 21 01-0971 CUMBERLAND 221-22-8104 01153790 HARRIET E TERESA L MCLOUGHLIN 25 E LISBURG RD BOWMANSDALE Cd-. ,~.}I \ ().Lvfl \ 0V ~ lfi;:). CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ iifi=is4-i-E)f-AFit-rilf=oQi------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 02-04-2002 ESTATE OF DRAPER HARRIET E DATE OF DEATH 09-17-2001 COUNTY CUMBERLAND FILE NO. 21 01-0971 TAX RETURN WAS: S.S/D.C. NO. 221-22-8104 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01153790 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 139721-11 TYPE OF ACCOUNT: () SAVINGS ()() CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 04-26-1994 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 1,630.27 0.500 815.14 .00 815.14 .45 36.68 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WIllS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) PAYMENT MUST BE MADE BY 06-18-2002*. TOTAL TAX CREDIT .00 BALANCE OF TAX DUE 36.68 INTEREST AND PEN. .00 TOTAL DUE 36.68 . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCU~ TION OF ADDI IONAL INTEREST. . ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQ~IRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT.. ( CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) COMMONWEALTH OF PENNSYLVANIA {11_,. /J t.J DEPARTMENT OF REVENUE I J-' *,c/ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z8D6Dl HARRISBURG, PA 171Z8-D6Dl NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLOWANCE OR DISALLOWANCE OF DEDUCTION~, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REY-1541 EX AFP 02-001 nf DATE " ESTATE OF DATE OF DEATH FILE NUMBER COUNTY FEB -8 P 1 :5lJiSN.lDC ACN 02-04-2002 DRAPER 09-17-2001 21 01-0971 CUMBERLAND 221-22-8104 01153791 Allaunt Rellitted HARRIET E ReCCIIC:,:: TERESA L MCLOUGHLIN 25 E LISBURG RD BOWMANSDALE .02 PA 170bBE.'rk Curnbe; i 'J, I~ ~\~~I G&- cp"'la~ MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ iifi=i54-i-i)f-AFit-fiz-:oQi------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 02-04-2002 ESTATE OF DRAPER HARRIET E DATE OF DEATH 09-17-2001 COUNTY CUMBERLAND FILE NO. 21 01-0971 TAX RETURN WAS: S.S/D.C. NO. 221-22-8104 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01153791 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 139721-05 TYPE OF ACCOUNT: (~SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 05-04-2001 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 2,003.16 1.000 2,003.16 .00 2,003.16 .45 90.14 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER ?ORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) PAYMENT MUST BE MADE BY 06-18-2002~. TOTAL TAX CREDIT .00 BALANCE OF TAX DUE 90.14 INTEREST AND PEN. .00 TOTAL DUE 90.14 . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDI IONAL INTEREST. . ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ..CREDIT" ( CRl, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTI~S. l COMMONWEALTH OF PENNSYLVANIA 17...-./5... I '-I DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 171Z8-0601 *' v NOTICE OF INHERITANCE TAX APPRAISE"ENT~ ALLOWANCE OR DISALLOWANCE OF DEDUCTIONtj~_AND ASSESS"ENT OF TAX ON JOINTLY KELD OR TRUST ASSETS REY-1548 EX iFP C12-DD) TERESA L MCLOUGHLIN 25 E LISBURG RD BOWMANSDALE .02 FE8-8 PA 17008 C:S'fh. CUITlbend(I~::, J~ '11~l~~ U0~ IDd- DATE ~ATE OF ;:IJATE OF DEATH FILE NUMBER COUNTY P f~DC AclC 02-04-2002 DRAPER 09-17-2001 21 01-0971 CUMBERLAND 221-22-8104 01153789 Allount Rellitted HARRIET E F:i\ MAKE CHECK PAYABLE AND~EMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE1 PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-V=is4-i-i)f-AFFr-rilr=ooi------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 02-04-2002 ESTATE OF DRAPER COUNTY CUMBERLAND HARRIET E DATE OF DEATH 09-17-2001 ACN 01153789 FILE NO. 21 01-0971 TAX RETURN WAS: S.S/D.C. NO. 221-22-8104 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 139721-00 TYPE OF ACCOUNT: (~SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 04-26-1994 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 