HomeMy WebLinkAbout01-1068
Estate of MHo T1RF.T1 r. _ MYF. R!=:
also known as
PETITION FOR PROBATE and GRANT OF LETTERS
J.J-O / - 'OlD g
No,
To:
Register of Wills for the
, Deceased. County of CTTMBE'RT A~n in the
Social Security No. 206 - 36- 315 2 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 r ix
last will of the above decedent, dated A pr ill t) ,
named Executrix in the Codicil dated
?OOl
nf t-hp
, 19.9..9..-
A 11 g11 S t 3 1 .
and
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Cumberland County, Pennsylvania, with
h er last family or principal residence at 801 16th Street
Borouqh of New Cumberland
(list street, number and muncipality)
Decendent, then 93 years of age, died November 9, 2001
U Hnly !=:pirit Hn~pjtAl
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 $ 1, 126 , 000 . 00
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personalproperty in County $
Value of real estate in PeIl11s)iIvania $ 115 , 000 . 00
situated as fQllows:
~01 16th Street, Borough of New Cumberland
Cumberland County, PA
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters 'T'P!O: t- rlmpn h:l ry
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
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Marcia Myers v'-J
15 Ardmore Circle
New Cumberland, PA 17070
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 1- 8M
COUNTY OF CUMBERLAND J ~
Sworn to or affirmed and
before me this 20th
Nov
The petitioner(s) above-named swear(~) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
~&.~- ~~
Marcia Myers
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No.
21-2001-1068
Estate of
MILDRED C. MYERS
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW November 27 , }001 , in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
ITISDECREEDthattheinstrument(s)dated April 15, 1999 and Auqust 31, 2001
described therein be admitted to probate and filed of record as the last will of and Cod ic il
Mildred C. Myers
and Letters Testamentary
are hereby granted to Marc ia Myers
Mary C.
A. Johnson (06340)
Duffie, Stewart & Weidner
. FEES
Probate, Letters, Etc. ......... $ 865.00
Short Certificates( 5) . . . . . . . . .. $ 15.00
Renunciation ................ $
Codicil $ 10.50
x-Pages T~ $ 39.00
JCP ---- ~.uu
Filed . Novanber. 27,20.01..............
$ 934 . 50
109
ADDRESS
(717) 761-4540
PHONE
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MAILED LETTERS 10 AT'IORNEY HORACE A JOHNSON
HAJ/PAR/April12, 1999/14741-(4)
lo
21-2001-1068
mast mill Anb mtstamtnt (@f
OF
MILDRED c. MYERS
I, MILDRED c. MYERS, of the Borough of New Cumberland, Cumberland
County, Pennsylvania, make, publish and declare this to be my Last Will and
Testament, hereby revoking and making void any and all previous Wills or Codicils
made by me.
ARTICLE I
I direct that all my legal debts and funeral expenses be paid and satisfied by my
Executor hereinafter named, as soon after my death as may be found convenient.
ARTICLE II
Except for those items set forth in a Letter of Instruction referred to below, I
bequeath my automobiles, household and personal effects, jewelry, and other tangible
property of like nature, not including cash and securities, to my grandchildren,
KRISTIN MYERS and JENNIFER MYERS, or the survivor thereof, to be divided
between them by my Executor with due regard for their personal preferences, in as
nearly equal shares as practical, provided however, my Executor may in my Executor's
sole discretion sell any item which neither grandchild wants, or both want, or my
Executor decides is not in the best interest of either grandchild to have.
HAJ/PAR/Apri112, 1999/14741-(4)
~
Notwithstanding any other provision in this Article II, I may leave a separate dated
and unsigned Letter of Instruction, which I shall place with my Will containing
directions as to the ultimate disposition of certain of the property bequeathed under this
Article II; such Letter of Instruction shall determine the distribution of such items.
ARTICLE III
I make the following pecuniary bequests:
A. One Thousand ($1,000.00) Dollars to my nephew, JOHN ADAIR, of
Loysville, Pennsylvania.
B. One thousand ($1,000.00) Dollars to CHARLOTTE and FRANK
HORTON, of 926 16th Street, New Cumberland, Pennsylvania, or to the
survivor thereof.
C. One Thousand ($1,000.00) Dollars to MARY MARGARET KULBOK,
of Walpole, Massachusetts.
D. Two Thousand Five Hundred ($2,500.00) Dollars to JOHN TUCKER, of
Naples, Florida.
E.
One Thousand ($1,000.00) Dollars to MARCIA MYERS.
----
\
,
2
HAJ/PAR/April12, 1999/14741-(4)
'.
ARTICLE IV
I give, devise and bequeath one-half (1/2) of the rest, residue and remainder of my
estate of every nature and wherever situate to the Trustee hereinafter named, TO THE
KRISTIN MYERS TRUST, IN TRUST, for the benefit of my granddaughter,
KRISTIN MYERS and one-half (1/2) of the rest, residue and remainder of my estate to
said Trustee, TO THE JENNIFER MYERS TRUST, IN TRUST, for my
granddaughter, JENNIFER MYERS, in accordance with the following provisions:
A. In each Trust, the Trustee shall accumulate the net income and expend and
apply so much of the net income, accumulated income, and principal of the
Trust as Trustee in its sole discretion deems advisable for the support and
education (including college education, both graduate and undergraduate) of
each child after taking into consideration said child's other readily available
assets and sources of income until the termination of the Trust as
hereinafter provided.
B. If a beneficiary of her Trust has a bachelor of science degree, a liberal arts
degree or some other degree from an accredited educational institution and
has attained the age of at least thirty (30) years, the Trustee shall distribute
one-half (1/2) of principal of said Trust to said beneficiary. The Trustee
shall in its sole discretion determine whether the educational institution
awarding the degree is an accredited one.
C. When KRISTIN MYERS attains the age thirty-five (35) years, the Trustee
3
HAJ/PAR/AprilI2, 1999/14741-(4)
shall terminate her Trust and distribute the income and principal in the
KRISTIN MYERS Trust to KRISTIN MYERS.
D. When JENNIFER MYERS attains the age thirty-five (35) years, the
Trustee shall terminate her Trust and distribute the income and principal in
the JENNIFER MYERS Trust to JENNIFER.
E. Should the balance of principal at any time in a Trust created pursuant
hereto be Ten Thousand ($10,000.00) Dollars or less, the Trustee in its
discretion may terminate said Trust and make distribution to the
beneficiary .
F. Should a beneficiary of her Trust die during the term of her Trust and be
survived by issue, the Trustee shall terminate her Trust and distribute the
income and principal in said Trust to said issue, per stirpes.
G. Should a beneficiary of her Trust die during the term of the Trust and not
be survived by issue, but be survived by a sister, then the income and
principal in the deceased beneficiary I s Trust shall be added to her sister's
Trust created under this Article IV; if no such Trust then exists, said
income and principal shall be distributed to the surviving sister. Should a
beneficiary of her Trust die during the term of her Trust and not be
survived by issue, nor by a sister, if said sister has surviving issue, the
income and principal of the deceased beneficiary's Trust shall be distributed
4
HAJ/PARlApri112, 1999/14741-(4)
to said issue, otherwise it shall be distributed to said deceased's
beneficiaries I estate.
H. No beneficiary shall have the power to anticipate, encumber or transfer his
interest in any Trust in any manner. No part of any Trust shall be liable for
or charged with any debts, contracts, liabilities or torts of a beneficiary or
subject to seizure or other process by any creditor of a beneficiary.
ARTICLE V
I devise and bequeath all property over which I have a power of appointment,
including the property subject to power of appointment given to me in the Will of my
deceased husband, JACOB M. MYERS, and all Codicils thereto, to my Trustee to be
disposed of in accordance with the provisions of Item IV hereof.
ARTICLE VI
All federal, state and other taxes payable because of my death, 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 in connection with such tax, shall be
considered a part of the expense of the administration of my estate and shall be paid from
my residuary estate without apportionment or right of reimbursement. All such taxes on
present or future interest shall be paid at such time or times as my Executor or Trustee
may think proper, regardless of whether such taxes are then due.
5
HAJ/PAR/April12, 1999/14741-(4)
ARTICLE VII
I appoint ROBERT SLENCAK, Executor and my daughter-in-law, MARCIA
MYERS, Co-Executrix, of this my Last Will (hereinafter collectively referred to as
Executor). Should one fail to qualify or cease to act as Executor, the other shall act as
my Executor. Should both fail to qualify or cease to act as Executor, I appoint
FARMERS TRUST COMPANY, of Carlisle, Pennsylvania, as Executor of this my
Last Will.
ARTICLE VIII
I appoint FARMERS TRUST COMPANY, of Carlisle, Pennsylvania, as Trustee
of any Trust or Trusts created pursuant to this Will. If my Trustee determines that the
assets in any Trust make it impractical to continue to hold the assets in Trust, the Trustee
may distribute the Trust assets to those who are then allowed distribution of income.
ARTICLE IX
In the event any of my property should pass, either under this Will or otherwise,
to KRISTIN MYERS or JENNIFER MYERS, who at the time for distribution are
minors, I appoint ROBERT SLENCAK Guardian of any such property with respect to
which I am authorized to appoint a Guardian and have not otherwise specifically done so.
Said Guardian shall have the power to use principal as well as income from time to time
for the minor's support and education (including college education, both graduate and
undergraduate) without regard to their parents' ability to provide for such support and
6
HAJ/PAR/April12, 1999/14741-(4)
education, or to make payment for these purposes, without further responsibility, to the
minor. I authorize said Guardian to hold any specifically devised property to which said
minor may be entitled until said minor attains the age of eighteen (18) years, or to
distribute the property to the minor's parent or person taking care of the minor or to hold
for the minor until she attains the age of eighteen (18) years, or deliver it to the minor in
his discretion.
ARTICLE X
I authorize my Executor, in my Executor's sole discretion, to distribute any
property specifically given to a minor to hold same until said minor attains the age of
eighteen (18) years, or to distribute the property to the minor's parent or person taking
care of the minor or deliver it to the minor.
ARTICLE XI
I direct that my Executor, Trustee and Guardian shall not be required to give bond
for the faithful performance of their duties in any jurisdiction.
ARTICLE XII
All fiduciaries acting under this Will, whether or not named herein, shall have the
following powers, applicable to all property held by them, effective without court order
and until actual distribution:
7
HAJ/PAR/April12, 1999/14741-(4)
A. To retain any or all of the assets of my estate, real or personal, without
regard to any principal of diversification or risk;
B. To sell at public or private sale, to exchange, or to lease for any period of
time, any real or personal property, and to give options for sales,
exchanges, or leases, for such prices and upon such terms or conditions as
they deem proper;
C. To invest in all forms of property (including stock, common trust funds and
mortgage investment funds whether maintained by my corporate fiduciary
or others) without restriction to investments authorized for Pennsylvania
fiduciaries, as they deem proper without regard to any principal or
diversification or risk;
D. To make distribution in cash or kind, or partly in cash and partly in kind,
and in such manner as they may determine, and at valuations finally to be
fixed by them;
E. To allocate receipts and expenses to principal and income or partly to each
as they from time to time deem proper in their sole discretion;
F. To compromise any claim or controversy;
G. To borrow money from any person or institution, and to mortgage or
8
HAJ/PARJApril12, 1999/14741-(4)
pledge any or all real or personal property as they in their sole discretion
shall choose, without regard for the dispositive provisions of this interest;
H. To employ legal counsel, brokers, custodians, accountants, investment
counsel and other agents to act in their behalf, and to delegate to such
agents discretionary powers and to compensate them for their services;
I. To include taxable items and items of deductions and returns for their
income tax purposes or purposes of any other tax in such manner and
proportion as they in their absolute discretion may deem advisable from the
standpoint of my entire estate and the situation of my beneficiaries without
the necessity of making any adjustments or apportionments among my
beneficiaries or between principal and income.
IN WITNESS WHEREOF,
/5 day of ~
I have hereunto set my hand and seal, this
,1999.
~}lijm 4 h1'f.e-r.s (SEAL)
Lb C. MYERS
Signed, sealed, published and declared by the above-named Testatrix, as and for
her Last Will and Testament, in the presence of us who at request, in her presence
and in the presence of each other, have here
9
.
I.HAJ/PARlAPril12, 1999114741-(4)
~
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
: ss:
COUNTY OF CUMBERLAND
We, MILDRED C. MYERS, ~,_'-'-"- ~.~ ' and
~Y"' L .~ ' the Testatrix and the esses, respectively, whose
na are signed the attached or foregoing instrument, being first duly sworn, do
hereby declare to the undersigned authority that the Testatrix signed and executed the
instrument as her Last Will and that 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
witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and
that to the best of his/her knowledge the Testatrix was at that time eighteen years of age
or older, of sound mind and under no constraint or undue influence.
Subscribed, sworn to and acknowledged before me by MILDRED C. MYERS,
Testatrix, and subscribed and sworn to before me by \~ ~ ~...........
and ~ -c . ~ ,witnesses, this k~ . day of
()v.. . , 1999.
.~~~
Notary Public ~
My Commission Expires:
10
NOTARIAL SEAL
DIANNE LENIG, Notary Public
Lemoyne Borough Cumberland Co.
My Commission Expires Dec. 21, 2001
,MAJ/RJM/August 15, 2001/149074
, .
21-2001-1068
<!tnbieil tn
iJast Dlilll\nb Wtstamtnt
OF
MILDRED C. MYERS
I, MILDRED C. MYERS, of Cumberland County, Pennsylvania, declare this to
be the sole Codicil to my Last Will and Testament dated April 15, 1999.
ITEM I
I hereby revoke Article III of my Last Will and Testament and in lieu thereof
provide as follows: /
I make the following pecuniary bequests:
A. Ten Thousand Dollars ($10,000.00) to ROBERT SLENCAK
B. Two Thousand Five Hundred Dollars ($2,500.00) to JOHN TUCKER, of
Naples, Florida.
C. One Thousand Dollars ($1,000.00) to MARCIA MYERS.
D. One Thousand Dollars ($1,000.00) to my nephew, JOHN ADAIR, of
Loysville, Pennsylvania.
~1\J/RJM/August 15, 2001/149074
E. One Thousand Dollars ($1,000.00) to MARY MARGARET KULBOK,
of Walpole, Massachusetts.
ITEM II
I hereby revoke Article VII of my Last Will and Testament and in lieu thereof
provide as follows:
ARTICLE VII
I appoint my daughter-in-law, MARCIA MYERS, Executrix of this my Last Will
and Testament. Should she fail to qualify or cease to act as Executrix, I appoint M & T
Bank of West High Street, Carlisle, Pennsylvania, as Executor of this, my Last Will
and Testament.
ITEM III
Wherever in my Last Will the words "Farmers Trust Company" appear, said
words are changed to read, "M & T Bank. "
IN WITNESS WHEREOF, I have hereunto set my hand and seal, this
oJ~ day of ot
~~~s
(SEAL)
MILDRED C. MYERS
2
~t\J/RJM/August 15, 2001/149074
Signed, sealed, published and declared by the above-named Mildred C. Myers, as
and for her Sole Codicil to her Last Will and Testament dated April 15, 1999, in the
presence of us, who at her request, in her presence a the
have hereunto subscribed our names as witnesses.
3
It~J/RJM/August 15, 2001/149074
. .
. .
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
: ss:
COUNTY OF CUMBERLAND
We, MILDRED C. MYERS, ~ ~. ~~ , and
~'Jv....\v.......... Q ~ '- A.\. /> :. I ~. the Testatrix and the wit ses, respectively, whose
names are signed the attache~ foregoing instrument, being fIrst duly sworn, do
hereby declare to the undersigned authority that the Testatrix signed and executed the
instrument as a sole Codicil to her Last Will and 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 witnesses, in the presence and hearing of the Testatrix, signed the sole Codicil
to her Will as witness and that to the best of his/her knowledge the Testatrix was at that
time eighteen years of age or older, of sound mind and under no constraint or undue
influence.
~
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4
~A'J/RJM/August 15, 2001/149074
.' .
. ,
. .
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Subscribed, sworn to and acknowledged before me by MILDRED C. MYERS,
Testatrix, and subscribed and sworn ~o before me.by \~.~ _....... -Q.~
and VY\ ~ \^ ~ .. Q ~ ~ t.\. AA A ~. ....€;" wItnesses, thIS 1:. \ day of
~ ~. ,2001.
~~~.
Notary Public ' "~~...
My Commission Expires:
NOTARIAL SEAL
DIANNE LENIG, Notary Public
Lemoyne Borough Cumberland Co.
