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HomeMy WebLinkAbout01-0998 Register of Wills of CUMBERLAND County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of KATHRYN A. FREW No. 21-01-998 also known as , Deceased Social Security No. 177-38-7608 MELLON BANK, NA, SUCCESSOR BY MERGER TO COMMONWEAL TH NATIONAL BANK Petitioner(s), who is/are 18 years of age or older, apply)ies) for: (COMPLETE "A" OR "B" BELOW:) G] A. Probate and Grant of Letters and aver that Petitioner( s) is/are the execut OR named in the Last Will of the Decedent, dated and codicil(s) dates (AND IS SUCCESSOR BY MERGER TO COMMONWEALTH NATIONAL BANK) State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child bom or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: o B. Grant of Letters of Administration (c.I.a., d.b.n.c.l.a.: pendente lite, durante absentia: durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with his/her last family or principal residence at 210 BIG SPRING ROAD, NEWVILLE, P A 17241 (WEST PENNSBORO TWP) (list street, number and municipality) Decedent, then 90 years of age, died OCTOBER 17 , , 19~, at CARLISLE HOSPITAL, CARLISLE, P A (Location) Decedent at death owned property with estimated values as follows: {if domiciled in PA All personal property ......................................... $ 210,000.00 {if not domiciled in PA Personal property in Pennsylvania .................... $ (if not domiciled in PA Personal property in County .............................. $ Value of real estate in Pennsylvania ........................................................................................ $ Total... ........ ..... .............. ............ ................. ................. ........ ..................... ............ $ 21 0,000.00 Real Estate situated as follows: Wherefor. Petitioner{s) respectfully request{s) the probate of the last Will and Codicil{s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Typed or printed name and residence MELLON BANK NA ATTN: DON E. MARCHIONE P.O. BOX 7899 PHILADELPHIA PA 19101-7899 RW-1 /7-/~~ Oath of Personal Representative Commonwealth of Pennsylvania County of CUMBERLAND The Petitioner(s) above-named swear(s) and 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 representative(s) of the Decedent, Petitioner(s) will well and truly administer jJ:tate acc9fdinffl '7w. _ ~/ ~2. ' (VZ~ y;,~ Sworn to and affirmed and subscribed - /' before me this 30th day of OCTOBER ~82001 7/~<"I/t'i?,()~-;;I()~ DECREE OF REGISTER Estate of KATHRYN A. FREW also known as Deceased 21-01 qqR No. Date of Death: OCTOBER 17,2001 Social Security No: 177-38-7608 AND NOW, OCTOBER 31 ,~..QQ.L, in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters iii Testamentary a of Administration are hereby granted to MELLON BANK, NA ((c.I.a., d.b.n.c.l.; pendente lite; durante absentia; durante minoriate) in the above estate and that the instrument(s), if any, dated MARCH 3rd, 1987 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters .................................... Short Certificates(s) .../C/........ Renunciation ...... ..... ............... Extra Pages ( ) ............... I. T. R. ...................................... JCP Fee ................................. Inventory ... ............................. Other.... .... ..... ........... ........... ... TOTAL .............................$ $ 270.00 $ $ $ $ $ $ $ $ 30.00 6.00 5.00 311. 00 ~<'<'.l( a ~1~:iI'v')~ 4,./( Register of Ills "(1~ Attorney: HAMIL TON C. DAVIS 1.0. No: 10264 Address: P.O. BOX 40 SHIPPENSBURG PA 17257 Telephone: 717 532-5713 ~~~ 41"<:;.,q"" R~V 9/<:'>(:. This is to certify that the information here given is correctly copied fro~ an original certificate of death dul~ tIled with Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filmg. WARNING: It is illegal to duplicate this copy by photostat or photograph. me as No. ~~.'2~~~ Local Registrar Fee for this certificate, $2.00 p 7714168 OCT 20 2.001 Date 21-01-998 Hl0S. aJ A...., 2117 COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH iT y,,- SlATE FILE NUMBER SOCIAL SECURITY NUMBE.R - 38 DATE OF DEATH ,Mctlltl. 0..... ....." 