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HomeMy WebLinkAbout01-1081 - Estate of LORAYNE C. TRITT also known as PETITION FOR PROBATE and GRANT OF LETTERS :J1-ol -'0 '1/ No. To: Register of Wills for the Ibl_32._tf013eceased. County of CUMBERLAND in the Social Security No. 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 in the last will of the above decedent, dated Auqus t 30, and codicil(s) dated or _ named 2001 (state relevant circumstances, e.g. renunciation, death or executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h er last family or principal residence at 611. High Street l.5h.,-l" East Pennsboro ~ownship (list street, number and muncipality) Decendent,then 61 years of age, died October 28, 2001 at Carolyn Croxton Slane Residence Except as follows, deceder.t 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 $ 18 , 000 . 00 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ 13 8 , 000 . 00 situated as follows: 611 Hlgh Street, East Pennsboro Township Cumberland County, PA WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) pre~ented herewith and the grant of letters ~PS t- rlmpn t- rI ry (testamentary; administration c.t.a.; administration d.h.n.c.t.a.) theron. ..... '" 'if u c ... "'C ..... .- '" "'~ ..... ~... C "'Co c':: CU"=: ~~ 'if... 50 OJ c ~ en ~~U//c! ltd/ ames R. Tritt '611 Hi9h street Enola, PA 17025 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } ss COUNTY OF CUMBERLAND The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will we~dttulY administer es a according to law. Sworn to or affirmed and subscribed {~ ~ ;? I ~ before me this 27th day of J es R. Tr i t t ~. Yrwf>mhpr 2 001 ~ ~~~~.~~ ~ \ ?A.-o... ~.~. ~ Register ~ L 7 --;) 2> - I 0 No. 21-01-1081 Estate of LORAYNE C. TRITT , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW NOVEMBER 28 200 ~ in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated August 30, 2001 described therein be admitted to probate and filed of record as the last will of IDRAYNE C. TRITT' Testamentary and Letters are hereby granted to James R. Tritt Probate, Letters, Etc. ......... Short Certificates( 1) . . . . . . . . . . Renunciation ................ x-pages jr:p $ 235.00 $ 3.00 $ 12.00 $ 5.00 TOTAL - $ 255.QO . . . . . . .l';J9Y':o: . ?~.,.~Q9f-. . . . . . . . . . . . . . fYla.:1 C-. ~Q<.. PB 1".\-, WLRegister of ~il1s Edmund G. Myers Johnson, Duffie, Stewart & Weidner ATIORNEY (Sup. Ct. 1.0. No.) 301 Market St., P. O. Box 109 Lemovne, PA 17043-0109 ADDRESS (717) 761-4540 . FEES Filed PHONE n C; - a;- d :0 3 -. ..... ::IJ (0 0- ;~" m () (l) : ,) {(1 0 z ..... :::1 (':J Ct c::::J """" E~t c:::: <'> :::1) , ("; (:; N --...I :;g ."". (i 1:"1 N C )> - ---U', --...I 'Y1GtM ~ to ~; IJ -~'% -OJ "U'''c;.~"c; ?'"="Y C1,.'Q(, This is to certify that the information here given is correctly copied fro~ an original certificate of death dul~ filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filmg. WARNING: It is illegal to duplicate this copy by photostat or photograph" 21-01-1081 "., ~"~7 .,;.,:?...-;' t..f.,/-',;./:iV"- ( (0/ t:;:!"t.~_~ No. Fee for this certificate, $2.00 Local Registrar p 7745446 NOV 0 2 7001 Date .143 Rev. 2/87 COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECOROS CERTIFICATE OF DEATH NAME OF DECeDENT IFtrSl. Middle, L._. SEX SWEFR..E~R SOCIAL SECURITY NUMBER 61 v... COUNTY OF OEAI"H UNDER. DIll' HoIn ! LfinuIeI a. female 3. 161 - 32 DATE OF OEATH ,Momn. Day, ....J ~ October 28, 2001 .. Lora ne C. Tritt AGE (LaIl ~ UNDER' YEAR - o.y. BlRTHl'I.ACE ICily"'" S&aIe Of FOfIl9" CounIry) ~o Dauphin DECEDENT'S USUAl ClCC\JPjQ'1OH (Give Iund 01_ doN"""'" moor hie~"" do noI_ ''''od.) .