My Commission Expires Dec. 21, 2001
5
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This is to certify that the information here given is correctly copied fro~ an original certificate of death dul~ filed with
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent fihng.
me as
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
2_
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Fee for this certificate, $2.00
p
7746060
NOv 1;2 200t
Date
21-2001-1068
; 4J Rev. 2187
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
STA1EFIlE~
NAME Of DECEDENT (FIfSl. Middle. l_1
.~i1dred
Carrie
Myers
1~male
..
SOCZ-~6URITY NUjgER
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3152
DAlE OF DEATH ,McnIh. 0..,. ......J
.. NOIIIl........bll..... 9. "2..oc l
AGE (l"'1IWNoy1
UNDeR . YEAR
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8IRTHPl.ACE (Coty and
s.. or Fcre.gn Cl:U\Ify)
PlACE <Y DEATH fChed& any Qt\e 'iCM.nsuucLoot on ~ ...
HOSPITAL,
......... 0 llOA 0
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93 v...
COUNTY OF DEAl"H
Cumberland
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SURVIVING SPOUSE
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801 16th Street
.Iew Cumberland. PA 17070
FAn!iR'S NAMt;,(Firlt.~. lalli
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INFORMANT'S NAME (T-""",,
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Cumberland 17..lJ ~-==::.. New Cumberland
MOTHE~~I;:!(F"t._._Su<"""'. Gutshall
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METHOD OF DISPOSITION ~
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LOCR1ON.C~. _, Zip~
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DATE PRONOuNCED DEAD 1_. Day. IN'.
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.MEDlCAl EXAMINER/CORONER
On the b.... of .xamination and/or inv..llgation. in my opinion. d.ath occuRed at the lima, data. and place, and due to Ihe ClUNe.. and
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REGIST
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TO Register of Wills Office FROM
Cumberland County Courthouse JOHNSON, DUFFIE, STEWART & WEIDNER
1 Courthouse Square Attorneys at Law
Carlisle, PA 17013-3387 P.O. Box 109
Lemoyne, PA 17043
(717) 761-4540
SUBJECT: Estate of Mildred C. Myers DATE: February 5,2002
No. 21-01-1068
Enclosed is a check in the amount of $52,000.00 as a payment on account of Inheritance
Tax for the above-captioned Estate, being made within the 90 days to allow for the 5% discount.
SIGNED: Horace A. Johnson csh
LAW OFFICES
JOHNSON, DUFFIE, STEWART S WEIDNER
301 MARKET STREET
P. O. BOX 109
LEMOYNE, PENNSYLVANIA 17043-0109
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CUMBERLAND COUNTY COURTHOUSE
1 COURTHOUSE SQUARE
CARLISLE, PA 17013-3387
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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
JOHNSON HORACE A
3RD & MARKET STREETS
P. O. BOX 109
LEMOYNE, PA 17043
____un fold
ESTATE INFORMATION: SSN: 206-36-3152
FILE NUMBER: 2101-1068
DECEDENT NAME: MYERS MILDRED C
DATE OF PAYMENT: 02/06/2002
POSTMARK DATE: 02/05/2002
COUNTY: CUMBERLAND
DATE OF DEATH: 11/09/2001
REMARKS: MARCIA MYERS
C/O HORACE A JOHNSON
CHECK# 1013
SEAL
ACN
ASSESSMENT
CONTROL
NUMBER
101
TOTAL AMOUNT PAID:
INITIALS: DO
RECEIVED BY:
REGISTER OF WILLS
REV-1162 EX(11-961
NO. CD 000833
AMOUNT
--------
I $52,000.00
I
I
I
I
I
I
I ,
I
$52,000.00
MARY C. LEWIS
REGISTER OF WILLS
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: MILDRED C. MYERS
Date of Death: November 9,2001
Will No.: 21-01-01068
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
~3jt7cL
Name
Jane F. Burke, Trust Officer
M & T Trust Company
Robert Slencak
John Tucker
Marcia Myers
John Adair
Mary Margaret Kulbok
Kristin Myers
Jennifer Myers
Address
1415 Ritner Highway, P. O. Box 220
Carlisle, PA 17013
801 16 St., New Cumberland, PA 17070
601 93r St, N., N. Naples, FL 34108
15 Ardmore Cr., New Cumberland, PA 17070
R. D. #1 Box 312, Blain, PA 17006
214 Fisher St., Walpole, MA 02081-3909
15 Ardmore Cr., New Cumberland, PA 17070
15 Ardmore Cr., New Cumberland, PA 17070
Notice has now been given to all persons entitled thereto under Rule 5.
Date: #....s~ 2-
Si
N m
Johns n, uffie, Stewart & Weidner
Add~ s : 301 Market St.
P. O. Box 109
Lemoyne, PA 17043-0109
hone: (717) 761-4540
Capacity: Personal Representative
X Counsel for personal representative
r
TO Register of Wills Office
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013-3387
FROM
JOHNSON, DUFFIE, STEWART & WEIDNER
Attorneys at Law
P.O. Box 109
Lemoyne, PA 17043
(717) 761-4540
DATE: August 5,2002
SUBJECT:
Estate of Mildre dC. Myers
No. 21-01-01068
Enclosed for filing in the above-captioned Estate are the following:
1. Original Inventory.
2. Original and copy of Inheritance Tax Return.
3. Copy of Form 706 - Federal Estate Tax Return.
4. Check in the amount of $28.00, filing charges.
5. Check in the amount of $3,563.90, Inheritance Tax.
SIGNED: Horace A. Johnson
"
tfNSON, DUFFIE, STEWART Be WEIDNER
ATTORNEYS AT LAW
301 MARKET STREET
p, O. BOX 109
LEMOYNE. PENNSYLVANIA 17043
;- -.;
csh
"'
; ../
First Class '"
RR~TQ~~D n~ ~~~__ __
..
Register of Wills of
CUMBERLAND
County, Pennsylvania
INVENTORY
Estate of MILDRED E. MYERS
Also known as
,Deceased
No. 21-01-01068
Date of Death: November 9. 2001
Social Security No. 206-36-3152
I. Marcia Myers
Personal Representative(s) of the above Estate. deceased, verify that the items appearing in the following inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the
valuation place opposite each item of said Inventory represent its fair value as of the date of the Decedent's death, and that
Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end
of this Inventory. l!We verify that the statements made in this Inventory are true and correct. l!We understand that false statements
herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of
Attorney:
Personal Representative:
Horace A. Johnson
I.D. No.:
06340
Address:
15 Ardmore Circle
Address:Johnson. Duffie. Stewart & Weidner
New Cumberland. PA 17070
301 Market Street. P.O. Box 109
Telephone: 717/774-3336
Lemovne. PA 17043
Telephone: (717) 761-4540
Dated:
?-~-6~
Description
1. Real Estate - 801 16th Street, Borough of
New Cumberland, Cumberland County, PA
(Deed Book
Appraised Value - Copy of Appraisal attached
Value
2. Household Goods - Appraised Value
$138,500.00
5,775.00
5,630.00
3. 1996 Buick Century - Date of death value
4. Allfirst Bank - Checking Account No. 00288-5400-4
Date of death balance, plus accrued interest
., .
.,.
11,192.28
5. Allfirst Bank - Money Fund Account No. 00982-9295-1
Date of death balance, plus accrued interest
,
1- iO ~
70.
18,313.74
(See Continuation Page(s) attached)
.. J
6. 4,251.985 Shares - AXP High Yield Tax-Exempt Fund
@ $4.360 per share
7. Legg Mason - Investment Account No. 363-00793
Date of death value
18,538.65
1,050,736.30
8. GNMA - Certificate No. 03570667SF
Principal Amount: $25,000.00
Issued: 8/01/1979
Maturity Date: 5/15/2009
Date of death value
26,593.75
9. GNMA - Certificate No. 02798069SF
Principal Amount: $25,000.00
Issued: 9/01/1976
Maturity Date: 9/15/2006
Date of death value
26,343.75
10. GNMA - Certificate No. 03667830SF
Principal Amount: $25,000.00
Issued: 11/01/1976
Maturity Date: 11/15/2006
Date of death value
26,343.75
11. GNMA - Certificate No. 02797589SF
Principal Amount: $25,000.00
Issued: 11/01/1976
Maturity Date: 11/15/2006
Date of death value
26,343.75
218.00
12. One Beacon Insurance - Automobile insurance refund
13. Internal Revenue Service - 2001 income tax refund
14,574.00
1,831.00
61.54
14. PA Department of Revenue - 2001 income tax refund
15. Merck-Medco - refund
16. The Patriot-News - refund
17.65
17. Two (2) copper bracelets; 1 small non-working pocket
Watch and Harrisburg Hospital Pin - no value
-0-
TOTAL
$ 1.371.013.16
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
JOHNSON HORACE A
3RD & MARKET STREETS
P. O. BOX 109
LEMOYNE, PA 17043
-------- fold
ESTATE INFORMATION: SSN: 206-36-3152
FILE NUMBER: 2101-1068
DECEDENT NAME: MYERS MILDRED C
DATE OF PAYMENT: 08/06/2002
POSTMARK DATE: 08/05/2002
COUNTY: CUMBERLAND
DATE OF DEATH: 11/09/2001
NO. CD 001482
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $3,563.90
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: MARCIA MYERS
C/O HORACE A JOHNSON ESQUIRE
CHECK#1050
SEAL
INITIALS: CW
RECEIVED BY:
REGISTER OF WILLS
$3,563.90
MARY C. LEWIS
REGISTER OF WILLS
/'7-0202-//
'" BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF DETERMINATION AND
ASSESSMENT OF PENNSYLVANIA
ESTATE TAX BASED ON FEDERAL
ESTATE TAX RETURN
*'
REV-483 EX AFP 101-D21
HORACE A JOHNSON
JOHNSON ETAL
PO BOX 109
LEMOYNE
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
09-23-2002
MYERS
11-09-2001
21 01-1068
CUMBERLAND
201
MILDRED
C
Allount Rellitted
,. .,
PA ..1], 7043
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 FILES ~
REV=483--E;rAFP-Toi:-02r----..-NoricE--oF-UETE-RMINATICrti-AN-li-AS-SES'!ftiENY------------------------- ---
OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN ..
ESTATE OF MYERS
MILDRED
C FILE NO.21 01-1068
ACN 201
DATE 09-23-2002
ESTATE TAX DETERMINATION
1. Credit For State Death Taxes as Verified
51, 114.00
2. Pennsylvania Inheritance Tax Assessed
(Excluding Discount and/or Interest)
55.563.90
3. Inheritance Tax Assessed by Other States
or Territories of the United States
(Excluding Discount and/or Interest)
.00
4. Total Inheritance Tax Assessed
55.563.90
5. Pennsylvania Estate Tax Due
.00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
-IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO 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.)
//-c;J~-/ /
~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
HORACE A JOHNSON
JOHNSON ETAL
PO BOX 109
LEMOYNE
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
; :' () COUNTY
ACN
09-23-2002
MYERS
11-09-2001
21 01-1068
CUMBERLAND
101
'*
REY-15~7 EX AFP IDl-UU
MILDRED
C
Allount RelliUed
PA 170413
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:is4-j-i3f-AFP--foI:':o2Y-NoYici--oF-YtiHiifiTAifci-YA';C-XpPRjrisii'-ENT~--ALi-oWAifci-(fR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MYERS MILDRED C FILE NO. 21 01-1068 ACN 101 DATE 09-23-2002
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)
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
Cl)
(2)
(3)
(4)
(5)
(6)
(7)
138.500.00
1.174,899.95
.00
.00
57.613.21
.00
.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/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
ClO)
92,463.13
8.644.78
(11)
Cl2)
Cl3)
Cl4)
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
1,371,013.16
101.107 91
1,269,905.25
.00
1,269,905.25
NOTE: I~ an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ Abb 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
.00 X 00 = .00
1,258,905.25 X 045 = 56,650.74
.00 X 12 = .00
11,000.00 X 15 = 1,650.00
Cl9)= 58,300.74
TAX CREDITS:
-. l+J AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-05-2002 CDOO0833 2,736.84 52,000.00
08-06-2002 CDOO1482 .00 3,563.90
TOTAL TAX CREDIT 58,300.74
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
· 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.)
AMENDED
v--.
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
, Deceased
No. 21~lr l
Date of Death 11/9/2001
Social Security No. 206-36-3152
Estate of MYERS, MILDRED C.
also known as
Marcia Myers, Executrix
The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory
include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania
of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the
Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that
which appears in a memorandum at the end of this Inventory. l!We verify that the statements made in this Inventory are true
and correct. l!We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904
relating to unsworn falsification to authorities.
Attorney:
Horace A. Johnson
Personal Represe'2~ative /7
Signature: ')JJ.a.-. C.~))l~ C/~~
Marcia Myers, Executrix I I
1.0. No.:
06340
Signature:
Signature:
Address:
301 Market Street
Lemoyne, PA 17043-0109
Address: 15 Ardmore Circle
New Cumberland, P A 17070
Telephone: 717/761-4540
Telephone: (717) 774-3336
Dated:
l/t/2?'t/3
I I
.
Personal Prooertv
$25,000.00 Government National Mortgage
Association - GNMA Pool Number 011701
Initial Principal Amount - $25,000.00 - Issued
11/01/1976 - 8% interest - Matures: 11/15/2006.
Calculation: $25,000 x .021516 (factor figure) = $537.91, date of death value.
Decedent was receiving both Principal and Interest each month, thereby reducing the principal
amount. Copy of original certificate attached. Legg Mason provided us with the purchase
price of the GNMA certificate as of the date of death instead of the outstanding balance of the
certificate as of the date of death.
537.91
(Attach additional sheets if necessary)
Total Personal Property and Real Estate
$1,267,918.24
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
continued
, Deceased
No. 21 - 01 - 01068
Date of Death 11/9/2001
Social Security No. 206-36-3152
Estate of MYERS, MILDRED C.
also known as
$25,000.00 Government National Mortgage
Association - GNMA Pool Number 033441X
Initial Principal Amount - $25,000.00 - Issued
August 1, 1979 - 9% interest - Matures: 5/15/2009
Calculation: $25,000 x .030999 (factor figure) = $774.98, date of death value. Decedent was
receiving both principal and interest each month
thereby reducing the principal amount. Copy of
original certificate attached. Legg Mason provided us with the purchase price of the GNMA
Certificate as of the date of death instead of the outstanding balance of the certificate as of the
date of ddeath.
774.98
$25,000 Government National Mortgage Association - GNMA Pool Number 012882X
Initial Principal Amount - $25,000.00 - Issued 11/01/1976 - 8% interest - Matures - 11/15/2006
Calculation: $25,000.00 x .0183319 (factor figure) = $457.98, date of death value.
Decedent was receiving both Principal and interest each month thereby reducing the principal
amount.
Copy of certificate attached. Legg Mason provided us with the purchase price of the GNMA
certificate as of the date of death instead of the outstanding balance of the certificate as of the
date of death.
457.98
$25,000 - Government National Mortgage Association GNMA Pool Number 011651X-
Initial Principal Amount - $25,000.00 - Issued
9/01/1976 - 8% interest - Matures: 9/15/2006
Calculation: $25,000 x .030368 (factor figure) = $759.21, date of death value. Decedent was
receiving both Principal and interest each month
thereby reducing the principal amount. Copy of
original certificate attached. Legg Mason provided us with the purchase price of the GNMA
certificate as of the date of death instead of the outstanding balance of the certificate as of the
date of death.
759.21
4,251.985 Shares - AXP High Yield Tax-Exempt
Fund @ $4.360 per share
18,538.65
Legg Mason - Investment Account No. 363-00793
Date of death value
1,050,736.30
57,613.21
. Total Personal Property
\,} ~
$1,129,418.24
2
-.-
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
continued
also known as
Estate of MYERS, MILDRED C.
No. 21-01-01068
Date of Death 11/9/2001
Social Security No. 206-36-3152
. Deceased
Real Estate
138,500.00
Total Real Estate
$138,500.00
3
/"7 -c2 <2-- / /
\,
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
IN~Ea!TANCE TAX DIVISION
. DEPT. Z80601
HARRISBURG, PA 171Z8-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT. ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
HORACE A JOHNSON
JOHNSON ETAL
PO BOX 109
LEMOYNE
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
03-10-2003
MYERS
11-09-2001
21 01-1068
CUMBERLAND
101
Allount Rellitted
PA 171'143
*
REV-l547 EX AFP (Ol-OS>
MILDRED
C
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 ~
iffV'=is4-f-Ex--AFP--roY=03Y-No,.-icE--oF-YNHEifiTANci-yAX-APPRA-isEMENT~--AL1-owAirci-oR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MYERS MILDRED C FILE NO. 21 01-1068 ACN 101 DATE 03-10-2003
TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN NO. 01
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Stock/Partnership Interest (Schedule C) (3)
4. Mortgages/Notes Receivable (Schedule D) (4)
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
. 00 NOTE: To insure proper
. 00 credi t to your account.