17, 2001 'T K NAME OF DECEDENT {fIr,.. Mtda4I. L_I ,. AGE tL.. 8<tthoay) 90 BIRTHPlACE (C.1y aACS Slale 01 F C'809" CCllJ/'IIfYl =-',0 COUNTY OF DEATH ... Cumberland Ill! EllEHT'S USUAl OCCU"""," (~'=:_:;"c::::~:r n Teacher no. Education OECEDENT'S MA.L1NG AOOAESS (SIr.... ClfylTown. s... ZoCodeI DECEDENT'S ACTUAl. RESIDENCE ........... -- 11.. $I...p a MARITAL STATlJS. Metried Hevw ManitCl. WIc:IDwed. -- ,..Widmved IT..W....._......Wcot PCRRoboro ..... 210 Big Spring Rd Newville PA 17241 ,.. FATHER'S NAME IF... MidcIe. L.., ,,,.. Q;d - lwe>in. -' - Ave IME 0# DEATH ~ 41 21. MJn' I: Ente,tt\e CIiM..... iftiur*Of complication. which caloIUd IMd..th. Do l.* 0ftIt OM cauM on Hdlline. ). 00 I Cf J.&uL DUE 10 (OR AS ACON$EOUENCE OF): >t. I~e :=-= I i $ PART II: 0thlM ~ CCIndIIioNCOIWiIluIing to doth. buf noc tMUling '" the lIIICIIftyWIg cauM QWen in PJt.RT I. l : WERE "U~ FJNCMHQS ~8LE PAtOA 10 COMP\.E11ON OfF CAUSE Of' llERH' DUE 10 (OR AS A CONSE:OUENCE Ofl: CA D 'f, DUE 10 lOA AS. CONSEQUENCE OF), MANNER OF OEATH DATE OF fNJUAY (Month. Oey. .,..." TIMe OF IHJURY IHJUAV n WORK? DESCRIBE HOlt INJURY OCCURRED. ....... ........ IE' o o Hom;cicM "'1"IdinQ1nwese'9*11on Coutd noc be delllmllned o o o PlACE OF INJURY. AI hOme. farm, SltMt. factory, omce M. tM.tikIn9. etC.1Speotv) :!Go, ... 0 NoD NoY2l' .....0 NoD ....... -MEDICAL EXAMINER/COAONEA On the belie of ..am'natlon and/or in"..tlgJlUon.ln my opinion. d.ath occurred at the time. da'e, and place, and due to the cau..{.. and 31.~.nner.. ....ted.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 REGISTRAFrs SIGNATUFlE AND N l4 lid.! II a eX; .d.CXJ \ I - -, CEln'IAUI10'lectt only anet -cunJPYlNG ~SICIA" (F'hytoClllrl c.er1/fyln9 caused death ""'*" ~nomer ghvsc.." has p'Ol"OUnceddealn &tIO comoteled 118m 23J To the beet of 1ft, knowledte. de... OCCunwd Clue to 11M cauae{t. and ma""',.e a.eted. . . . . . . . . . . . . . . . . . . . . ... "1'tIIONOUHC1HQ AND CERTIFYINQ PHYSICIAN IPh~ DOlt1 ;)f~/'lClOQ ONth and cet1llY'l"9IO caUM Of deathl To the Met of 1ft, knowte4t_. a... OCCurrM at the time. da'lI. Jlnd pIKe. and due 10 the clluM{a'.ncI mll"n.,.. .latM " ,J ~~'X'\ ~ '. ~ \ , ~ j ~ ;. .~ U \, ~ "'\ ,~"" ~ \'~ ) HAMILTON C. DAVIS ATTORNEY AT LAW NEWVillE & SHIPPENSBURG PENNA. LAST WILL AND TESTAMENT I, KATHRYN A. FREW, of West Pennsboro Township, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and revoke any will or codicil previously made by me. ITEM I: I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the administration of my estate. ITEM II: I give and bequeath the sum of Twenty-Five Thousand ($25,000.00) Dollars to my half-sister, ALICE J. LAUBY, providing she shall survive me by thirty days. ITEM III: I devise and bequeath the residue of my estate of every nature and wherever situate as follows: A. One half thereof in equal shares per capita to, KENNETH C. FREW and VIVIENNE K. HEWLETT, the nephew and niece of my late husband. Should either KENNETH C. FREW or VIVIENNE K. HEWLETT predecease me or die on or before the thirtieth day following my death. I devise and bequeath his or her share to the survivor of them. Should both KENNETH C. FREW and VIVIENNE K. HEWLETT predecease me or die on or before the thirtieth day following me death, then, in that event. this gift shall lapse and the share(s) specified herein shall pass purusant to Paragraph B of this ITEM III. B. One half thereof to my half-sister. ALICE J. LAUBY, providing she shall survive me by thirty days. Should my half-sister, ALICE J. LAUBY, predecease me or die on or before the thirtieth day following my death, I devise and bequeath her share to her issue, per stirpes, living on the thirty-fist day followIng my death. ~ ITEM IV: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be HAMILTON C. DAVIS ATTORNEY AT LAW NEWVILLE & 5HIPPEN58URG PENNA. , . paid from my residuary estate as part of the expenses of the administration of my estate. ITEM V: I appoint COMMONWEALTH NATIONAL BANK, of Shippensburg, Pennsylvania, executor of this my last will. I hereby express my desire that HAMILTON C. DAVIS, ESQUIRE, of Newville, Pennsylvania, be retained as the attorney in the settlement of my said estate. ITEM VI: My corporate fiduciary shall be entitled to compensation based upon its regular schedule of fees for such services in effect from time to time during the period over which its services are performed. ITEM VII: I direct