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Home My WebLink About01-1067 PETITION FOU IlRODATE and GRANT OF LETTERS ~~D(P1 No. To: Estate of ~he.ccaJ1-----Dunn also known as _______________________________________ Register of Wills for the _ __ _____________ _____, Deceased. County of Cumbacland in Social Security No. 205-09-9440 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut rix in the last will of the above decedent, dated "M",rC'h 19Q'l and codicil(s) dated the named ,19_ (state relevAnl circlll11stances. e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with ILer___ last family or principal residence at _49_Z_jilllnu t Bot tom Road. -GaI,"Us18~-----PA 17013 (list street, number and muncipality) Decendent, then _9..6-___ years of age, died __21 Dc_tober 2001 , 19 at __442__Walnu t~o t tom,_ Road~__Car.1isle..-P A.....l7 011 Except as follows, decedent did not many, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was nol the victim of a killing and was never adjudicated i ncoll1 pet en t : Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania sitllated as follows: ____________________________ $ 8,000. 00 $ $ $ None WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary (testamentary; administration c.I.a.; administration d.b.n.c.l.a.) theron. * u t: <I) "'~ .- '" "'~ <I)'" c<:<I) t: ",0 t:'::;: cd'O ~ .> ~o.. <1)'_ So (;j t: bO Ui ~-.----~-----~----_._-------------- ~Z-Q)~ ~n . D. Soutner -5~ogeRtown ROR~ _..Mechanicsburg-,-----PA-l.20 5 5 OATH OF PEUSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } ss COUNTY OF ()1TT1hprl rind 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 petitionel (s) will well and truly administer the estate according to law. Sworn to or affirmed and SUbscribed~ ~_ dnJ f9. d-7~ ~ before me this 19th day of -- ~ ovembe '~~ a . j.,U-'lV AU-1- _ M< l...~ ~ LeW1S ,r- Register; 'L / ~ /7-d;? -/0 ~o. 21-2001-1067 Estate of REBECCA M. DUNN , Deceased DECREE OF PROBATI~ AND C;RANT OF lJ~TTERS AND NOW November 21st, ~ 200l in consideration of the petition on the reverse side hereof, satisfactory proof having been presented bcf(>re me, IT IS DECREED that the instrument(s) dated March 6th, 1995 described therein be admitted to probate and filed of record as the last will of REBECCA M. DUNN and Letters TESTAMF.N1'ARY are hereby granted to MARIAN D. SOU'T'NF.R FEES Probate, Letters, Etc. ......... $ 40.00._ Short Certificates( 2) .......... $ 6.00 Renunciation ................ $ x-PAGES (1) $ 3.00 JCP TOTAL _ $ 5.00 Filed .~Wffil;:R .2J1?t,;2.QQl...S. .?4..~Q.. John M. Eakin 06351 A"/TOI{NEY (Sup. Cl. I.D. No.) 06351 Market Square Building ADDRESS Mech~~. PA 17055 PHONE (717) 766-3172 nc :D ,.. ..,- d = (1) ro ~ -"j - ?,',.. 0 0- ~, ",,", ~T:\ z ".~, f"'" 0 :::b <: ,'). ..... \.0 -0 W "T'I 0 )::. r"''''1 0 MAILED LETTERS ID ATI'ORNEY 21-2001-1067 REGISTER OF WILLS OF Cumberland COUNTY OATH OF SUBSCRIBING WITNESS Faye B. Herman and Grace L. Bohn ...codici t:: (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that they were present and saw Rebecca M. Dunn the testatt:ix , sign the same and that they signed as a witness at the request of test at rix in h...e.x._ presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me his 19th day of 2001 H ~~ 6 4t1--;~~ (Name) 55 Ashford Drive, En01a, PA ~Ad~~~ (Name) 57 Ashford Drive, Eno1a, PA (Address) REGISTER OF WILLS OF COUNTY OATH OF NON-SUBSCRIBING WITNESS (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that familiar with the signature of codicil will testat_ of (one of the subscribing witnesses to) the presented herewith and codicil believes the signature on the will is in the handwriting of that to the best of knowledge and belief. Sworn to or affirmed and subscribed before me this day of 19_ (Name) (Address) Register (Name) (Address) '__""".