. 00 subllit the upper portion
. 00 of this forll with your
. 00 tax paYllent.
.00
.00
(8) .00
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
TAX CREDITS:
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequestsj Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
.00
.00
(11)
(12)
(13)
(14)
NOTE:
.00 X
1.258.905.25 X
.00 X
11,000.00 X
00 =
045 =
12 =
15 =
(19)=
DATE
02-05-2002
08-06-2002
l+J
INTEREST/PEN PAID (-)
2,736.84
.00
AMOUNT PAID
52.000.00
3,563.90
NUMBER
CD000833
CD001482
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
00
.00
.00
1.269,905.25
.00
56.650.74
.00
1.650.00
58.300.74
58.300.74
.00
.00
.00
( 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.)
REV-1470 EXf!;oll8)
..
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENTS NAME
REVIEWED BY
Mildred C. Myers
CHARLES WRIGHT
ITEM
SCHEDULE NO.
INHERITANCE TAX
EXPLANATION
OF CHANGES
FILE NUMBER
ACN
EXPLANATION OF CHANGES
2101-1068
101
Forwarded to Post Assessment Review Unit in reference to the reduction to schedule B
ROW
Page 1
\. / "]-c:2c;2 - / /
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*'
REY-1607 EX AFP 101-05'
t1f
I
, .
'OJ
jUL 21
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
'.' .r' 1
,;) .' . i COUNTY
ACN
07-14-2003
MYERS
1l-09-2001
21 01-1068
CUMBERLAND
201
MILDRED
C
EDMUND G MYERS
JOHNSON DUFFIE
PO BOX 109
LEMOYNE
ETAL
Allount Rellitted
,-'
PA 17043
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
NOTE: To insure proper credit to your account. subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV:i6'irj-EX-AFP--(Oy:03T------...--f~ii.._ERj;TANCE--fA;r-Si''irfEMENf-irF'-A'ifcouiif--.-..---------------- -- ---
ESTATE OF MYERS
MILDRED
C FILE NO. 21 01-1068
ACN 201
DATE 07-14-2003
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAYMENTS. THE CURRENT BALANCE. AND. IF APPLICABLE.
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-23-2002
PR I NC I PAL TAX DUE: ...'.......................................................................................................................................................................................................................
135.62
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
08-06-2002 CDOO1482 .00 135.62
TOTAL TAX CREDIT 135.62
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
II IF PAID AFTER THIS DATE. SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1.
NO PAYMENT IS 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. Z8D6Dl
HARRISBURG, PA 171Z8-D6Dl
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
F
REV-I'D7 EX iFP <DI-D51
'03 ,JUL 21
~,~.. :r'l
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
07-14-2003
MYERS
1l-09-2001
21 01-1068
CUMBERLAND
101
MILDRED
C
EDMUND G MYERS
JOHNSON DUFFIE
PO BOX 109
LEMOYNE
ETiAl .
:'-~t- f'r
Allount Rellitted
PA 17043
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 pay.ent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV=i6"ifj-Ex-AFP-foY:oiY------...--iNHERITANCE--YA3f-STA-fEMENY-ifF-AC-Couiff--.-..---------------------
ESTATE OF MYERS MILDRED C FILE NO.21 01-1068 ACN 101 DATE 07-14-2003
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-10-2003
P R I NCI PAL TAX DUE: ...........................................................................................................................................................................................................................
53,661.47
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-05-2002 CDOO0833 2,683.07 52,000.00
08-06-2002 CDOO1482 .00 3,428.28
TOTAL TAX CREDIT 58,1l1.35
BALANCE OF TAX DUE 4,449.88CR
INTEREST AND PEN. .00
IE IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 4,449.88CR
SIDE 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. Z80601
HARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
"'. S (tlJlA)NTY
ACN
07-10-2003
MYERS
11-09-2001
21 01-1068
CUMBERLAND
101
."
, "
'03
JUL 21
EDMUND G MYERS
JOHNSON DUFFIE
PO BOX 109
LEMOVNE
HAL
'.,./ .
PA 17043 CVP'
Allount Rellitted
'*
REV-1593 EX AFP 101-05'
MILDRED
C
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 ~
iifi=islfi-ix--AFP--foi-=oil------.ii-iN-HERI-fANc-i-Tiri-RE-CORD--AUj-USTiiiNT--..-----------------------------
ESTATE OF MVERS
MILDRED
C FILE NO. 21 01-1068
ACN 101
ADJUSTMENT BASED ON:
VALUE OF ESTATE:
BOARD OF APPEALS REFUND
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)
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adllinistrative Costs/
Miscellaneous Expenses (Schedule H)
Debts/Mortgage Liabilities/Liens (Schedule I)
Total Deductions
Net Value of Tax Return
Charitable/Governllental Bequests; Non-elected 9113 Trusts
Net Value of Estate Subject to Tax
10.
11.
12.
13.
14.
TAX:
lS. Allount of Line 14 at Spousal rate
16. Allount of Line 14 taxable at Lineal/Class A rate
17. Allount of Line 14 at Sibling rate
18. Allount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
DATE
02-05-2002
08-06-2002
NUMBER
CD000833
CD001482
INTEREST/PEN PAID (-)
2,683.07
.00
(1)
(2)
(3)
(4)
(S)
(6)
(7)
138.500.00
1.071.805.03
.00
.00
57.613.21
.00
.00
(8)
DATE
07-10-2003
(9)
UO)
92,463.13
8,644.78
(11)
(2)
(3)
(14)
1,267,918.24
101.107.91
1.166.810.33
.00
1.166,810.33
.00
52.011.46
.00
1.650.00
53.661.47
58 111. 35
4,449.88CR
.00
4,449.88CR
. 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.)
(Schedule J)
(1S)
(6)
(7)
(8)
.OOX 00 =
1.155.810.33X 045=
.OOX 12 =
11.000.00X 15 =
(9)
AMOUNT PAID
52,000.00
3,428.28
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
PENNSYLVANIA ESTATE TAX
RECORD ADJUSTMENT
'*
--
REV-UU EX AFP '01-03)
PA 17043
DA1e'. .
ESTATE OF
DATE OF DEATH
FILE NUMBER
couf{t} JUL 21
ACN
~ ..1 I
CVn\c
MAKE CHECK PAYABLE AND
07-1U-2003
MYE-RS
11-09-2001
2~ 0),,-;1068
CU~~I<<.AND
201
MILDRED
C
EDMUND G MYERS
JOHNSON DUFFIE
PO BOX 109
LEMOYNE
HAL
Allount Relli Hed
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 LONER PORTION FOR YOUR FILES .......
REy:i623-i3f-iF'P--foY:03Y----..-p-iNNSYLV"-tif'A--isTirfE-TAX-ificoifD'-'AifJuST-tiENY-..--------------------
ESTATE OF MYERS
MILDRED
C FILE NO.21 01-1068
ACN 201
CODE
DATE 07-10-2003
706
AD~USTMENT BASED ON: ADMINISTRATIVE CORRECTION
1.
Credit For State Death Taxes as Verified
51,114.00
2.
Pennsylvania Inheritance Tax Assessed
(Excluding Discount and/or Interest)
50,978.38
3.
Inheritance Tax Assessed by Other States
or Territories of the United States
(Excluding Discount and/or Interest)
.00
4.
Total Inheritance Tax Assessed
50,978.38
5.
Pennsylvania Estate Tax Due
135.62
6.
Amount of Pennsylvania Estate Tax Previously Assessed
Based on Federal Estate Tax Return
.00
7.
Additional Pennsylvania Estate Tax Due
.00
TAX CREDITS:
PAYMENT RECEIPT
DATE NUMBER
08-06-2002 CD001482
DISCOUNT (+)
INTEREST/PEN PAID (-)
.00
AMOUNT PAID
135.62
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
135.62
.00
.00
.00
. IF PAID AFTER THIS DATE, SEE REVERSE SIDE ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY
FOR CALCULATION OF ADDITIONAL INTEREST. BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
Bt>ARD OF APPEALS
DEPT. 281021
HARRISBURG, PA 17128-1021
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
EDMUND G MYERS ESQ
JOHNSON DUFFIE ET AL
PO BOX 109
LEMOYNE PA 17043-0109
IN RE ESTATE OF:
MYERS MILDREOJ.t ,JUL 21:.8 :(12
DOCKET NO.: ,. 0306086
TAX TYPE: r.l.IY1L.I\1~eritance
APPEAL TYPE Refund
FILE NUMBER: 2101-1068
ACN: 101
APPRAISEMENT: 9/23/2002
PETITION FILED: 3/20/2003
EXAMINER: LISA GARLAND DIAZ
Direct Dial: (717) 772-3736
Fax: (717) 787-7270
Email: Idiaz@state.pa.u5
MAILING DATE: June 25, 2003
DECISION AND ORDER
On September 23,2002, the Department issued an appraisement and assessment
accepting the original inheritance tax return as filed. Petitioner has now established that the
actual date of death values of the GNMA certificates reported as items 2, 3, 4 and 5 on Schedule
B should be reduced to $774.98, $537.91, $457.98 and $729.21 respectively. These
adjustments will reduce the total taxable value of Schedule B property to $1,071,805.03.
Although these adjustments will reduce the inheritance tax obligation by $4,639.28, the actual
refund should be $4,449.89 since the allowable Pennsylvania Estate Tax credit for inheritance
tax payments will be reduced to $50,978.38.
MYERS MILDRED C
BOARD DOCKET NO. 0306086
Page 2 of 2 . . .
Accordingly, it is hereby, Ordered that the petition for refund is granted-in-part.
The Department is directed to reduce Schedule B to $1,071,805.03. It is further Ordered
that a refund be issued for the resulting overpayment, plus interest if appropriate.
FOR THE BOARD OF APPEALS
JOSEPH R. SLEEK, MEMBER
ANY APPEAL FROM THIS DECISION MUST BE FILED WITH THE BOARD OF FINANCE
AND REVENUE, 1101 SOUTH FRONT ST., SUITE 400, HARRISBURG, PA 17104,
WITHIN NINETY (90) DAYS OF THE MAILING DATE OF THIS DECISION. TELEPHONE
(717) 787-2974
A CASH REFUND CHECK WILL BE MAILED TO YOU BY THE BUREAU OF
INDIVIDUAL TAXES.
IF YOU REQUIRE THIS INFORMATION IN AN ALTERNATE FORMAT UNDER THE
PROVISIONS OF AMERICANS WITH DISABILITIES ACT OF 1990, PLEASE CALL (717) 783-
3664, OR FOR SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND SPEAKING
NEEDS: 1-800-447-3020 (TT ONLY)
"
STATUS REPORT UNDER RULE 6.12
Name of Decedent: MILDRED C. MYERS
D~eofDe~h: November 9, 2001
Will No.:
2001-01068
Admin. No.:
Pursuant to Rule 6.12 ofthe Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration ofthe above-captioned estate:
1. State whether administration of the estate is complete:
Yes 0 No IX!
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete: on or before April 30. 2004
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 0
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 th Clerk of Orphans' Court
and may be attached to this rep
Date: -1.QL 29/03
A. Johnson
C/~
oK
e
Johnson, Duffie, Stewart & Weidner
301 Market st., P. O. Box 109
Lemoyne, PA 17043-0109
Address
-''"'j
(717) 761-4540
Telephone No.
Capacity: 0 Personal Representative
E3 Counsel for personal representative
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
PENNSYLVANIA ORPHANS' COURT DIVISION
NO. 21-01-01068
ESTATE OF MILDRED C. MYERS, DECEASED
Late of New Cumberland Borough
FIRST AND FINAL ACCOUNT OF
MARCIA MYERS, EXECUTRIX
Date of Death:
Date of Executrix Appointment:
Advertisement of Letters:
Accounting for the Period:
November 09, 2001
November 27, 2001
Cumberland Law Journal:
December 14, 21, 28, 2001
The Patriot-News:
December 11, 18,25,2001
November 27, 2001 - November 30, 2003
Purpose of Account: Marcia Myers, Executrix offers this Account to acquaint interested
parties with the transactions that have occurred during her administration.
It is important that the account be carefully examined. Requests for additional information or
questions or objections can be discussed with:
Marcia Myers, Executrix
15 Ardmore Circle
New Cumberland, PA 17070
(717) 774-3336
or
Horace A. Johnson, Esquire
Johnson, Duffie, Stewart & Weidner
301 Market Street
P.O. Box 109
Lemoyne, PA 17043-0109
(717) 761-4540
#221741
SUMMARY OF ACCOUNT
Principal
Receipts
Net Loss on Sales
Adjusted Balance
Less Disbursements:
Debts of Decedent
Funeral Expenses
Administration Expenses
Federal and State Taxes
Fees and Commissions
Real Estate Expenses
Reserve
9,251.86
4,756.20
3,716.81
250,431.90
61,000.00
4,156.32
21,350.00
Balance before Distributions
Distributions to Beneficiaries
Adjusted Balance
Advance Distributions to Beneficiaries
Principal Balance Remaining
For Information:
Real Estate - 801 16th Street
Income
Receipts
Rental Income/Expenses
Adjusted Balance
Less Disbursements
Income Balance Remaining
PROPOSED DISTRIBUTIONS TO
BENEFICIARIES
*COMBINED BALANCE REMAINING
*Combined Balance Remaining
consists of cash.
#221744
Fiduciary
Acquisition
Page Value
3-4-5
6-7-8-9-10
11-12-13
14
15
16
17
18-19
20
21
-2-
$1,311,702.13
7,819.96
1,303,882.17
354,663.09
949,219.08
26,905.00
922,314.08
500,000.00
$ 72,778.36
3,504.94
76,283.30
9,326.00
$422,314.08
66.957.30
$489.271.38
RECEIPTS OF PRINCIPAL
Cash:
Allfirst Bank - Checking Account
No. 00288-5400-4
Allfirst Bank - Money Fund Account
No. 00982-9295-1
One Beacon Insurance - refund -
Automobile insurance
Internal Revenue Service - refund-
2001 income tax
PA Department of Revenue - refund
2001 income tax
Merck-Medco - refund
The Patriot-News - refund
Tangible Personal Property:
Household Goods - appraised value
1996 Buick Century
Two (2) copper bracelets; 1 small non-
Working pocket watch and Harrisburg
Hospital Pin - no value
Investment Account:
LeggMason - Account No. 363-00793
Cash
LeggMason Money Market Fund
LeggMason Bond Funds
Equities
Preferred Stocks
Mutual Funds
Stocks:
4,251.985 Shares - AXP High Yield
Tax-Exempt Fund @ $4.360 p/share
Fiduciary
Acquisition
Value
11,192.28
18,313.74
218.00
14,574.00
1,831.00
61.54
17.65
46,208.21
5,775.00
5,630.00
-0- 11,405.00
66.31
46,338.41
27,496.64
531,186.31
113,065.00
332.583.63 1,050,736.30
18,538.65 18,538.65
-3-
Receipts of Principal, Continued
Adjusted Values:
GNMA Certificates:
Value of the GNMA certificates was incorrectly
provided by Legg Mason. The actual date of death
value should have been based on the decedent
receiving both principal and interest payments
each year since the GNMA'S were purchased in
1976 and 1979.
Certificate No. 03570667SF - CitiMortgage, Inc.
Principal Amount: $25,000.00
Issued: 8/01/1979
Maturity Date: 5/15/2009
Incorrect date of death value - $26,593.75
Correct date of death value.
Certificate No. 02798069SF - Wells Fargo
Principal Amount: $25,000.00
Issued: 9/01/1976
Maturity Date: 9/15/2006
Incorrect date of death value - $26,343.75
Correct date of death value.
Certificate No. 02797589SF - Union Planters Mortgage
Principal Amount: $25,000.00
Issued: 11/01/1976
Maturity Date: 11/15/2006
Incorrect date of death value - $26,343.75
Correct date of death value.
Certificate No. 03667830SF - Chase Manhattan Mortgage
Principal Amount: $25,000.00
Issued: 11/01/1976
Maturity Date: 11/15/2006
Incorrect date of death value - $26,343.75
Correct date of death value.
Realty: .