that my executor or guardian or their successors shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I hereunto set my hand and seal to this my Last Will and Testament, written on three (3) sheets of paper, dated this ~~ day of J1ta/rM , 1987. ':r;: ;':;rafhr~A. ~~;"~ (SFAL) The preceding instrument, consisting of this and two (2) other typewritten pages, each identified by the signature of the testatrix, was on the day and date thereof signed, published and declared by the testatrix therein named, as and for her Last Will, in the presence of us, who at her request, in her presence, and in the presence of each other have subscribed our names as witnesses hereto. ~(?L. ~_ 7x,-f'~ residing at ~.dle J fc. , residing at 51; p pe;t rt &c.-re;, /,,4 #' r _ 2 . . COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND I, KATHRYN A. FREW, the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. ~1fa' . / L kL~I~ c-? ,-~:;;:,,-- (SEAL) Kadlryn A. Frew Sworn to or a~ed and acknowledged before me by ~vu A; .,t;(el.<.l , the ~. t~,::jLis ::UL day of /L , 1987. EUZ~. 1: B. FUZE?, p,ro'rA~:Y PUBLIC ." WEST PEPlr~S.gOIfO TWP., C!J~fmUJ.&i1) COUffJY IY COUMIs.s!ti1~ E1U"ll!fS SEPT. 12. 1987 COMMONWEALTH OF PENNSYL'IIti~ Pellbsylllillla ~3rDd.tkm of NotlArles ss. COUNTY OF CUMBERLAND !: We (or I), ~,' ~ ('4,"j and Ve l Gl~ fl...-. S- €..a J" c:. witness(es) whose name(s) are (is) signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were (I was) present and saw the testatrix sign and execute the instrument as her Last Will; that the testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the Will as a witness; and that to the best of our (my) knowledge the testatrix was at that time eighteen (18) or more years of age a d of sound mind and under no constraint or undue influence. , the HAMILTON C. DAVIS r;ibed to ATTORNEY AT LAW NEWVILLE & SHIPPEN5BURG PENNA. /' N I . ELl;,}" 3N Ii ::P'l~J; 1'''''/',1'.1 "U"!./" '- . ...... - ~r; '-'f ..ti f.:r,~~ jj .... IIJ ... WES "~"C""", ",.,,~, . "~lJ"'.w <Hi'., (;U~lni!tMm COUN.TY MY COMMISS!!lH !:KrIRJES SEPT. 12, 19'7 -"ember, Pennt,>lul'llf>> A3S/lell!tion of Nlltl'rifl 3 - - _/ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: KATHRYN A. FREW Date of Death: October 17. 2001 Will No.: 21-01-0998 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 November 13.2001 : Name Address Alice 1. Lauby 77 Middle Road. Apt. 265. Bryn Mar. PA 19010 Vivienne K. Hewlett 1004 Virginia Avenue. Altamonte Springs. FL 32701 Kenneth C. Frew 250 Verbeke Street. Apt. 2. Harrisburg. P A 17102 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none. Date: /I/I-S/O I / / SignabJre: ~ II. (! J . .-"'" Name: Hamilton C. Davis Address: P.O. Box 40. Shippensburg. PA 17257 Telephone: 717-532-5713 Capacity: _ Personal Representative Capacity: --X- Counsel for Personal Representative ., ~ Mellon Mellon Private Asset Manageme January 16, 2002 Estate of: Died: Fi le No: Kathryn A. Frew October 17, 2001 21-01-0998 Register of wills, cumberland County 1 Courthouse square carlisle PA 17013-3387 Dear Sir/Madam: The enclosed Mellon Bank check for $25,935.00 represents payment of the pennsylvania Inheritance Tax due for the above named estate. The tax has been calculated on $115,000.00 at 12% and on $90,000.00 @15%, less the 5% discount for payment within three months of the decedent's death. please send us your official receipt. enclosed for your convenience. vi tru7y yours; ~/I~ Cs~ra Quay Tax Administration 215-553-2538 A return envelope 7S / nc ;:.; .,,, =<'t :::I:; gr '" F3 C- ::x::> z ~l, '"".) --- 00 -'l'-~ -,:I f'-.J o --- Room 193-0205 . 1735 Market Street. P.O. Box 7899 . Philadelphia, PA 19101-7899 A Mellon Asset Management Company SM :o~ (0 C ~:~:, :;; f::'i'~' :;.; r LlJ cr: ~> a.. 0: . N .... cr: C V) "'"""'N. t- ClCI:I:C 'z Q......IQ..-CO::J 0:.....101-0 'Q.LlJ- ~ CI) CI Zcr: . cr: <J: ::> .....I J J: a.. ~,~ ~l") ~ ID .T -"'. .. '-I,~ -EA- :5 : = ~~C;O =- ,~ ,'- . QIII c c '" c ru c U1 I]"" ..D \Tl U1 ru .. .:r c c c c .:r I]"" M M C C I"- - c CIl E CIl 0) a c 0\ a 0\ ::E 00 - r-;- CIl 0 en en 0\ <I: ~ CIl ~ ~ - g <:1)0\ ......0"1 cd' ';: l1) 00._ ..Io:r-,.c Q. 8><..9- C ::Eon) .2 iJ:I"O <n :'0 'i "'o:.a ::E ~o.;o... ." ~ tf.l ::J r-- o 00 ::c C'"l H C'"l ~ I o~~ tf.lu<:o Hi><::Jr-- H H 0'...