~"" ":'."-::,\T n:,Q.'~ .l'his is to certifY that the information here given is correctly copied from an original certificate of death dul~ filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filIng. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 p 7744663 No. 21-2001-1067 ~L~'~~ OCT 2 4 2001 Date '43 Rev. 2117 COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECOROS CERTIFICATE OF DEATH NAME OF DECEOENT Ih.. MIddle, L" .. Rebecca M. Dunn AGE(l"'1Iinr>doyl UNDER' YEAR - Ooro SEX 2. Female ':1. STAll F'lE NUMBf.R SOCIAl SECURITY NUMBER 2. 205 - 09 -9440 DAlE OF DEATH dt.torch. 0.). ..... .. October 2], 200] c-.ao (1.401S"'. 96 Y... ~ (CoIy aAd PlACE ~DERH~ aNy 0f\tI-- ...tntI'uct.oNonoehel ... _.. f~ C....." HOlIPlTAL; Marysville, Pa....-O E~ 0 7. i\C&Jf'Y NAME (It noI~. ON'* sit... and runoer,1 ::.v. 0 Did - .... -' 11...00 :-..-==.=.. Carli s 1 e UOTHER'S_IF.... _. _s.._ Maude Kitner S-...GAllIlAESSt5o'... ~ _. Z;PCodol 514 Ho estown Rd. Mechanicsbur Pa. 17050 PlACEOf'DISF'OSITlClN._"~er-y UlCRlON.~ _.Z;P~ .. 0IIl0r "'- 210. Rolling Green Mem. Park _ AND AllIlAESS Of' f",OCIUTY ~ichardson F.H. 29 S. LICENSE NUWllER COUNTY 01' DEATH Cumberland DECEDENT'S USUAl. OCCUMION ~.::::.:':a~=~:r 110. Housedut ies ItIl. DECEIlENTSMAlUNG_S8tslr_~. _Z;PCodol .442 Walnut Bottom Rd. I..Carlisle, Pa. 17013 l'oVlIER.S_IF.... _. LaIIl Ie. Arthur Kendig Manning INFOAMANT'S_(T~ Marian Soutner METHOOOI'llISPOSITION .....n ~O ___0 _0 0IIl0r~ '0. -.- 01' FUNEIIALSER , " DECEDENT'UDUCATIOH _DECEDENT EIlER.. U.S. ARUEDFORCES' ... 0 No Ql Pa. ~ "t'! .... Cumberland 200] .. (\~~" DUE lOtOA AS A CONSEOUENCE Of): I". c. . DUE 'IOtOA AS A CONSEOUENCE Of): DUE 10 lOR AS A CONSEOUENCE Of): WEREAU1OPSY~ _ROF DEATH -.ul8LE_1O COtoIPUmOH 01' CAUSE (!(' 0 OF DEATH? - - - 0 P--..... 0 ...0 No 0 - 0 Could noI be dlllimuned 0 ORE OF INJURY 1-. Day._1 _swus._ --.-. ~~ ,.. Widowed 1?c.O ....__.. - _. Allen Twp. Pa. Pa. ]7025 It. .- I ....... ......n : GnMI.-cI.... I l~ _.: CIlhor....-_--.IO_.... nol.........in..~C8UM giwninMRT t. TIIoIE OF INJURY INJURY III _, DESCRIBE HOW lNJURY OCCURRED. _ 0 NoD a. . ... PlACE Of INJURY. At home,...... ....... factory. office -_..- _. _. CERTIflEJlIChodo _..... .CI!IIJIII'nrIQ PHYSICIAN (Ph'fllC*' ctlf1IIyft)aused ~...." ~ ghY$IC..... has plOf"IOlInCed de.... NtOcampeted nem 23) ,........oe""ILnowIectge......IDCC1IrI'ed.........PVM(.).,.,IIMftMf'............................. ..................... _........... -PIIONOUNCINQ AND CERTIFYING PHYsactAH (Phys.cen bQtfl ;>>onounc.ng dHIh.,.... cef1lfyw1g 1oe.,.. 01 dNft"l~ To the ..... Of my kno..... de... occur,............. dale. And pIKe, end'" to the UUMC_) ....lMnnef.. ...tecI.. , . . . . . . . . . . . . .IIEIlICAL EllAIIlNERlCORONER On 11M .... oIeunNnetlon anellOI' Inv..ltgMion. in my opirUon. de"'" occurred -' the 111M. d.... and pIKe. and ""0 the cauM(a) and m..,.er...t.ted..... _............................................................. ....... .... .................... :11.. REGISTRAR'S SIGNATURE AND NUMBER I~ /I~/ ,/ I t)\.... LICENSE NUUBER D_JIo'l. 