Residence - 801 16th Street, Borough of
New Cumberland, Cumberland County,
PA - (Deed Book S, Volume 12, Page 471)
Appraised Value
-4-
774.98
759.21
537.91
457.98 2,530.08
138.500.00 138,500.00
Receipts of Principal, Continued:
Receipts Subsequent to Inventory
(Valued when received)
Legg Mason - decedent's investment account
closed - balance remaining
GNMA - Union Planters - principal payments
GNMA - Wells Fargo - principal payments
GNMA - Chase - principal payments
GNMA - CitiGroup - principal payments
J. Gordon Gaines, Inc. - insurance claim - gutters
137.53
611.91
125.80
179.58
84.30
1,676.89
Refu nd:
8/05/03 - Department of Revenue - Inheritance
Tax Division - Refund of Inheritance Tax paid,
plus interest, based on the Supplemental
Inheritance Tax Return filed for the Estate
reporting the correct date of death value of
the GNMA Certificates.
4,449.88
11/12/03 -Internal Revenue Service - Refund of
tax paid - based on the Supplemental Information
Form 706 - filed for the Estate reporting the
correct date of death value of the GNMA Certificates.
36,518.00
TOTAL RECEIPTS OF PRINCIPAL
#167401
-5-
2,816.01
40,967.88
$1.311.702.13
GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS
Gain Loss
12/3/01 400 Shs. PWG Capital Trust
1- 8.30% - 12/01/2036
Proceeds $10,000.00
Fiduciary Acquisition Value 10.000.00 -0- -0-
6/6/02 500 Shs. Enron Cap. Trust
Net Proceeds 580.00
Fiduciary Acquisition Value 450.00 130.00
8/2/02 768 Shs. DOE
Fiduciary Acquisition Value 13,532.00
Net Proceeds 9,429.00 (4,103.00)
8/2/02 4,420.812 Shs. Eaton Vance
Fiduciary Acquisition Value 33,112.00
Net Proceeds 27.895.00 (5,217.00)
8/2/02 2,756.244 Shs. Federated Utility
Fiduciary Acquisition Value 23,483.00
Net Proceeds 17.309.00 (6,174.00)
8/2/02 600 Shs. Great Plains Energy
Fiduciary Acquisition Value 14,406.00
Net Proceeds 11.128.00 (3,278.00)
8/3/02 500 Shs. International Paper
Fiduciary Acquisition Value 12,495.00
Net Proceeds 12.224.00 ( 271.00)
8/2/02 477 Shs. Mirant Corp.
Fiduciary Acquisition Value 11,644.00
Net Proceeds 1.278.00 (10,366.00)
8/2/02 800 Shs. OGE Energy
Fiduciary Acquisition Value 17,496.00
Net Proceeds 14.787.00 ( 2,709.00)
8/2/02 1,000 Shs. Pacificorp. Cap.
Fiduciary Acquisition Value 24,500.00
Net Proceeds 22.835.00 ( 1,665.00)
8/2/02 200 Shs. Southern Corp.
Net Proceeds 5,282.00
Fiduciary Acquisition Value 4.550.00 732.00
-6-
Gains and Losses on Sales, Continued:
8/2/02 400 Shs. TECO Energy
Fiduciary Acquisition Value 10,564.00
Net Proceeds 8,559.00 ( 2,005.00)
8/2/02 1,095 Shs. UGI Corp.
Net Proceeds 32,847.00
Fiduciary Acquisition Value 32.248.00 599.00
8/2/02 122 Shs. Unocal Corp.
Fiduciary Acquisition Value 4,013.00
Net Proceeds 3.739.00 ( 274.00)
8/2/02 200 Shs. Westar Energy
Fiduciary Acquisition Value 3,450.00
Net Proceeds 2,189.00 ( 1,261.00)
8/15/02 1,693.143 Shs. LeggMason
PA Tax Free Income Tr.
Net Proceeds 28,055.00
Fiduciary Acquisition Value 27.497.00 558.00
8/30/02 GNMA No. 03570667SF
Fiduciary Acquisition Value 775.00
Proceeds 631.00 (144.00)
8/30/02 GNMA No. 02798069SF
Fiduciary Acquisition Value 759.00
Proceeds 690.00 (69.00)
8/30/02 GNMA No. 02797589SF
Fiduciary Acquisition Value 538.00
Proceeds 447.00 (91.00)
8/30/02 GNMA No. 03667830SF
Fiduciary Acquisition Value 458.00
Proceeds 369.00 (89.00)
9/06/02 4,600 Shs. Dominion Resources
Net Proceeds 279,901.00
Fiduciary Acquisition Value 268.870.00 11,031.00
-7-
Gains and Losses on Sales, Continued:
9/06/02 3,105 Shs. UGI Corp.
Net Proceeds 104,752.00
Fiduciary Acquisition Value 91.442.00 13,310.00
11/11/02 4,251.85 Shs. AXP High Yield
Tax-Exempt Fund
Net Proceeds 18,921.00
Fiduciary Acquisition Value 18,539.00 382.00
11/11/02 65.612 Shs. AXP High Yield
Tax-Exempt Fund
Net Proceeds 292.00
Fiduciary Acquisition Value 292.00 -0- -0-
05/16/03 Real Estate - 801 16th St.
New Cumberland, PA
Fiduciary Acquisition Value 138,500.00
Sale Price 138.500.00 -0- -0-
07/07/03 1,000 Shares Wells Fargo Cap. Trust
IV 7% tr pfd. Sees. due 9/1/31
Net Proceeds 26,998.00
Fiduciary Acquisition Value 24,970.00 2,028.00
11/07/03 1,075 Shares Scudder U.S.
Govt Sees. Fund Sh Ben
Inti CL A
Fiduciary Acquisition Value 9,341.75
Net Proceeds 9.255.75 (86.00)
11/06/03 4,841.414 Shares Delaware Grou
Tax Free PA Fund - CL A
Proceeds 38,973.38
Fiduciary Acquisition Value 38,198.76 774.62
-8-
Gains and Losses on Sales, Continued:
11/06/03 3,242.32 Shares Dreyfus Premier
State Mun. Bond Fd.
PA Ser. CL A
Proceeds 51,488.04
Fiduciary Acquisition Value 50,241.57 1,246.47
11/06/03 6,009.195 Shares Franklin
Templeton Funds US Govt.
Securities - CL A
Fiduciary Acquisition Value 41,403.35
Proceeds 40.321.70 (1,081.65)
11/06/03 6,431.649 Shares Franklin
Templeton Funds PA Tax
Free Income Fd. CL A
Proceeds 66,631.88
Fiduciary Acquisition Value 65,924.40 707.48
11/06/03 1,000 Shares Lehman Bros
Hldgs Cap. TR I - 8% TR
PFD Sees. Ser I due 3/31/48 B/E
Fiduciary Acquisition Value 25,650.00
Net Proceeds 25,208.09 (441.91)
11/06/03 600 Shares Merrill Lynch
Preferred Cap Tr III - 7%
Net Proceeds 15,646.08
Fiduciary Acquisition Value 15.000.00 646.08
11/06/03 500 Shares Nuveen PA Premium
Income Muni. Fund 2
Net Proceeds 7,385.31
Fiduciary Acquisition Value 7,055.00 330.31
11/06/03 500 Shares Pepco Holdings, Inc.
Fiduciary Acquisition Value 10,555.00
Net Proceeds 8.658.49 (1,896.51 )
-9-
Gains and Losses on Sales, Continued
11/06/03 7,928,269 Shares Putnam PA
Tax exempt income Fd.-SB I
Net Proceeds 71,592.27
Fiduciary Acquisition Value 70.878.72 713.55
11/06/03 1,000 Shares Southern Co.
Net Proceeds 28,996.52
Fiduciary Acquisition Value 22.750.00 6,246.52
11/06/03 396 Shares Verizon Comm.
Fiduciary Acquisition Value 18,612.00
Net Proceeds 12.579.08 (6,032.92)
Total Gains and Losses
39,435.03
47,254.99
39,435.03
($7.819.96)
Less Gain
NET LOSS
#167403
-10-
DISBURSEMENTS OF PRINCIPAL
Debts of Decedent
11/14/01-
11/19/01 Checks that cleared Allfirst Checking
Account No. 00288-5400-4 1,053.50
Maintenance fees - Allfirst Checking
Account No. 00288-5400-4 30.00
12/5/01 Verizon - telephone 20.44
12/5/01 AT&T - telephone 12.22
12/5/01 Carlos Leffler - heating oil 248.00
12/5/01 Com cast - cable 29.77
12/5/01 Shelby Insurance - homeowner ins. 278.80
12/5/01 Charlotte Horton - yard/house work 127.50
12/19/01 PA American Water Co. 15.43
12/19/01 PP&L - electricity 41.20
1/03/02 United States Treasury - 4th Quarter
income tax payment - 2001 6,100.00
1/03/02 PA Department of Revenue - 4th
Quarter income tax payment - 2001 800.00
4/05/02 Hartman & Scheuchenzuber, CPAs
prepare decedent's final 2001
federal and state income tax returns 495.00 9,251.86
Funeral Expenses
12/5/01 Parthemore Funeral Home 4,301.20
12/5/01 Marcia Myers - reimbursement for
grave opening charges 455.00 4,756.20
Administration Expenses
11/20/01 Register of Wills - probate charges 934.50
11/30/01 Cumberland Law Journal - legal
advertisement 75.00
12/5/01 Lester Connor - real estate appraisal 275.00
12/11/01 Register of Wills - short certificates 9.00
12/12/01 Allfirst Bank - charge for estate checks 13.50
1/18/02 The Patriot-News - legal advertisement 96.81
1/23/02 Chuck Bricker - household goods
appraisal 80.00
1/30/02 Register of Wills - short certificates 6.00
1/30/02 Allfirst Bank - charge for estate checks 13.50
2/04/02 Legg Mason - charge to transfer funds
to Allfirst checking account 20.00
3/11/02 Allfirst Bank - analysis fee 10.00
6/19/02 Allfirst Bank - charge for estate checks 13.50
7/16/02 Barbara Coble Abstracting - copy of
Deed to real estate 21.00
-11-
Principal Disbursements, Continued:
8/13/02
8/21/02
9/05/02
9/06/02
9/11/02
1 0/9/02
12/4/02
1/06/03
4/11/03
5/28/03
Register of Wills - file Inventory and
Inheritance Tax Return
Register of Wills - short certificates
LeggMason - charge to transfer funds
toAllfirst checking account
Register of Wills - short certificates
Allfirst Bank - analysis fee'
Allfirst Bank - analysis fee
Allfirst Bank - charge for estate checks
Register of Wills - file supplemental
Inventory & Inheritance Tax Return
Michael D'Angelo - survey & description
Legg Mason - returned check - stop
range fee
28.00
15.00
20.00
6.00
10.00
10.00
14.00
31.00
1,990.00
25.00
Federal and State Taxes
2/05/02 Register of Wills - 90 day Inheritance Tax
payment:
Gross $54,736.84
Discount (2.736.84)
8/2/02 Register of Wills -Inheritance Tax
8/2/02 United States Treasury - Federal Estate Tax
due on Form 706 - Estate tax return
Fees and Commissions
8/27/02 Marcia Myers - on account of Executrix
commission
8/27/02 Johnson, Duffie, Stewart & Weidner - on
account of attorney fee
1/20/03 Marcia Myers - on account of Executrix
commission
1/20/03 Johnson, Duffie, Stewart & Weidner - on
account of attorney fee
1/02/02
1/02/02
1/02/02
1/23/02
1/24/02
2/08/02
2/21/02
4/01/02
Real estate expenses - Maintenance/Sale
Comcast - cable
AT&T - telephone
Carlos Leffler - heating oil
PP&L - electricity
Verizon - decedent's account
AT&T - final telephone charges
Borough of New Cumberland - sewer/trash
Verizon - decedent's account - Feb/Mar.
-12-
3,716.81
52,000.00
3,563.90
194,868.00 250,431.90
20,500.00
20,500.00
10,000.00
10,000.00 61,000.00
29.77
.10
248.00
56.89
29.12
48.82
57.43
46.19
Principal Disbursements, Continued:
5/16/03
5/16/03
6/21/03
#167417
Real estate expenses - Maintenance/Sale Continued:
Recorder of Deeds - transfer tax
Sewer charges adjusted at settlement
The Gutter Guys - Gutters/down spouts/corners
Reserve:
Register of Wills - file account/distribution
Johnson, Duffie, Stewart & Weidner - final
Attorney fee
Marcia Myers - final Executrix commission
TOTAL DISBURSEMENTS OF PRINCIPAL
-13-
1,038.75
22.25
2,579.00
350.00
10,500.00
10,500.00
4,156.32
21.350.00
$354.663.09
DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES
TO: KRISTIN MYERS and JENNIFER MYERS
- Article II of decedent's Will
1996 Buick Century 5,630.00
Household Goods - appraised value 5,775.00
Bracelets; Pocket Watch; Hospital Pin -0-
TO: ROBERT SLENCAK - Item I (A) of Codicil
to decedent's Will
Cash 10,000.00
TO: JOHN TUCKER - Item I (B) of Codicil to
decedent's Will.
Cash 2,500.00
TO: MARCIA MYERS - Item I (C) of Codicil to
decedent's Will.
Cash 1,000.00
TO: JOHN ADAIR - Item I (D) of Codicil to
decedent's Will.
Cash 1,000.00
TO: MARY MARGARET KULBOK - Item I (E) of
Codicil to decedent's Will.
Cash 1.000.00
Total Distributions of Principal to Beneficiaries
$ 26.905.00
#167420
-14-
ADVANCE DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES
TO: Manufacturer's & Trader's Trust Company, Trustee
of the Kristin Myers Trust under Article IV of
decedent's Will.
1/13/2003 - Cash
$100,000.00
7/14/2003 - Cash
150,000.00
$250,000.00
TO: Manufacturer's Trader's Trust Company, Trustee
of the Jennifer Myers Trust under Article IV of
decedent's Will.
1/13/2003 - Cash
$100,000.00
7/14/2003 - Cash
150,000.00
250.000.00
Total Advance Distributions to Beneficiaries
$500.000.00
#215979
-15-
INFORMATION SCHEDULES - PRINCIPAL
5/16/03 Real Estate - 801 16th Street, Borough of New Cumberland, Cumberland County,
Pennsylvania
Appraised value as of the date of
death.
$138.500.00
Decedent's Will distributes the residue of her Estate - one-half to Manufacturer's &
Trader's Trust Company, Trustee for the benefit of Jennifer Myers and one-half to Manufacturer's
& Trader's Trust Company, Trustee for the benefit of Kristin Myers.
Jennifer Myers, purchased her grandmother's residence at the appraised value of
$138,500.00. The distribution to Manufacturer's & Trader's Trust Company for the Jennifer Myers
Trust will be reduced by $69,250.00. The distribution to Manufacturer's & Trader's Trust
Company for the Kristin Myers Trust will receive $69,250.00 additional cash.
A Promissory Note signed by Jennifer Myers on May 16, 2003 in the amount of
$69,250.00 will be held by Manufacturer's & Trader's Trust Company, Trustee of the Jennifer
Myers Trust to cover the one-half interest in the real estate until Jennifer Myers reaches Age 30.
The Promissory Note will be held by the Trustee to protect any remainder beneficiaries of the
Jennifer Myers Trust.