-1 HZtf.l :3S~<: ~Utf.lp.., o ::J ~o ~Z::C~ ~<:HH HH~tf.l tf.l~::JH H~OH iz5~u~ ~U...-IU 'tv '\.1\\ \ 0: l\d .'\l{\.(.., y!'-.\qu"YJ . . '"a'~ 8 t N\if '0 ~a. ; l"\ .10..pel"-" 'Zo. ... .....- .....- ...-. ...-::: ...-' .-- ..'-" 0"--' ....- ...-::: ..,- .....- ... .....- ..,-.. ......... ,-;:>,}j .:-.1 .:::1 .:,., I:'" fJ:' 1'1:' ..,.. ...:' .~.., .:::- "... .,.., ,. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128.0601 RECEIVED FROM: MELLON BANK, NA. SUCCESSOR BY PO BOX 7899 PHILADELPHIA, PA 19101-7899 __n__n fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: SSN: 177-38-7608 FILE NUMBER: 21-2001- 0998 DECEDENT NAME: FREW KATHRYN A DATE OF PAYMENT: 01/18/2002 POSTMARK DATE: 01/16/2002 COUNTY: CUMBERLAND DATE OF DEATH: 1 0/ 1 7 /200 1 REMARKS: MELLON BANK NA CHECK# 10346261 SEAL ACN ASSESSMENT CONTROL NUMBER 101 TOTAL AMOUNT PAID: INITIALS: CW RECEIVED BY: REV-1162 EX(11-96) NO. CD 000770 ~ AMOUNT -------- I $25,935.00 I I I I I I I I $25,935.00 MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA EXECUTOR #: 108439L7000 SS COUNTY OF PHILADELPHIA Don E. Marchione, Vice President of Mellon Bank N.A., Executor(s) of the will of Kathryn A. Frew, deceased, being duly sworn according to law, depose(s) and say(s) that the items appearing in the following inventory include all of the intangible personal assets wherever situate and all of the tangible personal assets and real estate in the Commonwealth of Pennsylvania of said decedent; that the valuation placed opposite each item of said inventory represents its fair market value as of the date of the decedent's death, according to information and belief of the deponents and that decedent owned no tangible personal assets and real estate outside the Commonwealth of Pennsylvania, except that which may appear in a memorandum at the end of the inventory. Sworn~d subscribed before me thi5f~ day of r/,o.RlJ.#..1Y A.D. 2002 MELLON BANK N.A. I am not a stockholder, director or officer of Mellon Bank N.A. By0~z--0~ Don E. Marchione Vice President INVENTORY of the Goods and Chattels, rights and credits, which were Kathryn A. Frew, late of Cumberland County, Pennsylvania, taken and made in conformity with the above deposition as of October 17, 2001 date of the decedent's death. Inventory for the Estate of Kathryn A. Frew, Deceased Who Died October 17, 2001 ============================================================================== Cash Farmers National Bank Checking Account #11-691-2 $ 3,599.01 Farmers National Bank Money Market Account #1594931 Interest accrued to 10/17/2001 33,837.55 40.29 Bonds $2,000 H Bonds 2,000.00 $500 HH Bonds 500.00 Stocks 11,330 Shs. ACNE Corp. com. @ 18.575 210,454.75 Personal Property Personal Property appraised @ 228.00 $ 250,659.60 TOTAL PRINCIPAL RECEIPTS --------------- --------------- 39L-700 - 1 - 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 NO CD 001210 . MELLON BANK NA ROOM 193-0205 POBOX 7899 PHILADELPHIA, PA 19101-7899 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold ---------- -------- 101 I $2,374.05 ESTATE INFORMATION: SSN: 177-38-7608 I FILE NUMBER: 2101-0998 I DECEDENT NAME: FREW KATHRYN A I DATE OF PAYMENT: OS/24/2002 I POSTMARK DATE: OS/22/2002 I COUNTY: CUMBERLAND I DATE OF DEATH: 10/17/2001 I I TOTAL AMOUNT PAID: $2,374.05 REMARKS: MELLON BANK NA CHECK# 10388520 INITIALS: CW SEAL RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS r--;-,' r I Ut .' : III I tI [I~"~~g ~ ; ~l.~J : ~~,-\"~ 1 0 / N c. N .1. _ .h:~ , - (J) (J) 00 "7 ..... o ..... (J) ..... <( E-< ~ rn :S E-<(J):t: C ~&1~ .2 ~~~ "i ~g~ 2 ~~re <I ~'.. : " -. .., 11' ~ ~ -: <:..' , 0.. ~ N . III "I :: [~:~~~6 e~ ~ \ ~.. 1;:::1 il~~ ~~;:. ~~~,;. ::-'-", o , N N U">... = "~ J,. . '''lL- . , ~) ,-111 110 C C .a D"' ru I"- ru c c c c j :ii en en ~ .9' c..) .... I! ~ t900 962& 2000 09hO 200L 1111111111111111111111111111111111111111 ~ ~ ~ ~ >-t E-i Z :::> o U ~ ~ ~ ~ ~ U ~ .... oi '" ~ ~ {.) " 00 C""l C""l I ~C""l .. P:: ....... 