427.92 0.500 213.96 .00 213.96 .45 9.63 TAX CREDITS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT1 SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS1 AGENT." PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) PAYMENT MUST BE MADE BY 06-18-2002*. TOTAL TAX CREDIT .00 BALANCE OF TAX DUE 9.63 INTEREST AND PEN. .00 TOTAL DUE 9.63 . IF PAID AFTER THIS DATEI SEE REVERSE FOR CALCULATION OF ADD I IONAL INTEREST. . ( IF TOTAL DUE IS LESS THAN $11 NO PAYHENT IS REqUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRl1 YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. l ~ If ti' 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 MCLOUGHLIN TERESA M 25 E L1SBURN ROAD BOWMANSDALE, PA 17008 -------- fold ESTATE INFORMATION: SSN: 221-22-8104 FILE NUMBER: 2101-0971 DECEDENT NAME: DRAPER HARRIET E DATE OF PAYMENT: 06/06/2002 POSTMARK DATE: 06/05/2002 COUNTY: CUMBERLAND DATE OF DEATH: 09/17/2001 NO. CD 001260 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $41 .78 I I I I I I I I TOTAL AMOUNT PAID: $41.78 REMARKS: TERESA M MCLAUGHLIN CHECK#104 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS ~-., /'7- /~ /~ \:. I BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' l2 TERESA L MCLOUGHLIN 25 E LISBURG RD BOWMANSDALE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN REV-UOIi EX AFP Cl2-00) ~:3 '-. 07-12-2002 DRAPER 09-17-2001 21 01-0971 CUMBERLAND 221-22-8104 01153789 Allount Rellitted HARRIET E PA 17008-0000 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1604 EX AFP (12-00) -- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 07-12-2002 ESTATE OF DRAPER HARRIET E DATE OF DEATH 09-17-2001 COUNTY CUMBERLAND FILE NO. 21 01-0971 ADJUSTMENT BASED ON: S.S/D.C. NO. 221-22-8104 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 01153789 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 139721-00 TYPE OF ACCOUNT: (X) SAVINGS () CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 04-26-1994 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.500 .00 .00 .00 .45 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAVMENT 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 FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ..CREDIT.. (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN * BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 17128-0601 REV-1604 EX AFP U2-00) TERESA L MCLOUGHLIN 25 E LISBURG RD BOWMANSDALE PA 17008-0000 07-12-2002 DRAPER 09-17-2001 21 01-0971 CUMBERLAND 221-22-8104 01153790 AlIOunt Rellitted HARRIET E MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE1 PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1604 EX AFP (12-00) -- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 07-12-2002 ESTATE OF DRAPER HARRIET E DATE OF DEATH 09-17-2001 COUNTY CUMBERLAND FILE NO. 21 01-0971 ADJUSTMENT BASED ON: S.S/D.C. NO. 221-22-8104 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 01153790 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 139721-11 TYPE OF ACCOUNT: () SAVINGS (X) CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 04-26-1994 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.500 .00 .00 .00 .45 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." 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 nn · IF PAID AFTER THIS DATEI SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. { IF TOTAL DUE IS LESS THAN $11 NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ1 YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) TERESA L MCLOUGHLIN 25 E LISBURG RD BOWMANSDALE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN * BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 17128-0601 REV-l'04 EX AFP Cl2-00> PA 17008-0000 07-12-2002 DRAPER 09-17-2001 21 01-0971 CUMBERLAND 221-22-8104 01153791 Allount Rellitted HARRIET E MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1604 EX AFP (12-00) -- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 07-12-2002 ESTATE OF DRAPER HARRIET E DATE OF DEATH 09-17-2001 COUNTY CUMBERLAND FILE NO. 21 01-0971 ADJUSTMENT BASED ON: S.S/D.C. NO. 221-22-8104 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 01153791 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 139721-05 TYPE OF ACCOUNT: (X) SAVINGS () CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 05-04-2001 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 1.000 .00 .00 .00 .45 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS. AGENT." 