#218919
-16-
RECEIPTS OF INCOME
Interest
Allfirst Bank - Account No. 00982-9295-1
Allfirst Bank - Account No. 00288-5400-4
GNMA - Citigroup
GNMA - Wells Fargo
GNMA - Chase
GNMA - Union Planters
Legg Mason - Acct. No. 363-00793 - 12/2001
Legg Mason - Estate account No. 363-01137
01/01/2002 - 12/31/2002
Legg Mason - Estate account No. 363-01137
01/01/2003 - 11/30/2003
Commonwealth of Pennsylvania - interest
on Inheritance Tax Refund
Dividends:
Legg Mason - Estate account No. 363-00793
12/2001
Legg Mason - Estate account No. 363-01137
01/01/2002 - 12/31/2002
Legg Mason - Estate Account No. 363-01137
01/01/2003 - 11/30/2003
Putnam Investments
Scudder Investments
Franklin Templeton Investments
Delaware Investments
Federated Utility Fund
AXP High Yield Account
TOTAL RECEIPTS OF INCOME
#167431
28.81
3.46
55.85
46.28
28.54
38.09
2,012.40
5,736.99
3,193.30
33.52
11,177.24
3,814.50
39,570.39
14,183.60
936.16
135.45
1,562.96
464.68
165.38
768.00
61.601.12
$72.778.36
-17-
RENTAL INCOME/EXPENSES
February 1,2002 - June 30. 2003 $14,100.00
Credit at settlement for real estate taxes
adjusted and trash adjustment 608.47
Total $14,708.47
Expenses:
2/08/02 PA Water Company 19.46
2/08/02 Carlos Leffler - heating oil 248.00
2/21/02 PA Water Company 31.15
2/21/02 PP&L 47.99
2/21/02 l\ew Cumberland Borough - Sewer/trash 57.43
3/07/02 Shelby Insurance - homeowner's insurance 214.10
4/03/02 AT&T - Jennifer's charges* 140.96
4/03/02 PA Water Company 26.07
4/03/02 PP&L 44.94
4/15/02 PA Water Company 23.71
4/15/02 Wolfe Contractors - repairs 48.00
4/15/02 PP&L 52.99
5/07/02 Verizon - Jennifer's charges* 29.54
5/07/02 Borough of New Cumberland - sewer/trash 69.36
5/07/02 AT&T - Jennifer's charges* 106.98
5/31/02 PP&L 46.27
5/31/02 PA Water Company 29.16
5/31/02 AT&T - Jennifer's charges* 101.95
5/31/02 Comcast Cable - Jennifer's charges* 71.98
6/05/02 Leggett - repair broken water line 632.00
6/09/02 Shelby Insurance - homeowner's insurance 214.10
6/09/02 Robin Gasparetti, Tax Collector - County/Borough 521.66
6/19/02 PA Water Company - charges due to water line
creak 1,238.50
6/19/02 PP&L 52.96
6/28/02 Don Haines - shower repairs 135.00
7/09/02 AT&T - Jennifer's charges* 66.69
8/23/02 Robin Gasparetti, Tax Collector
S::hool District real estate taxes 1,415.02
9/14/02 PP&L 305.14
9/24/02 Borough of New Cumberland -
e<cessive charges due to
V'Bter line break 527.20
10/11/02 PA Water Company 131.50
10/11/02 Carlos Leffler - heating oil 364.00
11/11/02 Borough of New Cumberland - sewer/trash 83.24
-18-
Rentallncome/Expenses Continued:
11/04/02 PP&L
11/04/02 Carlos Leffler - heating contract
11/17/02 PA Water Company
11/23/02 A1lfirst Bank - charge for insufficient
fund rental check
12/16/02 Shelby Insurance - Homeowner's
12/16/02 PP&L - Nov. & Dec.
12/16/02 PA Water Company
12/31/02 Carlos Leffler - heating oil
01/11/03 PP&L
02/04/03 Carlos Leffler - heating oil
02/26/03 PP&L
02/26/03 Carlos Leffler - heating oil
02/26/03 PAWC
03/17/03 PP&L
04/11/03 Robin Gasparetti - real estate taxes
04/11/03 PAWC
04/11/03 PP&L
05/06/03 Carlos Leffler - heating oil
05/06/03 Borough of New Cumberland - sewer/trash
05/13/03 PAWC
05/13/03 Carlos R. Leffler - heating oil
05/14/03 Ehrlich Pest Control- spray ants
05/14/03 PP&L
06/30/03 June Rent $600.00
*Charges paid for Jennifer
Deducted from June rent 518.10
Jennifer L. Myers - balance of June rent
05/16/03 Sewer charges due at settlement
OS/29/03 PP&L - final charges
06/10/03 Shelby Insurance - balance due
Total Expenses
NET RENTAL INCOME
#167427
-19-
52.73
123.45
32.30
6.50
283.60
123.61
38.84
364.00
79.31
364.00
57.36
430.30
37.33
78.59
651.33
99.08
64.77
364.00
166.74
39.49
182.00
143.10
68.98
81.90
20.19
15.68
137.30
11,203.53
$ 3,504.94
DISBURSEMENTS OF INCOME
02/04/2003
United States Treasury (Internal Revenue)
tax due on Form 1041 - Estate Income Tax
Return for fiscal year beginning November 9,
2001 (date of death) and ending October
31,2002.
Tax due.
02/04/2003
PA Department of Revenue - tax due on
PA 41 - Estate Income Tax Return for
fiscal year beginning November 9, 2001
(date of death) and ending October 31, 2002.
TOTAL DISBURSEMENTS OF INCOME
-20-
$ 8,501.00
825.00
$ 9,326.00
PROPOSED DISTRIBUTIONS TO BENEFICIARIES
BALANCE FOR DISTRIBUTION AS PER
FIRST AND FINAL ACCOUNT
Per Article IV of the Will:
TO: Manufacturer's & Trader's Trust Company, Trustee
of The Kristin Myers Trust
Cash
Per Article IV of the Will:
TO: Manufacturer's & Trader's Trust Company, Trustee
of The Jennifer Myers Trust
Cash
Promissory Note
$ 175,385.69
69.250.00
TOTAL
#221749
-21-
$489.271.38
$244,635.69
244.635.69
$489.271.38
.
.
COMMONWEALTH OF PENNSYLVANIA
:SS.
COUNTY OF CUMBERLAND
MARCIA MYERS, Executrix under the Last Will and Testament of Mildred C. Myers,
deceased, hereby declares under oath that she has fully and faithfully discharged the duties of
her office; that the foregoing First and Final Account is true and correct and fully discloses all
significant transactions occurring during the accounting period; that all known claims against the
Estate have been paid in full; that, to her knowledge, there are no claims now outstanding
against the Estate; that all taxes presently due from the Estate have been paid and that the
Grant of Letters and the first complete advertisement thereof occurred more than four (4)
months before the filing of the Account.
Subscribed and sworn to
by Marcia Myers, Executrix
before me this ~ ~
day of December, 2003.
,/1)t-<~ ~8~~
MARCIA MYER ,EXECUTRIX
-~.~~
Notary Public
NOTARIAL SEAL
DIANNE lENIG, Notary Public
Lemoyne Borough Cumberland Co.
My Commission Expires Dec. 21, 2005
#221739
-22-
--'""-"'_~ .,:r;-.-
~
I tlsroby certify that wntien notlco of the filing of
this Account. and of the data. time and place
when the same wiD be preoooted to the Court
for confirmation and of the IaIt day to fie written
{)bjections to saki Account. h8a been given to
evefY unpaid cI8im8nt and to fNf!JIty other person
known to the acoounI8nt k) have or ctairn an
interest in the estate as creditor, benekiery,
heir Of IlEIxt of kin.
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~ BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
REY-I6U1 EX AFP (OI-OSl
\)j
DATE
ESTATE OF
DATE OF DEATH
1\1' F.~J,.E NUMBER
II i cO(JNTY
ACN
08-04-2003
MYERS
11-09-2001
21 01-1068
CUMBERLAND
101
MILDRED
C
-2
EDMUND G MYERS
JOHNSON DUFFIE
PO BOX 109
LEMOYNE
ETAL
\ .
r~
PA 17043 ',.\
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 ~
REV=i6cfj-Ex-AFP-foY=o3Y------...--iNHERITANCE-YAX--STjrfEMENY-cfF'-ACCOu'Nf--...------------------ ---
ESTATE OF MYERS MILDRED C FILE NO.21 01-1068 ACN 101 DATE 08-04-2003
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-10-2003
P R I NC I PAL TAX DUE: ...........................................................................................................................................................................................................................
53,661.47
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-05-2002 CDOO0833 2,683.07 52,000.00
08-06-2002 CDOO1482 .00 3,428.28
07-14-2003 REFUND .00 4,449.88-
TOTAL TAX CREDIT 53,661.47
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 PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ,
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J
01/12/2004 09:21 FAX 717 761 3015
JDS&W
~002
c~
,. Internal Revenue Senric:e
f6W Cincinnd, OH 45999
Contact P....on: Brian Kaufmann
Badge Nun'lber: 17-14026
Telephone: 1-866-699 i083
(Toll Fl"88 Number)
~I-Oi-IO~~
December 29, 2003
Estate Tax Closing Document
(Not a bill for tax due)
MARCIA MYERS
15 ARDMORE CIR
NEW CUMBERLAND PA 17070
-.,:--
Estate Name: MILDRED C MYERS
Social Security Number: 206-36-3152V
Date of Death: 11/09/2001
NET ESTATE TAX: $
STATE DEATH TAX CREDIT: $
GENERATION-SKIPPING TAX: $
AMENDED
158.350.00
44.515.00
0.00
We have determined the following:
These figures do not Include any interest and penalties that may be charged.
Please keep this document in your permanent records. You may need it to complete
administration of the estate, such as: close probate proceedings. transfer title to property, and
settle state taxes. -Keep it with your cancelled check(s) to show that you have met the estate tax
obligation. Proof of payment in the amount shown above re..... you of personal liability
(IRe 2204). If the time for payment in the amount shown above is extended under
section 6161.6163. or 6166. personal liability is not released until full payment has been
received.
We will not reopen this return unless you notify us of changes to the return, or there is evidence
of misrepresentation of a material fact, a clearly defined substantial error based upon an
established Service position or a serious administratiVe omission. (See IRC 7121).
~~. / f1{,...-
,-
Field Director I Cincinnati Compliance Service Center
.-
December 29, 2003
Contact Person: Brian Kaufmann
Badge Number: 17-14026
Telephone: 1.866-699-4083
(Toll Free Number)
()/- /06~
g'''& Internal Revenue Service
f8fJII Cincinnati, OH 45999
Estate Tax Closing Document
(Not a biIUor:~ax du~)
HORACE A JOHNSON A TIORNEY
PO BOX 109
301 MARKET ST
LEMOYNE PA 17043
Estate Name: MILDRED C MYERS
Social Security Number: 206-36-3152V
Date of Death: 11/09/2001
NET ESTATE TAX:
$
$
$
AMENDED
158,350.00
We have determined the following:
STATE DEATH TAX CREDIT:
44,515.00
GENERATION-SKIPPING TAX:
0.00
These figures do not include any interest and penalties that may be charged.
Please keep this document in your permanent records. You may need it to complete
administration of the estate, such as: close probate proceedings, transfer title to property, and
settle state taxes. Keep it with your cancelled check( s) to show that you have met the estate tax
obligation. Proof of payment in the amount shown above releases you of personal liability
(IRC 2204). If the time for payment in the amount shown above is extended under
section 6161,6163, or 6166, personal liability is not released until full payment has been
received.
We will not reopen this return unless you notify us of changes to the return, or there is evidence
of misrepresentation of a material fact, a clearly defined substantial error based upon an
established Service position or a serious administrative omission. (See IRC 7121).
~~ 14--
Field Director, Cincinnati Compliance Service Center
G~L
PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF
THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM
YEARLY UNTIL COMPLETION.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: MILDRED C. MYERS
Date of Death: NOVEMBER 9. 2001
Will No.: 21-01-01068
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
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 . report.
Date:
11J1cU O~
re
reA. Johnson
me (Please type or print)
Johnson, Duffie, Stewart & Weidner
301 Market Street, P.O. Box 109
Lemovne. PA 17043-0109
Address
3QUIllQ
\U:70i:J
o l: lid 0 L (J\fW 170.
(717) 761-4540
Telephone No.
Capacity:
Personal Representative
~ Counsel for Personal Representative
REV.l5QO EX 16-(0)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
O'FFIC!AL'USE (WILY G
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..-12 ---d-;l-~_(l...____.___________
FILE NUMBER
21_ 0 1 0 1 068
COUNTY CODE
YEAR
NUMBER
....
Z
W
C
W
o
W
C
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
MYERS, MILDRED C.
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
11/9/2001 12/06/1907
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
SOCIAL SECURITY NUMBER
206 - 36 -3152
!XJ 1. Original Return
o 4. Limited Estate
~ 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (dale of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Mach copy oITrust)
D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
o 3. Remainder Return (dale of death prior to 12-13-82)
[K] 5. Federal Estate Tax Return Required
l 8. Total Number of Safe Deposit Boxes
D 11, Election to lax under Sec. 9113(A) (Attach Sch 0)
f-
Z
W
o
z
o
c..
Ul
W
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0::
o
U
.' 'tHI5'SECTI()rj"MCisT>EI~.COM'PLE'tEb.' AL.L'CORR~SPONtl'ENt:E.~~~,G'QN:f:';fp!:N'tIAI$-fAX;'Nf9RMATION.SH()\.I[p~e'[jjREcfE[);''tO:'.
NAME Ho r ace A. John son COMPLETE MAILING ADDRESS
301 Market St.
P. O. Box 109
Lemoyne, PA 17043-0109
FIRM NAME (If Applicable)
Johnson Duffie St Weidner
TELEPHONE NUMBER ( 7 1 7) 7 6 1- 4 54 0
(1)
(2)
(3)
(4)
(5)
138,500.00
1,174,899.95
~:.FICIAL US~
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)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (tolal 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)
13. Charitab.le and Governmental Bequests/Sec 9113 Trusts for which an election to lax has not been
made (Schedule J)
57,613.21
(6)
(7)
(8)
1,371,013.16
(9)
92,463.13
8,644.78
(10)
(11) 101,107.91
(12) 1,269,905.25
(13) -0-
(14) 1,269,905.25
x.O_ (15) -O-
x .0 45 (16) 56,650.74
x .12 (17) -O-
x .15 (18) 1,650.00
(19) 58,300.74
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
1,258,905.25
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
11,000.00
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
. . .... . ~> BE SURE TO ANSWER ALL QlO!:s'fioNS ON,RE;VERSE SIDE AND RECHECK MATH <<
'(,\)>/,:::,j(
Decedent's Complete Address:
STREET ADDRESS
801 16th street
CITY New Cumberland I STATE PA I ZIP 17070
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
52,000.00
2,736.84
Total Credits (A + 8 + C )
(2)
3. InteresVPenalty if applicable
D. Interest
E. Penalty
-0-
TotallnteresVPenalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
58,300.74
54,736.84
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due.
(5A)
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
3,563.90
-0-
3,563.90
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
a. retain the use or income of the property lransferred;.......................................................................................... D
b. retain the right to designate who shall use the property transferred or its income; ............................................ D
b. retain a reversionary interest; or.......................................................................................................................... D
d. receive the promise for life of either payments, benefits or care? ...................................................................... D
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. D
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ D
No
[Xl
@
[Xl
[Xl
~
[Xl
[Xl
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 pe~ury, I declare thaI I have examined this refurn. 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 all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILlN~TURN . I
?77~ n~r c'--c~R~
ADDRESS Marcia yers, Executrix
15 Ar ore ircle, New Cumberland, PA 17070
SIGNATURE OF P ER HE AN REPRESENTATIVE
ADDRESS
o. Box 109, Lemoyne, PA 17043-0109
DATE
'[5'- .;2 - (j ;r-
DATE
8J ~ ilL-
For dates of eath on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. ~9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)].
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum 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. 99116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV.I502EX. (1.97)
SCHEDULE A
REAL ESTATE
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
MYERS, MILDRED e. 21-01-01068
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged
between a willing buyer and a willing seller, neither being compelled to buy or sell, both baving reasonable knowledge of the relevant facts. Real property which is jOintly-owned with
right of
survivorshio must be disclosed on Schedule F.
ITEM
NUMBER
1.
ESTATE OF
DESCRIPTION
VALUE AT DATE
OF DEATH
Real Estate - No. 801 16th Street, Borough
New Cumberland, Cumberland County, PA
(Deed Book S, Volume 12, Page 471)
of
Appraised value $138,500.00
(Copy of appraisal attached)
TOTAL (Also enter on line 1, Recapitulation) $ 138, 500 . 00
(If more space is needed, insert additional sheets of the same size)
I
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APPRAISAL OF REAL PROPERTY
LOCATED AT:
80116th Street
Borough of New Cumberland, Cumberland County
New Cumberland, PA 17070
FOR:
Horace A. Johnson, Esq.
301 Market Street, Lemoyne, PA 17043
AS OF:
November-9,2001
BY:
Lester G. Connor, MAl
PA Certified General Appraiser
L. G. CONNOR REAL ESTATE APPRAISERS LTD
2159 Market Street,
Camp Hill, PA 17011
L.G. Connor ileal Estate Appraise1s
h:nn GA2 - ''TOT/\L 2QOO for Winciow~" apprais;-l! softwiirt bl a la mode, inc. --- 1-BOO-ALAMODE
l
I
I
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File No.
November 27, 2001
LG. Connor Real Estate Appraisers L TD
2159 Market Street
Camp Hill, PA 17011
Mr. Horace A. Johnson, Esquire
301 Market Street
Lemoyne, PA 17043
RE: 801 16th Street
Borough of New Cumberland, Cumberland County
New Cumberland, PA 17070
Dear Mr. Johnson:
Pursuant to your request, I have prepared a Complete Appraisal,
Summary Report for the property captioned in the "Summary of Salient
Features" which follows.
The accompanying report is based on a site inspection of
improvements, investigation of the subject neighborhood area of influence,
and review of sales, cost and income data for similar properties.