00<0 H:::>" H 0'....... HOO ~~< ~oop.., 0:::> o P::~~ ~E-iH E-iP::OO OO:::>H HOH 0U';;j ~"""'U o Eo< (It U) ~ ...., U t- ~ ;:: l ~ 9 8 Mellon May 20, 2002 Estate of: Di ed: Fi7e No: Kathryn A. Frew October 17, 2001 21-01-00998 Register of wi 7 7s, cumber7and County 1 Courthouse Square car7is7e PA 17013-3387 Dear Sir/Madam: Enc70sed in dup7icate is the pennsy7vania Inheritance Tax Return for the above estate, together with the fo77owing: 1. copy of the decedent's wi 7 7 2. copy of bank account ba7ance confirmation 3. copy of persona 7 property appraisa7 A7so enc70sed is a Me770n check for $2,374.05 representing payment of the ba 7ance of the tax ca 7cu7ated to be due. p7ease send us your officia7 receipt. vrry tru7y you), ~J L,~L \~~/(j"-C~~'1 / Sara Quay /' I Tax Administration ( . 215-553-2538-- ,i'""- . o ;--.".: r'...; .> ---" enc7s. Cc: Hami7ton C. Davis, Esq. Don E. Marchione, V.P. IIllnIlIllIllIIUlIlIIlIJlIIlIlllloalllllilll'~. II=- =--.1'1"=-:.] =-.: U.~"".I.l"'1 ~flI::li'..: r.,--w."e'I:l:;I :Ii'. n.".1 :'Cet :1.1I1~1...I~.'.I,d'..=- :1...:.1:1 =-~IIIIIIIIiIllIllIllIllIllIlJIIIIIIIJjI!5[11l11li1l11tm " '.' ... I!iI I!i1 ~~ I!ilI!i1 ----:;:;0- BostonSafl;! Deposit & Trust Company I!i1 I!i1 I!i1 I!iI I!i1 I!iI I!i1 I!iI I!i1 I!i1 I!i1 I!i1 I!iI I!i1 I!i1 I!i1 I!iI I!i1 Authorized Signature I!i1 Not Valid After Six Months " I!i1 ~~m~~~m~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 8 Menon Check No.: 10388520 Pay Two thousand three hundred seventy four and 05/100 Dollars To the Order Of REGISTER OF WILLS. AGENT ESTATE OF KATHRYN A. FREW FILE NO: 21-01-0998 1+' '''::::WM':''j WW:,,:~~;::~:: ~b. ~ II- 0 0 ~ 0 j B B 5 2011- I: 0 ~ ~ 0 0 ~ 2 j L.I: 2 g g g 2 B II- ... 8 Mellon May 20, 2002 .........., F.' .......'...- -- . d h~ Estate of: Died: Fi7e No: Kathryn A. Frew October 17, 2001 21-01-00998 f'<i .>. Register of wi 7 7s, Cumber7and County 1 courthouse square car7is7e PA 17013-3387 Dear Sir/Madam: Enc70sed in dup7icate is the pennsy7vania Inheritance Tax Return for the above estate, together with the fo77owing: 1. copy of the decedent' s wi 7 7 2. copy of bank account ba7ance confirmation 3. copy of persona 7 property appraisa7 A7so enc70sed is a Me770n check for $2,374.05 representing payment of the ba 7ance of the tax ca 7cu7ated to be due. p7ease send us your officia 7 receipt. very tru7y YQu'T' f j ',i'I.'! / ~L \ . (7---- J L' L/\---v \ / Sara Quay ( Tax Administration 2.Z5-553-2538 enc7s. Cc: Hami7ton C. Davis, Esq. Don E. Marchione, V.P. Pl'i\'afe Wealth Management Room 193.0205 . 1735 Market Street. PO. Box 7899 . Philadelphia, PA 19101-7899 A ll1ellOll Financial COmpmly.1I1 o 8 Mellon May 31, 2002 Estate of: Died: Fi le NO: Kathryn A. Frew October 17, 2001 21-01-00998 Register of wills, Cumberland County 1 courthouse Square carlisle PA 17013-3387 Dear Sir/Madam: In accordance with your request, I am enclosing a Me7lon check for the fi7ing fee re the pennsy7vania Inheritance Tax Return. p7ease send us your officia7 receipt. ,., vty tru7y ~urs, ..--... X ~. (~/L.ll';J (Skra Quay .... / Tax Administratio 215-553-2538 Private Wealth Management Room 193-0205 . 1735 Market Street. P.O. Box 7899 . Philadelphia, PA 19101-7899 A Mellon Financial Company'\! o 8 Mellon May 31, 2002 Estate of: Died: Fi7e NO: Kathryn A. Frew October 17, 2001 21-01-00998 Register of wi77s, cumber7and county 1 courthouse Square car7is7e PA 17013-3387 Dear Sir/Madam: In accordance with your request, I am enc7~sing a ~e77on check for the fi7ing fee re the pennsy7van7a Inher7tance Tax Return. p7ease send us your officia 7 receipt. very tru7y yours, Sara Quay Tax Administration 215-553-2538 ~.~ iilliliililliili5lmllllllllilillliliillllmlliD5'~.:1 =- :=p-......=-.l:a I: 11-.... _1.leu h'j I"'~.. :1"~""""e1:I:::I ....:-.:,...... ~,., :1.1..........10.'" ..!'.: .1 ,. =- :.1'....:.1::1 :_InIIi5Ii5I15I11IEj[iiIi5ISiIi5IiJ~IiiIliI!UEUEiISi~ !!I . '. ... . .... ..... ~ I ~.. ....... Menon 5-123 I i... .. "110 Boston Safe Deposit & Trust Company ffi ~ ffi ~ E ; CheckNo.: 10390533 ~ ~ ffi j Pay Fifteen and 00/100 Dollars m I ~;:~E~~~~LLS r:4~=::;w %Wll:: :N_~~*:' I ~ 21-2001-998 ~ ~ .~G, ~ I ~ ffi ~ . Authorized Signature. ffi ~ '.. .' ... .... Not Valid After Six Months .' .. . ffi ~~.~.~~~~~m~~~~m~m.mmm~~~m~~mmmm~mmm..mmm~m=~mm~m.m.mmm.==m~.m~m~~m~mm 11100 ~ 0 ~ q 0 5 ~ ~ III I: 0 ~ ~ 0 0 ~ 2 ~ l.1: 2 q q q 2 Bill /?-/? - x.!3 \., BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX REV-1547 EX AFP 101-021 ",-,>..