'joao'1 0~..""~()\~'J..'-I1' ~I 0(..\ -;.L."'.~' NAME AND ADDRESS OF PERSON WHO COUPLETED CAUSE OF DEATH (hem 27) T_.. Prinl t:I .n r'" - - '- t\t1:) btO Of) ~ \j' "'0 ""-~<."VV\-- o ~2. ~~() ~'t.I-,...,.\ ~tt~ {l...:\),t~... DATE FUO(MooIh. o.y, YaatJ 34. /"/%.~fi/ p~ 21-2001-1067 1ficl~Jt ~llJilI ctlt?J \Q}tgtCUtt~nt OF REBECCA M. DUNN I, REBECCA M. DUNN, of the Borough of Carlisle, County of Cumberland, and state of pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this my Last will and Testament. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. I direct that there shall be paid out of my residuary estate all estate, inheritance and like taxes together with any interest or penalty thereon imposed by the Government of the United states, or any state or territory thereof, or by any foreign . government or political subdivision thereof, in respect to all property required to be included in my gross estate for estate, inheritance or like tax purposes by any of such governments, whether the property passes under this will or otherwise. 3. I give, devise and. bequeath all the rest, residue and remainder of my estate, real, personal and mixed, as follows: - 1 - .. ~ A) One-fourth of the residue to my daughter, MARY JANE REINECKER. B) One-fourth of the residue to my daughter, MARIAN D. SOUTHER. C) One-fourth of the residue to my son, H. AUTHOR DUNN. D) One-fourth of the residue to the heirs of MELVIN L. DUNN, deceased, per stirpes. 4. Lastly, I nominate, consti tute and appoint my daughter, MARIAN D. SOUTHER, Executrix of this my Last will and Testament. I further direct that no bond or other security be required of my personal representative to guarantee faithful performance of her duties. IN WITNESS WHEREOF, I have hereunto set my hand and seal this t,'0. day of ))1au-l, , 1995. fd-e7 B ' (' . I -. It. ,Cc:# )17 . ~-"-,,,vl.-~(SEAL) , Rebecca M. Dunn Signed, sealed, published and declared by the above-named REBECCA M. DUNN as and for her Last will and Testament, in the presence of us who have subscribed our names hereto as witnesses, at her request, in her presence and in the presence of each other. .;};"L,y<- .(.) " lie '--Y?<4v-- 7:t'i .- :" '/ / L? ' " ./'/ l ,L... C (. 'A I " /./ ~.~.,,/.I iI-,,"')"~ t ~ 7'" """/' ).i-""'Vh p~ - 2 - f ,--- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Rebecca M. Dunn Date of Death: October 21, 2001 10(07 Will No. 1 082 ~I z.c.o I Admin. No. To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on December 14, 2001 Name Address Mary Jane Dunn Reinecker Rev. H. Arthur Dunn Leslie Dunn Essex Dr. Diane Dunn Homan RphpC'C';:l Dunn Zurawski 2466 Cranberry Road, York Springs, PA 17372 800 S. Market Street, Mechanicsburg,PA17055 232 Walnut Lane, Crown Point, IN 46307-3730 6536 Deer Lane, Palos Heights,IL 60463-2272 1106 A Street, LaPorte, IN 461,0 ",R Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None Date: Deep-mber lLf. 2001 Name John M. Eakin ...- "",.,,, if ...- ""- 'j N .-.-' 5: co ...- .." ;1'''''', "- " , c..J I, ~;) - '12 (j c:::l tD ~"",' f) ......' .0 u ...