This appraisal has been made with particular attention paid to the
applicable value influencing economic conditions and has been processed in
accordance with nationally recognized appraisal guidelines.
The value conclusions stated herein are as of the date of death of the
owner as stated in the body of the appraisal and contingent upon the
certifications and limiting conditions attached. The purpose of this report is to
determine the estimated market value for marketing purposes.
Please do not hesitate to contact me or any of my staff if we can be of
additional service to you.
!d (i~
o Lester G. Connor, MAl
Pennsylvania State Certified General Appraiser
Certification Number GA-000229-L
form OCVR - "TOTAL 2000 lor Windows' appraisal software by a la mode, inc. -1-800-ALAMOOE
SUbject Address
legal Description
City
Counly
State
Zip Code
Census Tracl
Map Reference
Sale Plice
Dale aI Sale
Borrower I Clienl
lender
Sire (~e Feet)
Plica per Square Fool
location
Age
Condition
Total Rooms
Bedrooms
Baths
Appraiser
Date of Appraised Value
Final Estimate alllalue
SUMMARY OF SALIENT FEATURES
80116th Street
Deed Book , Page
New Cumberland
Cumberland
PA
17070
3240-0107
NA
$ NA
NA
NA
Horace A. Johnson, Esq.
2,364
$
Good
85+/-
Fair to Avg
9
4
1.5
Lester G. Connor, MAl. Certified General Appraiser
November 9, 2001
$ 138,600
Form SSD - "TOTAL 2000 for Windows' appraisal software by e Ie mode, inc. -1-SOQ-ALAMODE
L.G. Connor Real Estate Appraisers
UNIFORM RESIDENTIAL APPRAISAL REPORT
r File No.
ProDMv Address 80116th Street CiIv New Cumberland State P A liD Code 17070
Lenal Desorinlion Deed Book .Paae Countv Cumber/and
Assessor's Parcel No. 26-23.0543-442 TaxYear 2001 R.E.Taxes~ 1878.94 ~eclal Ass=mms s 0.00
Borrower NA Current Ow""r Jacob M. Mvers et ux OCCI "'ant: r 1 Owner r Tenant IX'! Vacant
Prl\llert'4nOOts annralsed IX\ Fee SifluJle r 1 Leasehold PrOio..! TUN> I PUD I I Condominium IHUDNA onlv\ HOA t NA /Mo.
Neiohborhood or Proil!ct NlII18 Borouah of New Cumber/and Man Reference NA Census Tract 3240-0107
Sale Price $ NA Date of sale NA Oesc' .. I of Inan ch c :inn< to Iv! nald hv sener NA
Lender/Client Horace A. Johnson Esa. Address 301 Market Street Lemovne PA 17043
Annra/ser Lester G. Connor MAl Address 2159 Market Street CamD Hili PA 17011
Location !d Urban ~ Suburban U Rural Predominant S1n~e Ianllly hOUSIll:9 Present land use % Land use change
PRI AG
Buin up DOver 75% C8l 25-75% 0 Under 25'1'0 occupancy SrO) (yrs) Onelamily ~ C8l Not Il1<ely o Ukely
Growth rate o Rapid C8l Stable o Slow L8J Owner 5 LOW~ 2-4 family -L o In process
Proplllty values 0 lncreasif1g C8l Stable o Declining o Tenant 175 Hioh 75 Multi-family _ To:
Demand/supply 0 Shortage ~ ~n balance R ~ver supply ~ Vacant (0-5%) ",{"'dPredominant t::"i'- Commercial
Marketino lime Fi Under 3 mos. 3-6 mos. Over 6 mos. Vac I...r Sf-\ 125
Ilote: Race and \he racial _-",on at tho nolghbGl'baad are nat ap..alsal facto...
Nelghblllf100d boundaries and characteristics: The nelahbOrhood boundaries are Indicated on the enclosed nelahborhood maD In
the addenda of thIs reDort.
Factors that affect1he maiketability at the properties in the neighborhood (proximity 10 employment and amenities, employment stability, appeal to mBJl<et, etc.):
Schools shoDolna. emDlovment. recreation and houses of worshlD are all within a 10-20 minute dr/vlno time of the
subiect oroDertv. Averaae DrODertv maintenance Droarams were observed. Emolovment stabllltv Is aood due to the
State CaDitalln Harrlsbum- the Armv SUDDI" DeDat In New Cumberland and the Naval SUDDlv DeDot In
Mechanlcsbura.
Market conditions in the subject neighborhood Qncluding support for the above conclusions related to the trend at property values, demillKVsupply, and marketing time
-- such as data on competitive properties for sale in the neighborhood, descrfption of the prevalence of sales and financing concessions, etc.):
CouRtv tax records and MLS statistics show nrices to be stable. The MLS shows that the typical marketino time for
the area is three to sIx months. Mortaaae funds are readilv available with conventIonal loans belna 5.15% to 6.25%
Interest fixed 30 vear 95% mortaaae with UD to three ooints. Sellers are not reaulred to offer sales or financina
concessions. but seller assistance Is occurrlno.
ProjecllnlonnaDon lor PUDa (6 applicable) - -Is the developerlbuilder in control of the Home Owners' Association (HOA)? 0 Yes L8J No
Approximate fotal number of units In the subject project NA Approximate total number of unITS for sale in the subject project NA
Describe common elements and recreationallacilities: NA
Dimensions 168' x 333.15' x 80' x 120' x 70' x 186.5' Topography Level or oraded
SITe area 1.18+1- acres Comer Lot 0 Yes C8l No Size Above Averaoe
Specific zoning classillcation and descrfption Residential Shape Irreaular
Zoning compliance L8J legal Jfi Legal nonconfrfng (Grandfathered use) 0 Illegal o No zoning DraInage AODears Adeauate
H1nho_<f & h..t ".e as Imnroved' Present use Other use le,nlain\ View TVDlcal Street
UtiIfDee Public Other Off-aillllmprovements Type Public Private Landscaping TVDlcal for the area
E1ectriclty C8l Street Macadam L8J 0 Driveway surtace Macadam
Gas L8J Curb/gutter Concrete L8J 0 Apparenl easements Standard Utilltv
Wafer L8J Sidewalk Concrete L8J D FEMA Special Flood Hazard Area DYes L8J No
SanIlaJy sewer ~ Streetlights Adequate ~ R FEMA Zone C Map Date 2116"7
Storm sewer Alley None FEMA Man No. 420366-B
Commen1s (apparent adverse easemenls, encroachments, special assessmenls, slide areas, illegal or legal nonconforming zoning use, etc.): Standard
easements for electric. teleohone. etc... There are no known or aooarent adverse easements encroachments. or
conditions that would ne Jatlvelv ImDact on the value of the subject propertv.
GENERAL DESCRIPTION EX!1:RIOR DESCRIPTION FOUND/l nON BASEMENT INSULA nON
No, of Units One Foundation Stone Slab ConcrtlGravel Area Sq. Fl. 1 000+1- Roof _ 0
No. of Stories 2.5 Exterior Walls Brick Crawl Space Under extens % Rnished UnfiniShed Ceiling_ 0
Type (Det/AIl) Detached Roof Surface Slate/Comno Basement 75% Ceiling Unfinished Walls_D
Design (SIyJe) 2.5 StorY Gutters & Dwnspts. Galvanized Sump Pump Floor Drain Walls Stone Roor _ 0
ExIs11ngIProposed Exlstlna Window Type Wooden DH Dampness SlIaht Roar CncrtlGmd None _ 0
Age (Vrs.) 85+1. Storm/Screens Settlement SlIahtlaae Outside En\Jy Yes UnknowL-- L8J
Effective Aoe tvrs.l 50 Manufact\l"ed House No Infeslation None evident
ROOMS Fover Uvinn Dininn K~chen Den FamilY Rm. Ree. Rm. Bedrooms # Baths LavndlV Other Area Sn. Ft.
Basement 1 000+1-
Levell 1 1 1 1 .5 Porches 1.464
Level? 4 1 900
Rrished area above orade conlains: 9 Rooms' 4 Bedroomrsl' 1.5 Bath 5\' 2 364 S uare Feet of Gross Livinn Area
INTERIOR Material$/CondItion HEAnNG KITCHEN EQUIP. ATTIC AMENITIES CAR STORAGE:
Aoors Hard WoodfAva Type Steam Refrigerator 0 None 0 Areplace(s) # L- [8J None 0
Walls Plaster Fuel 011 Range/Oven L8J Stairs L8J Patio Covered L8J Garage # of cars
Trim/Finish Wood Gond'rtIon Ava Disposal 0 Drop Stair 0 Decll 0 Attached
Bath Roor Vinvl Tile COOUNG Dishwasher 0 Scuttle 0 Porch 2 L8J Detached 2 Car
Bath Wainscot Ceramic Tile Central fanlHood 0 Roar ~ Fence 0 Buitt-In
Doors Wood Other None Microwave R Heated R Pool R Calport
Condition Washer/[llVer Finished Driveway Macadam
Additional features (speCial energy efficient items, etc.): Coal cellar' old stvle s\nk:
Condition of \he improvements, depreclation (physical, functional, and external), repairs needed, quality of consllUCtion, remodeling/additions, etc.: Old stvle
kitchen & bath fixtures. Brick needs reDolntlno. Slate roof should be InsDected' several slate pieces mlsslno or loose.
Adverse enVironmental conditiOns (such as, but not limited to, hazardous wastes, 10lOC subslances, etc.) present In \he Improvements, on the site, or in 1he
immediate vicinity of the subject property,: There are no known or aDDarent adverse environmental conditions that would
neaatlvelv ImDact on the value of the DrODertv.
Freddie Mac Form 70 6193
PAGE I OF2
Fannie Mae Form 1004 6193
Val a"on S..,UO" e o.
'ESTIMATED SITE VALUE .' .................__.....h. .................= $ Comments on Cost Approach (such as, source of cost estimate, site value,
ESTlM,ATED REPROUUCTlON COST -NEW-OF IMPROVEMENTS: square 100\ calculalion and 101 HUD. VA and FmHA, the estimated remaining
Dwelling 2,364 Sq. R. @$ =$ economic life of the property): The Cost Aooroach aenerallv
1.000 Sq. R. @$ = will result in an excellent estimate to value if the
= buifdna Is new or reasonablv new and the
':' Garage/Carport ~ Sq. Ft. @$ = improvements reflect the hiahest and best use of the
Tolm Estimaled Cost New................ ............ =$ land. However. when Items of nhvsical deterioration
_ less Physical Functional Extemal and obsolescence must be estimated an area of
Deprecialion I I =$ fudaement Is Involved which is sublect to error. The
I Depreciated Value 01 Improvements .................................. =$ Cost ADDroach was not utilized due to the aae of the
'As-Is" Value of Site Improvements .... ........ ............. ........... =$ sublect orooertv.
lNOICATEOVAlUEP.VOOSTAI'I'ROACII ............................. =1:
ITEM 1 SUBJECT COMPARABLE NO. 1 COMPAMBLE NO.2 COMPARABLE NO.3
80116th Street 333 W 15th Street 726 W 16th Street 109 N 26th Street
Address New Cumberland New Cumberland New Cumberland New Cumberland
Proximitv to Sllhiect . ,;.', ~,.'- '".,''--'-'.- .,:::.;i';;~:.\.>'.' :~:~}0i0_et Within 5 blocks Within 3 miles
:',.....-.....:.::;:::
Sales Price NA 182 500 .""'>,,'::.'0;'.11: 185000 ..... .;.....',.....:1$ 180900
Poc.JGross livino Area $ rt. $ 95.85 81.14 rP 63.97 rP r
Data and/or Inspection Ext. Inspect; Apprsr Flies Ext. Inspect; Apprsr Files Ext. Inspect; Apprsr Flies
Velificalion Sour~e Courthse Rec Courthouse Records Courthouse Records Courthouse Records
VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION : +1-1$ Adlust. DESCRIPTION : +/-1$ Adlust. DESCRIPTION : +1-1$ Adiust.
Sales or Financing '"..t.,;.>: Conventional Conventional Conventional
Concessions ,"',i'.,!;;- Private Sale Private Sale Costs/8 DOM
Dale 01 SalPJljme 3/14/01 : 7/2/01 : 3/30/01 :
Location Good EQual : Eaual : Eaual :
leasehoJrl/Fee Simnle Fee Simole Fee Simole : Fee Slmole : Fee Slmole :
Site Good 0.84 aclEoual : +1 500 0.74 ae/Eaual : +3 000 0.18ac/Smallr :
View Tunical Street Ava. Street : Ava. Street : Ava. Street :
Deslon and Anneal 2.5 storv/Ava 2 storY 2.5 storY : 2.5 storY :
Qualitv of Construction Averaae StnlStcco/Ava : Brick/Ava : Wood/Inferior : +3 000
Aoe 85+1- 71+/- : 81+/- : 100+1- :
Conrlllion Fair to Ava Suoerlor : -45.000 SUDerior : -45.000 Sunerlor : -36.500
Above Grade T alai : Brlrms: Balhs Total : Bdrms: Balhs : Total : Bdrms: Baths : T olal : Bdrms: Balhs :
Room Counl 9 : 4 : 1.5 8: 4 1.5 : +3,500 8 4 1.5 : +1,000 9 4 3 : -3,500
Gross Uvlnn Area 2.364 ~n. R. 1.904 Sn Fl. : 2 280 So. R. : 2 828 So. Fl. : -4 000
Basement & Finished 75% Basemt Full Basemnt Full Basemnt Partl Basemnt :
Rooms Below Grade 25% Grnd/Con Unfinished Rec/Klt/Bath -6 500 Unfinished
. Functional IJIilitv Aver/Ioe Averaae : Averaae : Averaoe :
Heatina'Coonnn Steam/None Steam/None : Steam/None : FHA/CA : -3 000
Enernv Efficienf IIems FaIr Averaae : Averaae : Averaae :
Garanp/Camort 2 Car Garaae Det 1 Car Gar : -500 Det 1 Car Gar : -500 Off Street :
Porch, Palio. Deck, Porches/Patio Porch/Patio ScrPrch/Patio -500 Porch/Deck
Firenlacetsl etc. 2 Fireolaces FireDlace +2 500 FlreDlace +2.500 Fireolace +2.500
Fence Pool etc. None None : None : None :
ADDliances RIO RIO WID Dlso : -500 RIO WID Olsp : -500 RIO WID Diso : -500
Nel Adi. Ilolal\ ;'i'.. rl+ !XI- :$ 38 500 rl+ !XI - :$ 46 500 rl+ !XI- :$ 42.000
Adjusted Sales Price ...... '.:.r:;"!":....}'1 ':/.;<0".'>\
'j
of Comoarable .......':... 144 000 1"....:'.,.:'.',.'1$ 138 500 $ 138 900
Comments on Sales Comparlson Oncluding the subject property's compatibUity to tl1e neighbomood, elc.): After a thorouoh search of all available
data the comoarables chosen were considered the best available. Adlustments were made to reflect substantial
differences between the comoarable proDerties and the sublect. The adlustments that were made reflect the tvDlcal
actions of buvers and sellers In the marketolace. All comoarables were considered eouallu. Larne adiustments due to
condition of roof reoulred brick oolntlna. old stvte wirlna. There Is a mixture of old stvle & modem wlrlna: old stvle
kitchen & bath fixtures.
ITEM SUBJECT COMPARABLE NO. 1 COMPAMBLE NO.2 COMPAMBLE NO.3
Date, Plice and Data NA None None None
Source. for poor sales NA NA NA NA
wlfhjn vear of annralsal NA Courthouse Records Courthouse Records Courthouse Records
Analysis of any current agreemenl 01 sale, option, or listing of subject property and analysis of any prtor sales of subject and comparables within one year of the date 01 appraisal:
Prior sales 0' the comoarable Dropertles occurred more than one vear aoo.
:~~:~~ ~~~~:~=EC::~~:r:::~~l ".E~ii~~~dM~~i'R~i""" i.......Ni........iM~.~ .G~~~R~~i M~lii~li~~.... .NA.... = ~ 138500
This appraisal is made I8l 'as is' ,kl ~ subject to \he repairs. alIerations, Inspecllons or conditions listed below 0 Subject to completion per plans & specifications.
Candnlans of Appralsal: No warran of this aooralsalls alven or ImoJied. No lIabllitv Is assumed for the structural andlor
mechanical elements of the sublect.
Anal Reconciliallon: Due to the lack of rental data the Income Aooroach was considered Inaoorooriate and not utilized.
Greatest weloht was nlven to the Sales Comoarlson ADoroach as it reflects the tvDlcal actions of buvers and sellers in
the ODen market.