-. .d DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-15-2002 FREW 10-17-2001 21 01-0998 CUMBERLAND 101 KATHRYN A , " PHILA P~~l~?101 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=is4j-EX-iFP--foY=02Y-NOYicE--OF-YNHEifiTiNCi.-YA'X-'AppR'AisEMENY-,--iLi-owiNCi.-oi----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FREW KATHRYN A FILE NO. 21 01-0998 ACN 101 DATE 07-15-2002 TAX RETURN WAS: ( X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) ll) .00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) 212.954.75 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Hortgages/Notes Receivable (Schedule D) (4) .00 of this form with your 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) (5) 37.704.85 tax payment. 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. Total Assets (8) 250,659.60 APPROVED DEDUCTIONS AND EXEMPTIONS: 26,972.44 9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H) (9) 10. Debts/Hortgage Liabilities/Liens (Schedule I) llO) L 101. 61 11. Total Deductions (11) 28.074 05 12. Net Value of Tax Return ll2) 222,585.55 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) ll3) .00 14. Net Value of Estate Subject to Tax .. ll4) 222,585.55 NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate US) .00 X 00 = .00 16. Amount of Line 14 taxable at Lineal/Class A rate (6) .00 X 045 = .00 17. Amount of Line 14 at Sibling rate ll7) 123,792.77 X 12 = 14,855.13 18. Amount of Line 14 taxable at Collateral/Class B rate (8) 98,792.78 X 15 = 14,818.92 19. Principal Tax Due (9)= 29,674.05 AX CREDITS: n~~~.' . (+J AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 01-16'""2002 CDOOO770 1,365.00 25,935.00 05-22-2002 CDOO1210 .00 2,374.05 TOTAL TAX CREDIT 29,674.05 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 III IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) FRANCIS A BOYLE MELLON BK RM 193-0205 PO BOX 7899 \6 Amount Remitted ()d~ STATUS REPORT UNDER RULE 6.12 Name of Decedent: Kathryn A. Frew Date of Death: 10/17/2001 Estate No. 21-01-0998 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No_ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes_ No_. 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_ No_ d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' court and may be attached to this ~t (1. 1.- '__ Hamilton C. Davis, Esquire P.O. Box 40 Shippensburg, P A 17257 (717) 532-5713 Date: q~;j03 I ' .0 [".J {"".J Capacity: _ Personal Representative XX Counsel for Personal Representative STATUS REPORT UNDER RULE 6.12 G/ V- Ir) 1'- Name of Decedent: Kathryn A. Frew Date of Death: October 17.2001 .:. Will No. 2001-00998 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion ofthe administration ofthe above-captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, State the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes X No_ Date 10-9-03 Signature ~~~~. Name BARBARA SZYI\!,A,N:5r;J Mellon Ban;.,iv c' Address 1735 Market Streel' P.O. Box 7899 Philadelphia'. PA 19101-789''7 Telephone: (215) 553-3874 ,,' ! Capacity: X Personal Representative _ Counsel for Personal Representative REV-1500 EX + (6-00) OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA REV-1500 1'7- I 7 -- ) -.) DEPARTMENT OF REVENUE ~) DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 2001 00998 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Frew, Katluvn A 177-38-7608 DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 10/17/01 07/06/1911 WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 3. Remainder Return CHECK r Original Return ~2 Supplemental Return B (date of death prior to 12-13-82) APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required ~ate of death after 12-12-82) PRIATE 6. Decedent Died Testate 7. ecedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach copy of Will) (Attach a copy of Trust) BLOCKS 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death between 0 11. Election to tax under Sec. 9113(A) 12-31-91 and 1-1-95) (Attach Sch 0) #ij~$,:~ij:MQ$rijj:QQiP.Uttllt:AijijQQijijj$.P9NQjg:j*#.Qijf!Qiijfli4!AXU~fQRMAft.iQt(~ijQgUiji.::Q!R~etiP.f(:@ NAME COMPLETE MAILING ADDRESS COR- Francis A. Boyle VP Room 193-0205 RE- FIRM NAME (If Applicable) P 0 Box 7899 SPON DENT Mellon Philadelphia PA 19101-7899 TELEPHONE NUMBER 215-553-8649 ,.........., OFFICIAL USEONL Y 1. Real Estate (Schedule A) (1 ) None 2. Stocks and Bonds (Schedule B) (2) 212,954.75 3. Closely Held Corporetion, Partnership or Sole-Proprietorship (3) None None -, 4. Mortgages & Notes Receivable (Schedule D) (4) - 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 37,704.85 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested (6) None RECA- --,,' PITULA- 7. Inter-Vivos Transfers & Miscellaneous TION Non-Probate Property (Schedule G or L) (7) None 8. Total Gross Assets (total Lines 1-7) (8) 250,659.60 9. Funeral Expenses & Administrative Costs (Schedule H)(9) 26, 972 .44 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 1,101. 