- ..... s:: Q) p (l) = a:: G U Address Market Square Building Mechanicsburg, PA 17055 Telephone(717) 766-3172 capacity: Personal Representative x Counsel for personal representative '\: r COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT EAKIN JOHN M MARKET SQUARE BUILDING MECHANICSBURG, PA 17055 -------- fold ESTATE INFORMATION: SSN: 205-09-9440 FILE NUMBER: 2101-1067 DECEDENT NAME: DUNN REBECCA M DATE OF PAYMENT: 03/19/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 10/21/2001 ACN ASSESSMENT CONTROL NUMBER 101 TOTAL AMOUNT PAID: REMARKS: MARIAN D SOUTNER C/O JOHN M EAKIN ESQUIRE CHECK#1756 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS REV-1162 EX(11-96) NO. CD 000973 MARY C. LEWIS REGISTER OF WILLS AMOUNT $153.22 $153.22 /? -c:J.:J - /CI ~ 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 REY-1547 EX AFP (01-021 - - FILE NUMBER 21 01-1067 M EAKiW Es'ijW 10 :1,4 COUNTY CUMBERLAND JOHN ACN 101 MARKET SQUARE BLDG I Anount Renitted I MECHANICSl!ij~G PA 17055 Cum 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=is4j-E3f-iF'P-('oY=02Y-No'TicE--oF-YNHEiiiTAifcE-'T-A'x-APPRA-isEMENT~--iiU;WAifcE-'ifi-------------- --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF DUNN REBECCA M FILE NO. 21 01-1067 ACN 101 DATE 05-06-2002 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) U) .00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) .00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 subnit the upper portion 4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this forn with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6.635.74 tax paynent. 6. Jointly Owned Property (Schedule F) (6) 872 . 04 7. Transfers (Schedule G) (7) .00 8. Total Assets (8) 7,507.78 APPROVED DEDUCTIONS AND EXEMPTIONS: 319.00 9. Funeral Expenses/Adn. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) UO) 3.783.85 11. Total Deductions Ul) 4.102 85 12. Net Value of Tax Return (2) 3,404.93 13. Charitable/Governnental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax (4) 3,404.93 NOTE: 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. Anount of Line 14 at Spousal rate (15) .00 X 00 = .00 16. Anount of Line 14 taxable at Lineal/Class A rate (6) 3,404.93 X 045 = 153.22 17. Anount of Line 14 at Sibling rate (7) .00 X 12 = .00 18. Anount of Line 14 taxable at Collateral/Class B rate (8) .00 X 15 = .00 19. Principal Tax Due (19)= 153.22 TAX CREDITS: ~..._... (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03 19 2002 CDoo0973 .00 153.22 TOTAL TAX CREDIT 153.22 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 PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) DATE 05-06-2002 ESTATE OF DUNN DATE OF DEATH 10 21 2001 REBECCA M ~ 0Jjo~ STATUS REPORT UNDER RULE 6.12 Name of Decedent: Rebecca M. Dunn Date of Death: October 21, 2001 Will No.: 21-01-1067 Admin. No.: 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. 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 rn 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 ill 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. t;;.. ~ Date: Si~ John M. Eakin Name Market Square Building, Mechanicsburg, PA 17055 Address (717) 766-3172 Telephone No. Capacity: 0 Personal Representative flU Counsel for personal representative REV.1500 EX (1}-001 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 'r~n;' ~ I"'~,~ R , +:"1',;-, fW; INHERITANCE TAX RETURN RESIDENT DECEDENT t- Z W o w o w o DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) (//' OFflr-fAL t 'SF ONLY /7-d~ -/0 FilE NUMBER ~-L-~L COUNTY CODE YEAR _-L~~ NUMBER Dunn DATE OF DEATH (MM-DD-YEAR) Rebecca M. DATE OF BIRTH (MM-DD-YEAR) 7 21 Oct. 01 13 Dec. 04 -------- ---_._----~_._--- (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) W I- ~~l/) UO::~ wD..U :1:00 uO::..J D..lll D.. <( ~ 1. Original Return D 4. Limited Estate ~ 6. Decedent Died Testate (Allaoll copy of Willi D 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (dale aldealh aller 1212.82) o 7 Decedent Maintained a Living Trust (Allaeh copy or TrLlst) D 10. Spousal Poverty Credit (date or dealh between 12.31.91 and 1.1.95) SOCIAL SECURITY NUMBER 2~5 09 Q440 THIS RETURN MUST BE FILED IN DUPLICATE WITH THF REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Return (dale of death prior to 12-13.82) D 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Allaeh Sctl 01 I- Z W o z o D.. l/) W 0:: 0:: o U THIS SEctiON Most BE COMPLI:1ED. ALL CORRESPONbl: CE ANI) CONJ:ID N l.{ ~ . 0 NAME COMPLETE MAILING ADDRESS _______JQJm__M......._E.akinn____~_____________ Market Square Building FIRM NAME (II Applicable) John M. Eakin, ESQ. Mechanicsburg, PA 17055 TELEPHONE NUMBER 717 766 3172 ~\.,~ ,... . ::.;; (i" ~ l"'T" OFFICtii USE ONI.Y "r ,'''r 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1) (2) (3) (4) (5) 6635.74 (6) 8 72 . 04 (7) .0 N ':0 (8) $7.507.78 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Noles Receivable (Schedule D) z o ~ ::J t- o: <t o w 0:: 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus tine 11) (9) (10) 319.00 3783.85 (11) (12) (13) ur10? R" 3;404.93 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ ~ ::J D. :e o o g 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0_ (15) x.O 4.5 (16) (14) 3.404.93 16. Amount of Line 14 taxable at lineal rate 3,404.93 153.22 (19) 1"1 ?? 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT QU REV.I508 EX '(1.971 ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FilE NUMBER R~becca M. Dunn 21-01-1067 Include the prf)ceeds of litigiltion and the date the proceeds were received by Ihe estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. VALUE AT DATE OF DEATH ITEM NUMBER 1. 2. 3. DESCRIPT ION Merrill Lynch, Account 872-47474 See attached 6,310.12 MertillLynbh Dividend 8.72 BlueGrass Refund 316.90 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 6,635.74 Men;II Lync/J, Pierce, Fenner & SI,,;tl, Inc. Mplllber Seruril;es IlIveslcJI I'rotectic'rl Corporation (SH'e) Individual Investor Account - . .~ -. ,- ~"-"'" .-- ACCOUNT UIF/C U IPAGE U TELEPHONE U 812 41474 8167 1 717-975-4600 STATEMENT PERIOD SS OR ID 09/29/01 TO 10/26/01 205-09-9440 FINANCIAL CONSULTANT INVESTOR BRINDLE/WERTZ TEAM CREDIT LINE OFFICE SERVING YOUR ACCOUNT TYPE 214 SENATE AVE, STE 501 CAMP HILL PA 17011 CASH MS REBECCA M DUNN 514 HOGESTOWN RD MECHANICSBURG PA 17050-2610 ***** ACCOUNT SUMMARY ***** OPENING BALANCE CLOSING BALANCE $.00 $.00 I NVESH1ENTS $0 MONEY ACCOUNTS PRICED PORTFOLIO $.00 $.00 ***** MONEY ACCOUNTS SUMMARY ***** MONEY ACCOUNT OPENING BALANCE CLOSING BALANCE DIVIDEND/INTEREST THIS STMT. YEAR TO DATE MERRILL LYNCH READY ASSETS ***** DATE TRANSACTION 10 16 Sale 10 17 Dividend 10 19 Withdrawal 10 26 Check 10 26 CLOSING BALANCE $6,310.12 DAILY ACCOUNT ACTIVITY $.00 $8.72 $394.02 ***** DESCRIPTION AMOUNT 6310 ML READY ASSETS TRUST FULL LIQUIDATION FRAC SELL .12 @ 1.00 ML READY ASSETS TRUST CK R 00872-08760 MONTHLY AMT ISSUED $6310.12CR $8.72CR $6310.12 $8.72 $.00 CHECK YOUR ACCOUNT ANYTIMEI ENROLL IN MERRILL LYNCH ONLINE(SM) AT WWW.MLOL.ML.COM. -000016371 END OF STATEMENT OCTOBER 2001 rOR AN EXPl.ANII TfON OF SI'MBOI S, PLEASE SEE REVERSE SIDE PLEASE. !