The purpose of this appraisal Is to estimate the market value of the real property lhat Is the subject 01 this report, based on the above conditions and the certfficafion. contingent
and limiting conditions, and maJ1<et value definition that' are slaled In the alIached ffeddie Mac form 4391FNMA form 1004B (Revised June 1993 ).
I "'."_~;""L1.<," "''''OfTIIE'''' _""""',.,,."""'" Of"" ",""",AI" November 9. 2001
(WHICH IS THE DATE py AND !jiE EFFECTlVE DATE OF THIS REPORT) TO BE $ 138,500
APPRAISER: ~ SUPERVISORY AI'PRAISER(ONLY IF REQUIRED):
Sionature w _ - SJonature o Did o Did Not
Name Lester G. Connor. MAl Name Inspect Property
Date Reoort Sllllled November 30. 2001 Date Renort Sinned
Slate Certification # GA-000229-L Stale P A State Certification # State
Dr State Ucense # State Or Slate Ucense # Stale
UNIFORM RESIDENTIAL APPRAISAL REPORT FII N
freddie Mac Fonn 70 6193
PAGE 2 DF2
Form UA2 - "TDTAL2000 lor Windows' appraisal software bv a la mode, inc. -1-800-ALAMODE
Fannie Mae form 1004 6-93
Subject Photo Page
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Subject Front
801 16th Street
Sales Pnce NA
Gruss Uvin() Al\\a 2,364
Total RJoms 9
T olal Bedrooms 4
fotal8athwllnt> 1.5
location Good
View Typlca I Street
Site Good
Quality Average
Age 85+1-
Subject Rear
Subiect Street
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REAL ESTATE APPRAISERS
\L tv d 10 )C /J Lt-
2159 Market Street
Camp Hill, FA 17011-4707
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i-TiVING- AREA BREAKDOWN
L___~!ea~!,~n Subtotals
First Floor
30.0 x
18.0 x
4.0 x
Second Floor
SKETCH/AREA TABLE ADDENDUM
Prope~ ~~~s~~t~ Street______
Cily_Ne!^'.C:~l11berland _ . ___.__ __ County _Cumberl~~. State P A _____ _ ____
Borrower NA
LenderlClient Horace A. Johns';;:;: Esquire ______u --_________.n
App~aiser Nam-e-'. Lester G. Connor. MAl ------------- - ------~-,~. ___._n
Zip 17070
34.0'
18.0' 0 0
c:i 2 Car Garage d
N N
Q ~
cO CXl 34.0'
N N
30.0' 4.0' 30.0'
Q
an
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C Q
First Floor d Second Floor d
M M
8.0'
30.0' 30.0'
. Area
GLA1
--. ~a~~~!~;~CU~~_~_NS S~~!MA~~()tal~ ]
First Floor 900.00
First Floor 504.00
First Floor 60.00 1464.00
Second Floor 900.00 900.00
Porch 165.00
Porch 152.00 317.00
Garage 680.00 680.00
30.0
GLA2
pip
30.0
28.0
15.0
30.0 x
GAR
TOTAL LIVABLE (rounded)
2364 J
4 Areas Total (rounded)
e.PEX SOFlWAA.E 210-699-6666
-
Scale: 1 = 18
900.00
504.00
60.00
900.00
2364
Apx7100-w Apex!l
( Neighborhood Map)
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DEFINITION OF MARKET VALUE: The most probable price which a property should bring In a competitive and open millket under all conditions
requisite to a falr sale, the buyer and sener, each acting prudenlly, knowledgeably and assuming the price is not affected by undue stimulus. Implicit In this
definition is the consummalion ot a sale as ot a specl~ed date and the passing 01 1I11e trom seller to buyer under conditions whereby: (t 1 ooyec and seller are
typically motivated; (2) both parties are Vlell informed or well advised, and each acting In what he considers his own besllnleresl; (3) a reasonable time Is allowed
for exposure in the open millket; (4) payment is made In ferms of cash in U.S. dollars or in teems of financial arrangements comparable thereto; and (5) the price
represents the normal consideration for the property sold unaffected by special or creative financing or sales concessions' granted by anyone associated with
the sale.
. Adjustments fo the comparables must be made for special or crealive financing or sales concessions. No adjustments are necessary
for those costs which are nOlmally paid by sellers as a result of lralfmon or law in a millket area; these costs are readily identifiable
since the seller pays these costs in vlrtlJally all sales transactions. Special or crealive financing adjustments can be made to the
comparable property by comparisons to financing terms allered by a third party Institutional lender Ihat is not already involved in the
property or transaction. Any adjustment should not be calculated on a mechanical dollar for dollar cost of the financing or concession
but the dollar amount of any adjustment should approximate the millkel's reaction 10 the financing or concessions based on the
appraiser's judgement.
STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION
CONTINGENT AND LIMITING CONDITIONS: The appraIse(s certificalion thai appears in the appraisal report is subject to the following
conditions:
1. The appraiser wlll not be responsible for matters of a legal nature that affect either the property being appraised or the tille to it. The appraiser assumes that
the IIlIe is good and millketable and, therefore, will not render any opinions about the title. The property Is appraised on the basis of it being under responsible
ownership.
2. The appraiser has provided a sketch in the appraisal report to show approximate dimensions of the improvements and the sketch Is Included only to assist
the reader of the report In visualizing the property and understanding the appraiser's determination of tts size.
3. The appraiser has examined the available flood maps that are provided by the Federal Emergency Management Agency (or other data sources) and has noted
in the appraisal report whether the subject site Is located In an identified Special Rood Hazard Area. Because the appraiser is not a surveyor, he or she makes
no guarantees, express or Implied, regarding thls determination.
4. The appraiser will not give testimony or appear In court because he or she made an appraisal of the property in question, unless specific arrangements to do
so have been made beforehand.
5. The appraiser has estimated the value of the land In the cost approach at its highest and best use and the improvements at their contributory value. These
separate valuations 01 the land and Improvements must not be used in conjunction with any other appraisal and are Invalid if they are so used.
6. The appraiser has noted in the appraisal report any adverse conditions (such as, needed repairs, depreciatiOll, the presence of hazardous wastes, toxlc
substances, etc.) observed during the Inspection of the Subject propilrty or that he or she became aware 01 during the normal research involved in performing
the appraisal. Unless otherwise slated in the appraisal report, the appraiser has no knowledge of any hidden or unapparent conditions of the property or
adverse environmental conditions (including the presence of hazardous wastes, toxic substances, etc.) that would make the propilrty more or lass valuable, and
has assumed thai there are no such conllltions and makes no guarantees or warranties, express or Implied, regarding the condition of the property. The
appraiser will not be responsible tor any such conditions that do exist or tor any engineering Of testing that might be required to discover whether such
conditions exlst Because the appraiser Is not an expert In the fleld of environmental hazards, the appraisal report must not be considered as an
environmental assessment of the property.
7. The appraiser obtained the Information, estimates, and opinions that were eiqlressed in the appraisal report from sources thaI he or she considers to be
reliable and believes them to be true and correct The appraiser does not assume responsibility lor the accuracy of such Items that were fumished by other
parties.
8. The appraiser will not dlsclose the contents of the appraisal report except as provided for in the Uniform Standards of Professional Appraisal Practice.
9. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that is subject to satislactol)' complefion, repairs, or
alterations on the assumption that completion of the improvements will be pertormed In a woil<manlike manner.
10. The appraiser must prOVide his or her prtor wrttten consent belOle the lender/client specified In the appraisal report can distribute the appraisal report
pncludlng conclusions about the property value, the appraise(s Identity and professional designallons, and references to any professional appraisal
organizations or the firm with which the appraiser is associated) to anyone other than the borrower, the mortgagee or lis successors and assigns; the mortgage
insurer, consullanls; professional appraisal organlzalions; any state or federally approved financial institution; or any department, agency, or instrumentality
of the United States or any state or the District of Columbia; except that the lender/client may distribute the property description section of the repOlt only to data
collecllon or reporting servlce(s) without having to obtIin the appraiser's prior wrttten consent The appraiser's written consent and approval must also
be obtained before the appraisal can be conveyed by anyone to the public Illrough advertising, public relations, news, sales, or other media.
Freddie Mac Form 439 6-93
Page 1 of 2
Fannie Mae Form 10048 6-93
.._ L.~. Co.nnor ~e~ Es~ate Apprais~rs
APPRAISER'S CERTIFICATION: The Appraiser certifies and agrees that
1. I have researched the subject marl<el area and have selected a minimum of three recent sales of properties most similar and proximate to the subject property
for consideration in the sales comparison analysis and have made a dollar adjustmenl when appropnale to rel1ect the marl<el reaction to those Items of signillcant
variation. If a signilicanl item In a comparable property Is supenor la, or more favorable than, the sublecl property, I have made a negative adjustment to reduce
the adjusted sales price oflhe comparable and, It a significant Item in a comparable property is infenor to, or less favorable than the subject property, I have made
a positive adjustment to increase the adjusted sales pnce of the comparable.
2. I have laken into consideration the tacters that have an Impact on value in my development of the estimate of marl<et value in the appraisal report. I have not
knowingly withheld any significant Information from the appraisal report and I believe, to the best of my knowledge, that all statemems and lntorma1ion in the
appraisal report are true and correcl
3. I stated In the appraisal report only my own personal, unbiased, and professional analysis, opinions, and conclusions. which are subject only to ttle contingent
and limiting conditions specified in this form.
4. I have no present or prospective interest in the property that is the subject to this report, and I have no present or prospective personal interest or bias wittl
respect to the participants in the transaction. I did not base, ellher partially or completely, my analysis and'or !he estimate of market value In the appraisal report
on the race, color, religion, sex, handicap, familial status, or national ongin of either the pPJSpeclive owners or occupants 01 the subject property or 01 the present
owners or occupants of the properties in the vicinity of the subject property.
5. I have no present or contemplated future interest in the subJect property, and neither my current or tuture employment nor my compensalion tor pertorming this
appraisal Is contingent on the appraised value of the property.
6. I was not required to report a predetermined value or direction in value that favors the cause of the client or any related party, the amount of the value estimate,
the attainment 01 a specltic result, or the occurrence of a subsequent event in order to receive my compensation and/or employment for perlorming the appraisal. I
did not base the appraisal report on a requested minimum valuation, a specific valuation, or the need to approve a specltic mortgage loan.
7. \ pe~ormed this appl1lisal in conformity with the Unlform Standards of Professional Appraisal Practice that were adopted and promulgated by the Appl1lisal
Standards Board of The Appraisal Foundation and that were in place as of the effective date of this appraisal, wnh !he exception of the departure provision of those
Standards, which does not apply. I acknowledge that an estimate of a reasonable time tor exposure in the open marl<et Is a condition in the definition of market value
and the estimate I developed Is consislent with the marl<eting lime noted in the neighborhood section of this report, unless I have otherwise stated in the
reconciliation section.
8, I have personally inspected the intenor and menor areas of the subject property and the menor of a1f properties listed as cornparables in the appraisal report.
I further certify that I have noted any apparent or known adverse conditions In the subject improvements, on the subject site, or on any site within the Immediate
vicinity of the subject property of which I am aware and have made adjustments for these adverse conditions fn my analysis of the property value to the extent that
I had marl<et evidence 10 support lhem. I have also commented about the effect at the adverse condmons on !he marl<etabUity 01 the subject property.
9. I personally prepared all conclusions and oplnlons about the real estate that were set forth in the appraisal report. If I relied on signmcant professional
assistance from any Individual or Individuals in the perlormance of the appraisal or the prepara1ion of the appraisal report, I have named such individual(s) and
disclosed the specific tasks pertormed by them in the reconcitiation section of this appraisal report. I certify that any individual so named is qualified to perform
the tasks. I have not ilUlhortzed anyone 10 make a Change \0 any nem In the report; therefore, IT an unauthonzed change is made to the appraisal report. I will lake
no responsibillfy for n.
SUPERVISORY APPRAISER'S CERTIFICATION: If a supervisory appraiser signed the appraisal report, he or she certifies and agrees that:
I directly supB/Vise the appraiser who prepared the appraisal repo~, have reviewed the appraisal report, agree with the statements and conclusions of the appraiser,
agree to be bound by the appraiser's certifications numbered 4 througtl 7 above, and am taldng full responsibility tor the appraisal and the appraisal report.
ADDRESS OF PROPERTY APPRAISED: 80116th Street, New Cumberland, PA 17070
APPRAISE~Y). .J ;J ./l
Signature: ~ 'lr If( C:-"'~
Name: Lester G. Connor, MAl
Date Signed: November 30. 2001
State Certificalion #: GA.000229-L
or Stale License #:
Slate: P A
Expiration Date of Certnlcation or License: June 30, 2003
SUPERVISORY APPRAISER (only if required):
Signature:
Name:
Date Signed:
State Certificalion #:
or State License #:
Stale:
Expiration Date ot Certification or License:
o Did
o Did Notlnspecl Property
Freddie Mac Form 439 6-93
Page 2 of 2
Fannie Mae Form 1004B 6-93
Form ACR - 'TOTAL 2000 for Windows' appraisal software by a la mode, inc. - t-800-ALAMOOE
Borrower/Client NA .
Pronertv Address 801 16th Street
Gitv New Cumberland Couotv Cumberland State PA Zin Code 17070
lendei. Horace A. Johnson ESQ.
OJu......llillnmUII ....UutHIUum
File No
SPECIAL LIMITING CONDITIONS:
This appraisal is not a home inspection and the appraiser is not acting as a home inspector when preparing the report.
The borrower has the right to have the home inspected by a professional home inspector. When performing the
inspection of this property, the appraiser visually observed areas that were readily accessible. The appraiser is not
required to disturb or move anything that obstructs access or visibility. The inspection is not technically exhaustive. The
inspection does not offer warranties or guaranties of any k',nd.
If the property is sold, this appraisal is subject to satisfactory inspection reports including, but not limited to: wood
infestation, watertest(s), septic inspection, radon, building inspections, etc.
. URAR: Supplemental Certifications
I certify that,
This COMPLETE APPRAISAL. SUMMARY APPRAISAL REPORT was prepared by Lester G. Connor, MAl, for
the exclusive use of Mr. Horace A. Johnson, Esquire, for use in determining the estimated market value for marketing
purposes. Estimated market value is the most probable price in terms of cash or in terms of financial arrangements
equivalent to cash. For purposes of this report, Mr. Johnson is considered to be my client. The information and opinions
contained in this appraisal set forth the appraiser's best judgment in light of the information available at the time of the
preparation of this report. Any use of this appraisal by any other person or entity. or any reliance or decisions based on
this appraisal are at the sole responsibility and at the sole risk of the third party. I accept no responsibility for damages
suffered by any third party, as a result of reliance on or decisions made or actions taken based on this report.
In my opinion, the reasonable exposure time linked to the value opinion is up to 180 days.
I further certify that, to the best of my knowledge and belief:
-The statements of fact contained in this report are true and correct.
-The reported analyses, opinions, and conclusions are limited only by the reported assumptions and limiting
conditions, and are my personal, impartial, and unbiased professional analyses, opinions, and conclusions.
_I have no present or prospective interest in the property that is the subject of this report or to the parties involved
with this assignment.
-My engagement in this assignment was not contingent upon developing or reporting predetermined results.
-My compensation for completing this assignment is not contingent upon the development or reporting of a
predetermined value or direction in value that favors the cause of the client, the amount of the value opinion, the
attainment of a stipulated result, or the occurrence of a subsequent event directly related to the intended use of this
appraisar.
-My analyses, opinions, and conclusions were developed, and this report has been prepared, in conformity with
the Uniform Standard of Professional Appraisal Practice.
-I have made a personal inspection of the property that is the subject of this report.
-No one provided significant professional assistance to the person signing this report.
-This appraisal has been prepared in conformity with the requirements of the Code of Professional Ethics and the
Standards of Professional Appraisal Practice of the Appraisal Institute.
-The use of this report is subject to the requirements of the Appraisal Institute relating to review by its duly
authorized representatives.
~ ~ ,2;, ~~c/
Lester G. Connor, MAl, Certified General Appraiser
Form TAOO - "TOTAL 2000 for Windows' appraisal software by a la mode, Inc. -1-BOO'ALAMODE
Rf)/.I503 EX' (1-97)
SCHEDULE B
STOCKS & BONDS
COMMONWEAL TI-1 OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
21-01-01068
MYERS, MILDRED C.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
VALUE AT DATE
OF DEATH
DESCRIPTION
4,251.985 Shares - AXP High Yield Tax-Exempt
Fund @ $4.360 per share
18,538.65
2. $25,000.00 - Government National Mortgage
Association - Certificate No. 03570667SF
@ $106.375
3.