61 11. Total Deductions (total Lines 9 & 10) (11) 28,074.05 12. Net Value of Estate (Line 8 minus Line 11) (12) 222,585.55 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax (13) None has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 222,585.55 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (aX1.2) X .0 (15) - TAX 16. Amount of Line 14 taxable at lineal rate 0.00 X .0 45 (16) 0.00 - COMPU- 17. Amount of Line 14 taxable at si bling rate 123,792.77 X .12 (17) 14,855.13 TATION 18. Amount of Line 14 taxable at collateral rate 98,792.78 X .15 (18) 14,818.92 19. Tax Due (19) 29,674.05 20. 0 1:Pf$.ck.B.$jlMI#::VQU:Aijjgj~jgdij~li$\imR~ijpjjij{jij;~apA~fff::1 ...... ........ ................. """:'.;.'.:.;.; ..................... .......... .........................................................................'....,.... .................. ...... "'"'' .................. ..........................'........ ...,.,................ , , , , .. .................. ... . ..................... . . . . . . . . . . . . . . . . . . . .. .. ......... . ................................. ..... ........ . ,.. ............,...... .................... .................'..................... .................. :::::::~~:~e:$.Qat;TQ:AI!i!$~:A.u:::QVesn.QNa:Q~Ji'($l!e:~::ANP:6eGHf;G~MA:'ThI1~~::::: ...........................................................................'........ ................................. ............ o PA15001 NTF 29755 Copyright 2000 Greatland/Nelco LP - Forms Software Only Estate of: Kathryn A Frew SUM'v1ARY OF ALUX'ATIONS TO BENEFICIARIES Taxable at sibling rate Alice lauby 123,792.77 Taxable at collateral rate ViviemJ.e K Hewlett Kenneth C Frew 49,396.39 49,396.39 98,792.78 21-2001-00998 PA REV-1500 EX (6-00) Decedent's Com lete Address: STREET ADDRESS Page 2 210 Bi Road CITY Newville Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount STATE PA ZIP 17241 (1 ) 29,674.05 25,935.00 1,365.00 Total Credits (A + B + C) (2) 27,300.00 3. InteresUPenalty if applicable D. Interest E. Penalty (3) 0.00 (4) (5) 2,374.05 (SA) 0.00 (5B) 2,374.05 5. Total Interest/Penalty (D + E) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. :::::::::::::::::::::::::::::::::::. :::{:::)))::::::::) .:~:~~..~::::\~::::~:~I~:::;:::::::~;.GIS-r::~:g~: ":'I:.L,~~!~~;~::::..::..... "':::::::::::::::::::::::)}:::}}}:::::{::::::' ~[~i~:~::~~;;~R THE FOLLOWING'aUESTioNSHB~ipL.ACINGH"N "X" IN THE APPROPRIATE BLOCKS 4. 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; ....................................... b. retain the right to designate who shall use the property transferred or its income; ................. c. retain a reversionary interest; or. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of either payments, benefits or care? ... . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . . . 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on information of which re arer has an knowled e. SIGNATURE OF SON RESPONSIB OR G RETUR DATE Mell n . /' VICE P:?ESIDENT ADDRESS See Schedule attached SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE Yes No ~ I B ~ ~ MAY 1 5 'ir.jl'~2 I.-,U. DATE ADDRESS ...................................................... ....... .................. ........ ....................... ~;;/d~i~~..~{d~~th~~O; ;':ft~~'j~ry'i: ;~~~;,:~ d .~~iore. J~~~~~~: ~:: 1:~9:~::;h~.tax.;;,:t;;::~poi~db.;, th;;~~t~~i~~~rt~~;;~f~~~{~::~;i~h~::~:;~:~n~::~~~;~::~g~p~d~i;..~~2 ........ ....... . [72 P.S.191 16 (a)(1. 