\!lV1Sf 1'01.'11 n~J'l,rH'I^1 .!\r"/IS0P 1"~'An'I,\lFLl' Dr AliI' l1I~r.mT^rJ(:lrS or~ '1(.11111 8IAIEt"OJT on Ir '((lU GONlf':MrLATF. CH/ltJGINGfO'.lR AODRI:SS WHrN ""-'I;1I-J<1 11'()IJlf1IlS, r'L[,\~[ ML'1l t'HI '(l''1P I\C':'.'IJIJl tjIH.'lnr Il Mln ,',I'I'1IF ~~~ .'d,l (,C)fHH '-',r'''llr''rI/:f' f") TlIr ',f niT r:rn'iI'~lrJr, y'" In^,c<;r''1llf '.VI PI";' y(lfl \c' i pr<TI".'[" 111"'. :',1' Ir~.~rl,11 + "'"." III r'nl r',~r!I'."~ Irl'.I",'[ If,\ 1"'II'f"I'.; ~ Merrill Lynch CODF'iO~5 n (nn 01) ~-. ~-- REV-1509 EX. (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rebecca M. Dunn SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 21-01-1067 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 RELATIONSHIP TO DECEDENT A. Marian D. Soutner B. c. . I . AD.DRESS ,~~......... 514 ~n Rd Mechanicsburg, PA Daughter JOINTLY -OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number Attach DATE OF DEATH DECO'S V AWE OF NUMBER TENANT JOINT deed for joinlly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 2/1/70 PNC Bank Account 51-4011-4125 1,744.08 50 872.04 ~ TOTAL (Also enter on line 6, Recapitulation) $ 872.04 -- (If more space is needed, insert 8dditional sheets of the same size) COHHONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 *' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 01-1067 ACN 02100321 DATE 01-15-2002 REV-15~5 EX AFP [09-00) EST. OF REBECCA M DUNN S.S. NO. 205-09-9440 DATE OF DEATH 10-21-2001 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS [Xl CHECKING o TRUST D CERTIF . MARIAN D SOUTNER 514 HOGESTOWN RD MECHANICS BURG PA 17050 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PNC BANK 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 Pennsylveni~. Questions msy be enswered by calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 5140114125 Date 02-01-1970 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x I 1,744.08 50.000 872 .04 .15 130.81 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 57. discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax PART [!] [CHECK ] ONE BLOCK ONLY A. [] 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 interest, or you may check box nAn 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. PART [!J DATE PAID DEBTS AND DEDUCTIONS CLAIMED If you indicate a different tax rate, please state your relationship to decedent: PART [3J 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 d I TOTAL (Enter on Line 5 .' .... I $ of Tax Computation) Un~er 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 ( TFfEPHONE ) ) NUMBER DATE TAXPAYER SIGNATURE REV-1511 EX, (1299) ~~i~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Rebecca M. Dunn 21-01-1067 Debts 01 decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City ______________________ __ __ _ _________ State ____ Zip Year(s) Commission Paid: 2. Attorney Fees 200.00 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 54.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Filing Fees 15.00 8. Reserved for cost of release and filing 50.00 TOTAL (Also enter on line 9, Recapitulation) $ 119.00 (If more Sp8cn is needed, insert additional sheets of the same size) REV.15'2EX + 11-97) ~ *k COMMOljWEMJ 1\ or P[NNS~LV^NI^ INHERlfANCE TAX r<ETUr<N _______5h~~~~~~.ci~~_ . . .