4.
5.
6.
7.
26,593.75
$25,000.00 - Government National Mortgage
Association - Certificate No. 02797589SF
@ $105.375
26,343.75
$25,000.00 - Government National Mortgage
Association - Certificate No. 03667830SF
@ $105.375
26,343.75
$25,000.00 - Government National Mortgage
Association - Certificate No. 02798069SF
@ $105.375
26,343.75
$25,000.00 - Government National Mortgage
Association - Certificate No. 1175369SF
Paid off October 2000
-0-
Legg Mason - Investment Account No. 363-00793
Date of death value
1,050,736.30
TOTAL (Also enter on line 2, Recapitulation) $ 1, 174 , 899 . 9 5
(If more space is needed, insert additional sheets of the same size)
REV.ISOB EX -(1.971
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
MYERS, MILDRED C.
FILE NUMBER
21-01-01068
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.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Household Goods - appraised value
5,775.00
5,630.00
Automobile - 1996 Buick Century
Two (2) Copper bracelets~ 1 small non-working
pocket watch: Harrisburg Hospital pin
Allfirst Bank - Checking Account No. 00288-5400-4
Date of death balance, plus interest
No Value
11,192.28
Allfirst Bank - Money Fund Account No. 00982-9295-1
Date of death balance, plus interest
18,313.74
218.00
14,574.00
1,831.00
61. 54
17.65
One Beacon Insurance - auto insurance refund
Internal Revenue Service
2001 income tax refund
PA Department of Revenue - 2001 income tax refund
Merck-Medco - refund
The Patriot-News - refund
TOTAL (Also enter on line 5, Recapitulation) $ 57, 613 . 21
(If more space is needed, insert additional sheets of the same size)
RfV-1S11EX' (1-97)
ESTATE OF
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21-01-01068
MYERS, MILDRED C.
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
1.
2.
B.
7.
8.
9.
10.
11.
12.
13.
DESCRIPTION
FUNERAL EXPENSES:
Parthemore Funeral Home
Rolling Green - cemetery charges
1,
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Marcia Myers
Name of Personal Representative (s)
Social Security Numbe~s) I EIN Number of Personal Representative(s)
Street Address 15 Ardmore Circle
New Cumberland
Zip
17070
City
State P A
Yea~s) Commission Paid:
2002/2003
2.
3.
Attorney Fees - Johnson, Duffie, Stewart & Weidner
Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
Stale
Zip
4.
Probate Fees - Register of wills - Cumberland County
5.
AccountanfsFees Hartman & Scheuchenzuber - 2001 Returns
6.
Tax Return Prepare(s Fees
Cumberland Law Journal - legal advertisement
The Patriot-News - legal advertisement
Chuck Bricker - household goods appraisal
L. G. Connor - real estate appraisal
Register of Wills - short certificates
Register of Wills - file Inv. & Inh. Tax Return
Reserve for close-out costs
AMOUNT
4,301.20
455.00
41,000.00
41,000.00
934.50
495.00
75.00
96.81
80.00
275.00
9.00
28.00
175.00
Total from additional sheet 3,538.62
TOTAL (Also enter on line 9, Recapitulation) $ 92 , 4 6 3 . 13
(If more space is needed, insert additional sheets of the same sIze)
SCHEDULE H - CONTINUED
ESTATE OF: MYERS, MILDRED C.
21-01-01068
14. Shelby Insurance - homeowner's
insurance
15. Wolfe Contractors - minor repairs
16. PA Water Company - excessive water usage - inspection
discovered a leak in the water line to the house
17. Leggett - repair leak in water line
18. Robin Gasperetti, Tax Collector - West Shore School
District real estate taxes
214.10
48.00
1 ,238.50
623.00
1,415.02
Sub-Total
$3,538.62
ESTATE OF
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
MYERS, MILDRED C.
FILE NUMBER
21-01-01068
Include unreimbursed medical expenses.
ITEM
NUMBER
1.
10.
11.
12.
DESCRIPTION
2.
u. S. Treasury - 2001 estimated income tax payment
PA Department of Revenue - 2001 estimated income
tax payment
Carlos Leffler - fuel oil - decedent's account
Verizon - telephone charges - decedent's account
AT&T - decedent's account
AMOUNT
6,100.00
800.00
248.00
20.44
12.32
29.77
15.43
41. 20
57.43
127.50
521.66
671.03
3.
4.
5.
6.
7.
8.
9.
Comcast - cable charges - decedent's account
PA Water Co. - decedent's account
PP&L - decedent's account
Borough of New Cumberland - sewer/refuse - decedent's
account
Charlotte Horton - services to decedent prior to
death - cleaning residence/yard raking
Robin Gasperetti, Tax Collector - County and
Borough real estate taxes - 801 16th st.
Mellon Bank, N.A. - return of Trust income received
after death
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
8,644.78
~
1lEV.1S13 ex -1\.97)
.
'""
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
MYERS, MILDRED C.
FILE NUMBER
21-01-01068
ESTATE OF
~UM8ER
1.
NAME AND ADDRESS o.F PERSo.N(S) RECEIVING PRo.PERTY
TAXABLE DISTRIBUTlo.NS (include outright spousal distributions)
RELA Tlo.NSHIP TO DECEDENT
Do Not List Trustee(s)
AMQUNT o.R SHARE
o.F ESTATE
1. Kristin Myers - 15 Ardmore Circle, Granddaughter One-half tangibl es
New Cumberland, PA 17070 One-half residue,
in Trust.
2. Jennifer Myers - 801 16th Street Granddaughter One-half tangibl es
New Cumberland, PA 17070 One-half residue,
in Trust.
3 Marcia Myers - 15 Ardmore Circle Daughter-in-law $1,000.00 cash
New Cumberland, PA 17070 - bequest
4. Mary Margaret Kulbok - 214 Fisher st.
Walpole, MA 02081-3909 Stepdaughter $1,000.00 cash
bequest
5. John Adair - R. D. #1, Box 312 Nephew $1,000.00 cash
Blain, PA 17006 bequest
6. John Tucker - 601 93rd st. , N. Stepgrandson $2,500.00 cash
N. Naples, FL 34108 bequest
7. Robert Slencak - 801 16th Street Friend $10,000.00 cash
New Cumberland:, PA 17070 bequest
ENTER Do.LLAR AMo.UNTS Fo.R DISTRIBUTlo.NS SHo.WN ABo.VE o.N LINES 15 THRo.UGH 17, AS APPROPRIATE, o.N REV 1500 Co.VER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPo.USAL DISTRIBUTlo.NS UNDER SECTION 9113 Fo.R WHICH AN ELECTlo.N TO. TAX IS No.T BEING MADE
1.
B. CHARITABLE AND Go.VERNMENTAL DISTRIBUTlo.NS
1.
TOTAL OF PART IT. ENTER TOTAL No.N-TAXABLE DISTRIBUTlo.NS o.N LINE 13 OF REV 1500 Co.VER SHEET $
(If more space is needed, insert additionaJ,sheets of the same size)
REV .1500 EX... (6..00)
L-
" I
.L~
:!
(~
REV-1500 [I
INHERITANCE TAX RETURN IA""~.'"
RESIDENT DECEDENT 21
__ __':l~RIS8URG, PA 17128-0"9~l._____ __________ ____ _....J........90UNTY CODE_YEAL
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717/761-4540
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1 )
(2)
(3)
(4)
(5)
(6)
(7)
None
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT, 280601
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
01
01068
0-
Z
W
o
W
U
w
o
, MYERS, MILDRED C.
. oil iE6FDEATI-I(MM~DD-YEAR) ------roATE OF BIRTH (MM-DD-YEAR)-
I
: 11/09/2001 , 12/06/1907
I (IF APPLICABLE) SURVIVING SPOUSE;S NAME ( LAST, FIRST AND MIDDLE INITlAU'~---
206-36-3152
SOCIAL SECURITY NUMBER
_J'J1IIIi1BER___
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
_____ -J--- REGISTER OF~lllS ___
SOCIAL SECURITY NUMBER
138,500.00
---~._-_._._-
1,071,805.03
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3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
8,644.78
I
- -rr-j:-6;iginal Ret~ .-------~~Supplement;;;Retur~- --- - ---rr-3.Remainder Relurn (date of death prior to 12-13-~
w
" S '" 0 4 Limited Estate 0 4a. Future Interest Compromise (date of death after 0 5, Federal Estate Tax Return Required
fd g: ~ I: 12-12-82)
i3 ~ ~ 0 6: ~~~~ent Died Testate (Attach copy 0 7. ~o~~eo~~~~s~aintained a Living Trust (Attach 8, Total Number of Safe Deposit Boxes
<t 0 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (date of death between 0 11.Election to tax under Sec. 9113(A) (Attach Sch 0)
12-31-91 and 1-1-95) ______~~___~.~___
: TH1f'SE~TIQN.MU$T..'I;l.~"cqMP~e~pqAIWL~QRRE;sfi(i)NDeNcE;A!IIDqONf.I.PE;~iAili.T~JNFqtilA'I'lqN'~I;-IQYlWtiQg(QJ~e~TgpiT(i):
NAME I COMPLETE MAILING ADDRESS
Horace A. Johnson
FIRM NAME (If aPPlicable)--------- ------ 301 Market Street
, Johnson, Duffie, Stewart & Weidner
~ELEPHONEN-UMBER - ----~------- Lemoyne, PA 17043-0109
None
None
57,613.21
None
(9)
(10)
92,463.13
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 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
15. Amount of Line 14 taxable at the spousal tax rate,
or transfers under Sec. 9116(a)(1.2)
x .00
(/TiCI;.\: },. CtLY
(8)
1,267,918.24
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16. Amount of Line 14 taxable at lineal rate
1,155,810.33 x .045
(11 )
101,107.91
1,166,810.33
17. Amount of Line 14 taxable at sibling rate
x .12
(12)
(13)
(14)
1,166,810.33
18. Amount of Line 14 taxable at collateral rate
"
11,000.00 x .15
(15)
(16) 52,011.46
(17)
(18) 1,650.00
(19)
53,661.46
19. Tax Due
20. ~
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Copyright 2000 form software only The Lackner Group, Inc.
>> BE SURE TO ANSWER ALl. QUESTIONS ON REVERSE SIDE AND RECHECK MATH <<
Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
801 16TH STREET
--_._.~------------_.-
;STATE PA IZIP 17070
I
CITY
NEW CUMBERLAND
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
53,661.46
55,563.90
------.-.-
2,683.07
Total Credits (A + B + C)
(2)
58,246.97
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
0.00
---".----
4,585.51
(3)
(4)
(5)
(5A)
(58)
0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;................................................................................0 ~
~: ~:~::~ :h~e~;~;i:~~~:~~~~s~~~. ~~~~I. .~.~~. ~~~. :.~~:.~~~. ~~~~~~~~~~~. ~~. ~~~ .i.~.~~~~::::::::::::::::::::::::::::::::::::8 ~
d. receive the promise for life of either payments, benefits or care?.............................................................D ~
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?......................................................................... ........................................... 0 ~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 0 ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?...................................................................................................................0 ~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury. I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief. il is true, correct
and complete. Declaration
preparer other than the personal representative is based on all information of which preparer has any knowled~_. _ _.._._ ._._____~_ ____~_
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DATE
cMarcia Myers, Executrix 15 Ardmore Circle
~-.2 0 ~E~i- ~~EF 0:: u-~iESS New C1jmberland, P~1707~_
~
J t -6 ~
-------------!--=-------
DATE
/-6 -CJ3
ADDRESS
DATE
301 Market Street
Lemoyne, PA 17043-0109
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P,S. 39116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exempa 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. 39116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P .S. 39116
1.2) [72 P.S. 39116 (a) (1)],
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 39116 (a) (1.3)]. A sibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
*'
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
_._~----~-_..._.~---_.._------_.._-,._----_..
-'---~-
ESTATE OF ------~-------, FILENUMBER------ --
__M~-=RS, MILDRED =---~_________ __ ___J _~~0106~____
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER :
1
DESCRIPTION
UNIT VALUE
i VALUE AT DATE OF
. DEATH
537.91
$25,000.00 Government National Mortgage
Association - GNMA Pool Number 011701
Initial Principal Amount - $25,000.00 - Issued
11/01/1976 - 8% interest - Matures: 11/15/2006.
Calculation: $25,000 x .021516 (factor figure) = $537.91, date of death value. i
Decedent was receiving both Principal and Interest each month, thereby reducing the I
principal amount. Copy of original certificate attached. Legg Mason provided us
I with the purchase price of the GNMA certificate as of the date of death instead of the
I outstanding balance of the certificate as of the date of death.
I
2
$25,000.00 Government National Mortgage
Association - GNMA Pool Number 033441X
Initial Principal Amount - $25,000.00 - Issued
i August 1, 1979 - 9% interest - Matures: 5/15/2009
Calculation: $25,000 x .030999 (factor figure) = $774.98, date of death value.
Decedent was
receiving both principal and interest each month
thereby reducing the principal amount. Copy of
original certificate attached. Legg Mason provided us with the purchase price of the \
GNMA Certificate as of the date of death instead of the outstanding balance of the !
certificate as of the date of ddeath.
774.98
3
$25,000 Government National Mortgage Association - GNMA Pool Number
012882X
Initial Principal Amount - $25,000.00 - Issued 11/01/1976 - 8% interest - Matures -
11/15/2006
Calculation: $25,000.00 x .0183319 (factor figure) = $457.98, date of death value.
Decedent was receiving both Principal and interest each month thereby reducing the
principal amount.
Copy of certificate attached. Legg Mason provided us with the purchase price of the!
GNMA certificate as of the date of death instead of the outstanding balance of the
I certificate as of the date of death.
:
I
,
457.98
Total of Continuation Schedule(s) J
-_.._._--.._.._-_..._---_.._~._.._-_._-----_.._- .,----,._---._-',---
TOTAL (Also enter on line 2, Recapitulation)
I 1,070,034.16
l------
. 1,071,805.03
.. SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA I STOCKS & BONDS continued
INHERITANCE TAX RETURN . I
_ _-cc:=~~ES~.:DECED!ON~ .=-----L_==--=====-=-:=-===== =-==__.~ ---.-.-==_==c.
ESTATE OF : FILE NUMBER
MYERS, MILDRED C. 21 _ 01 _ 01068
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
4
--- _"m_'_ ---._- ---- -r' ..- '--"-
VALUE AT DATE OF
DEATH
----.--.-.----.-----;--' -- --.'-'---'-~ ---,------'-
759.21
UNIT VALUE
DESCRIPTION
I $25,000 - Government National Mortgage Association GNMA Pool Number
01l651X-
Initial Principal Amount - $25,000.00 - Issued
9/01/1976 - 8% interest - Matures: 9/15/2006
: Calculation: $25,000 x .030368 (factor figure) = $759.21, date of death value.
Decedent was receiving both Principal and interest each month
thereby reducing the principal amount. Copy of
original certificate attached. Legg Mason provided us with the purchase price of the
GNMA certificate as of the date of death instead of the outstanding balance of the
certificate as of the date of death.
5
i
I 4,251.985 Shares - AXP High Yield Tax-Exempt
Fund @ $4.360 per share
18,538.65
6
I Legg Mason - Investment Account No. 363-00793
I Date of death value
I
1,050,736.30
I
Page 2 of Schedule B
JAN.-28'02(MON) 08:37
LEGG MASON CAMP HILL
TEL:7177370800
P. 001
LEGG
MASON
Legg Mason Wood Walker, Incorporated
214 Senate Avenue, 7th Roor. P.O. Box 8853, Camp Hill, PA 17001.8853
717.737.6500 800.433.8186 Fax 717.737.0800
cG @ [fJw;
MsmbC( New Yotk Stack Ex~hllnllBt In clMem/Jef SJPC
J an unry 25, 2002
Ms. Cindy HublerlHnnl{ Johnson
Johnson, Dufiic, Stewart & Weidner
301 Market Street
P.O. Box 109
LcmQyne, PA 17043-0109
RE: Mildred C. Myers Estate
Dear Cindy,
Following please find the Date of Death Values on the GNMA certificates for Mrli.
Myers, No'Vcmber 9, 2001.
033441XSF
011651XSF
012882XSF
-14934
01] 701XSF
106.375/ share
105.375 / sbare
105.375/'lillare
P~id off October 2000
105.3751 sbqre
. If you have any questions or need any-[}dditJoual information plea$~ do nf?t hel'it~te
to call at 737~6500 eu. 3206.
S1ncerely.
ryv~
an Mij)iCk' , (?
MnTketin~ Assistant to G. Davia Bins
(~@ ~\J7
JM
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