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 FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) REV-1470 ~X (~) '* INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 DECEDENrs NAME FILE NUMBER HARRIET E. DRAPER 2101-0971 REVIEWED BY ACN Phyllis Hoch 01153789,01153790,011 53791 ITEM SCHEDULE NO. EXPLANATION OF CHANGES ADJUSTED ABOVE ACN'S TO ZERO. REPORTED ON PROBATE RETURN. ROW Paae 1 ! /?-/s:/y ~BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG. PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX '(J2 JUL 26 TERESA M MCLOUGLIN 25 E LISBURN RD BOWMANSDALE t....PA 17008 /-', \ .! ~ DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-22-2002 DRAPER 09-17-2001 21 01-0971 CUMBERLAND 101 .;; >; :19 *' REY-1541 EX AFP 101-02) HARRIET E Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ iffi=is4j-iif-AFP--coi-:oz'r-NoTIci--oF-i-NHiifiTANci-TAX-APPRAIsiifENT-,--Ar:rowANci-ifli----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF DRAPER HARRIET E FILE NO. 21 01-0971 ACN 101 DATE 07-22-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED } CHANGED If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets n} (2) (3) (4) (5) (6) (n .00 .00 .00 .00 4.320.36 2.030.68 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) nO} 5,422.63 .00 (ll) n2} U3} U4} NOTE: .00 X 00 = 928.41 X 045 = .00 X 12 = .00 X 15 = NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 6,351.04 'i.422 63 928.41 .00 928.41 U9}= .00 41.78 .00 .00 41.78 TAX CREDITS: . ". ....... "..'W..... . I T+l AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 12-12-2001 CDOO0637 2.09 129.63 06-05-2002 CDOO1260 .00 41.78 TOTAL TAX CREDIT 173.50 BALANCE OF TAX DUE 131.72CR INTEREST AND PEN. .00 TOTAL DUE 131.72CR . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) /?-/~-/~ ~ 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-in7 EX AFP CUi-a2) j( . ..... :! 7 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-19-2002 DRAPER 09-17-2001 21 01-0971 CUMBERLAND 101 HARRIET E TERESA M MCLOUGLIN 25 E LISBURN RD BOWMANSDA~~. PA 17008 Allount Rellitted 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 ~ RE-Y=i6"ifj-E3f-AFP-co1-:o2j-------...--iNHERITANCE--TA3f-SY'1rfEME-NT-ifF-Aifcouiff--...---------------- ----- ESTATE OF DRAPER HARRIET E FILE NO. 21 01-0971 ACN 101 DATE 08-19-2002 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-15-2002 P R I NC I PAL TAX DU E : ........................................................................................................................................................................................................................... 41.78 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 12-12-2001 CDOO0637 2.09 129.63 06-05-2002 CDOO1260 .00 41.78 07-30-2002 REFUND .00 131.72- TOTAL TAX CREDIT 41.78 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) ~\. STATUS REPORT UNDER RULE 6.12 Name of Decedent: \-\ Q('r \ eA- G. 1:)C'a..p..e..r Date of Death: q \ \.., \ () t CJ~K Will No.: geo\ - ooq,\ Admin. No.: ..J.l-. () \ _. oq'l Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes~ No 0 2. lfthe answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes _ No ~ 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 0 No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date:~ICB !J,rn.r(Je-;t~ Signature ~ r:::er.eeo.. M.. tv\Q..L<:HJ6" \ .,-) Name r-- c9 5 E. L('sbocr') R:..cl I Address G()~'sd~lsL ~A / II ()o~ (Y"'\ ~.::::i 'I f'-:'" ..-" ~........ ., t,,-lJ91 - \ c;SLD Telephone No. Capacity~ersonal Representative o Counsel for personal representative -.::::t