- ESTATE OF Rebecca M. Dunn SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Thornwald Home, Balance flue for nursing home care 2. Pharmerica, Prescriptions 3. Paul M. Dalby, DPM, Medical Bill 4. Sympheny Mabilex, X-rays 21-01-1067 AMOUNT 3,645.44 40.55 30.00 67.82 TOTAL (Also enter on line 10, Recapitulation) $ ----_.-~-~ (If more spaCE is needed, inserl additional sheels of the salTle size) 3 783 _.JiL-- REV-1513 EX . (1-97) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rebecca M. Dunn FILE NUMBER 21-01-1067 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE 1. Mary Jane Reinecker 2466 Branberry Rd. York Springs, PA Daughter 1/4 Residue 2. Marian D. SoutnQr 514 Hogestown Rd. Mechanicsburg, PA Daughter 1/4 Residue 3. H. Arthur Dunn 800 S. Market St. Mechanicsburg, PA Son 1/4 Residue 4. Leslie D. Essex 232 Walnut Lane Crown Point, Indiana Granddaughter 1/12 Residue 5. Diane D. Homan 6536 Deer Lane Palor Heights, Illinois Granddaughter 1/12 Residue 6. Rebecca D. Zurawski Granddaughter 1/12 Residue 1106 A Street, LePorte, Indiana ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II. 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) '~ (Ifr~NJJt 2Jli1iII N-1tO 'Q}.efftCllttfttt OF REBECCA M. DUNN I, REBECCA M. DUNN, of the Borough of Carlisle, County of Cumberland, and state of Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this my Last Will and Testament. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. I direct that there shall be paid out of my residuary estate all estate, inheritance and like taxes together with any interest or penalty thereon imposed by the Government of the United states, or any state or territory thereof, or by any foreign government or poli tical subdivision thereof, in respect to all property required to be included in my gross estate for estate, inher i tance or I ike tax purposes by any of such governments, whether the property passes under this will or otherwise. 3. I give, devise and. bequeath all the rest, residue and remainder of my estate, real, personal and mixed, as follows: - 1 - ..!~ - . ..~ "J . _' .j'''' ...._~ \-, '''~ . , A) One-fourth of the residue to my daughter, MARY JANE REINECKER. B) One-fourth of the residue to my daughter, MARIAN D. SOUTHER. C) One-fourth of the residue to my son, H. AUTHUR DUNN. D) One-fourth of the residue to the heirs of MELVIN L. DUNN, deceased, per stirpes. 4 . Lastly, I nominate, constitute and appoint my daughter, MARIAN D. SOUTNER, Executrix of this my Last will and Testament. I further direct that no bond or other security be required of my personal representative to guarantee faithful performance of her duties. IN WITNESS WHEREOF, I / t:/l \- v> - day of 1)){lU{ , have hereunto set my hand and seal this 1995. ,) /7 ~) ILi.t'f,C-:~t;;; )J/ U /L,(J-.,(....-t.'-CSEAL) " Rebecca M. Dunn Signed, sealed, published and declared by the above-named REBECCA M. DUNN as and for her Last Will and Testament, in the presence of us who have subscribed our names hereto as witnesses, at her request, in her presence and in the presence of each other. .;J , . . >'<- ,) lie t.,..,.' 'Jt-t' f...- ( / ,/ l ,<. C l., 'J .' ",)f _,_" ' /"-c..' " r'-/ i..'w,\..--" - 2 - _' ~ !:'.,\~,..,"~;'/ ,~.~;l:' ~"')'-:'~ ;r.n:/~~,~;j-;.'!'hf"'l",f~';;:!;' ...;.~'~~~,,\:>:. /,~ . ~' _ - ~ . . .