1)(i)]. For dates of death on or after January 1, 1995, the tax rate is imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 19116 (a) (1.1) (ii)]. The statute do@!; nnt f!Ixemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S.191 16(aX1.2)]. Th e tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%. except as noted in 72.P.S.li 9116(1.2) [72 P.S.li 91 16(aX1)]. The tax rate imposed on the net value of transfers to orforthe use of the decedent's siblings is 12% [72 P.S. li9116(aX1.3)]. Asibling is defined, under Section 9102. as an individual who has at least one parent in common with the decedent, whether by blood or adoption. o PA15002 NTF 29756 Copyright 2000 Greatland/Nelco LP - Forms Software Only Estate of: Kathryn A Frew 21-2001-00998 The follONing person(s) are signing the return as representative(s) of the estate: Mellon Room 193-0205 POBox 7899 Philadelphia, PA 19101-7899 EIN: 25-0659306 REV-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kathryn A Frew SCHEDULE B STOCKS & BONDS FILE NUMBER 21-2001-00998 All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 2000 H Bonds 2,000.00 2 500 HH Bond 500.00 3 11330 shs ACNE Co~ can 210,454.75 7 CPA31 NTF 10905 Copyright Forms Software Only, 1997 Nelco,lnc. TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 212,954.75 REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Kathryn A Frew 21-2001-00998 Include proceeds of litigation & date proceeds were received by the estate. All prop. Jolntlv-owned with right of survivorship must be disclosed on Sch. F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 Fanners National Bank, checking a/c 11-691-2 3,599.01 2 Fanners National Bank Money Mkt a/c 1594931 33,837.55 Interest accrued to 10/17/01 40.29 3 Tangible personalty appraised @ 228.00 7 CPA81 NTF 10908 Copyright Forms Software Only, 1997 Nelco, Inc. TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 37,704.85 REV-1511EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kathryn A Frew SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-2001-00998 Debts of decedent must be reported on Schedule I. ITEM NO. A. FUNERAL EXPENSES: DESCRIPTION AMOUNT 1 Egger F\meral Hare, Inc. 6,346.50 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Mellon Social Security Number(s)/EIN No. of Personal Representative(s) Street Address Rcx:m 193-0205, POBox 7899 City Philadelphia State 12,530.00 PA Zip 19101-7899 Year(s) Commission Paid: 2. 3. Attorney Fees Name : Hamil ton C. Davis, Esquire Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation) Claimant Street Address 7,500.00 0.00 City Relationship of Claimant to Decedent State Zip 4. Probate Fees 324.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 7 The Valley Times-Star, estate advertising 89.79 8 PA Department of Vital Records, multi-year search re decedent's predeceased husband, George Frew 28.00 9 Dennis L. Gottshall, personalty appraisal 25.00 10 Alice Lauby, reimbursment for estate related costs 17.65 11 Expenses re sale of personalty 111.50 7 CPA11 NTF10911 Copyright Forms Software Only, 1997 Nelco, Inc. TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 26, 972 .44 REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kathryn A Frew Include unreimbursed medical expenses. ITEM NO. DESCRIPTION SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS FILE NUMBER 21-2001-00998 AMOUNT 1 Presbyterian Hares Inc 1,101. 61 7 CPA12 NTF 10912 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,101. 61 Copyright Forms Software Only, 1997 Nelco, Inc. REV-1513 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES Katlrrvn A Frew No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Alice Lauby 77 Middle Road Bryn Mawr, PA 19010 2 Vivierme K Hewlett 1004 Virginia Ave Altarronte Springs, PA 32701 3 Kermeth C Frew 250 Verbeke St Apt 2 Harrisburg, PA 17102 FILE NUMBER RELATIONSHIP TO DECEDENT Do Not LIst Trustee(s) half-sister niece nephew 21-2001-00998 AMOUNT OR SHARE OF ESTATE 123,792.77 49,396.39 49,396.39 ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 17 AS APPROPRIATE ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE None B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS None 7 CPA13 NTF 10913 TOTAL OF PART II -- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 Copyright Forms Software Only, 1997 Nelco, Inc. (If more space is needed, insert additional sheets of the same size) PENNSYLVANIA WARNINGS Estate of Kathryn A Frew 4/24/02 9:04 am None