~usquehanna Twp. KIHD OF BUSlNESS/IHllUSTRV white SUR\IMNO SPOUSE (If .... grve tn8lden ,..,... Insurance R. Tritt DECEDENT'S ACTUAl RESIDENCE - on_we) "'P. Cumberland 1.. FIlrHER'S N....E (F.... .._. UlolI ... Geor e Grosh Cullen INFORMANrS NAME (TypoIPrinI) James R. Tritt METHOO OF 0lSl'0SlTI0N O _0 c_llilI ___0 ~ 00Il0r (SpKiIy ... SIGNoV\IRE OF '7b. 17..0 ::...~=.. MOTHER'S NAME IFilII. Mtddle. MaIdIln Surname) ... Mettie E. Turrell INFORMANT'S IoIAlUNO AIlllRESS (SIr.... CiIy_ Slolo. Zip ~I 611 High Street, Enola, PA 17025 PlACE OF DISPOSIT1ON- _ oI~orv. CromoIooy lOCRIOH -~. _. ZipCa>> <<0lIl<< ...." Con-O-Lite Crematory 2tc. ~. ORE OF DISPOSITION o ::--.Doy._) \O\~ \0 \ E OR PERSON ACTING AS SUCH lICENse NUMBER za. FS 012 849 L ...... bMI of my knowledge, death occwred" me line. dMe and place SC.Md. (SignoIu<..... T"', Schaefferstown, PA 17088 214. NAMEANOAOORESSOF...ctUTV Parthemore FH & CS, Inc. Uc.P.O. Box 431 New Cumberland PA 17070-0431 LICENSE NUMBER ORE SIGNED _. Cloy._1 DATE PRONOUNCED DEAD I"""'. Day. _) /ol.?.! I .Jool . . -...s CASE REFERRED TO MEDICAL EXAMlNERICORONER? N. ...Ii(lb'f F.D. NoD ,....",.,._ PAllTA: OOIlor..-_COIlIIiluIlng,._bu1 f.......bItwMft not....... in the UftdertW'ng ,**g;w. in MAT t : onMI and dIUh I I /0 """ .. LIAo- (" v-l1l. f.y fOfl AS A CONSlOUENCE OF): ~..- H""".~"_ cauee. EnIet.........Y1HG -<D-oo<< ",""y . .. It'IIII inItiMed evenIS '..a..grn_) LAST lb. c. d. DUE TO (011 AS A CONSEQUENCE OF): DUE TO (011 AS A CONSEOUENCE OF): WERE AUTOPSY FINDINGS A\tftIl.A8LE PRIOR 10 COMP\.ETIOH OF CAUSE OF DERH1' MANNER OF DEATH DATE OF INJURY tMonl'\, Oey. "at) TIME OF INJURY INJURV Ifr WORK7 DESCRlllE HOW INJURY OCCURRED. ....0 NoD ....- -- - ~ D o - Pending kwHI9110n Coukf not be detenntned o o o PlACE OF ItIUURY. AI home, larm, sI'.... t",Dry, office Y. buiIcInQ. etC. ,Speclf'" _. .... 0 NoD _. _. CERTIFIER (~...., one) .CEJnWYING PHYSICIAN (PhySOan centfytng Qu&e 01 deaIh whefl ano&her phVSll;1M1 has pronounced dealf'l ana compl8leclllem 231 To.....ofMy knowledge,..thOCCUl'Nd due to Ihe cauM(...nd manner .. mtllCl. ............,......................... ... M,P, b?1 /~I /0,/ I o ".. LICENSE NUMBER I DATE SIGNED I~. Day. "'" o ... f1{)"7~~7l -L ".. I"/;;j/.j NAME AND AIlDfIESS OF PERSON WHO COMPlETED CAUSE OF DEATH (lIem271Type<<P,int L-t' N,',., I.-i...., H, J:> On. ro, lV~dJ../~ +J. .J-fJ,e~t~ L1:"1' "~J fA '7"'1-] DATE FtLEO{MonIh. Day....,1 f ,,/~'} (" I ,.. "0 I "PRONOUNCING AND CERTIFYING PHYSICIAN (PhySICran boIh p.-aoounc;mg ueaIh M'd ceflll'ytng 10 cause of deaf'" To the bnt a' my knowledge. ..thocc.....red at the time. date. andpa.c., and due to tfMl UUM(s) and mann.,...I.led.......................... "MEDICAL EXAMINER/CORDNER on the..... of examination and/or tnv..Uganan,ln my opinH)n. d..th occurred a. the time, da'e, and place. and due to the cauae(s) and .....nnet' .. atated.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3t.. nQ ~ (0 3 ~. 0", ~ .',1 t;") Cl C 'r:) ):> d - :0 ::0(1) (tl(') <00 ...........""'"'" ~~ Z<t 51 !:::I ~ " :32 N (i) o -<t., . . - -.J 008965-00003/8.28.01/EGMIKL T/119522.3 1Last Will anb {!testament of LORAYNE C. TRITT I, LORAYNE C. TRITT, of West Fairview (East Pennsboro Township), Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills or Codicils at any time heretofore made by me. ARTICLE I I direct the payment of all my legal debts and the expenses of my last illness and funeral from my Estate as soon after my death as conveniently may be done. ARTICLE II I give and bequeath the sum of TEN THOUSAND ($10,000.00) DOLLARS unto my sister, GEORGIA G. CULLEN, or her then-living issue, per stirpes, should she predecease me. ARTICLE III I give and bequeath the sum of FIVE THOUSAND ($5,000.00) DOLLARS unto my mother, METTlE C. SIX, provided she survives me. 008965-00003/8.28.01/EGM/KL T/119522.3 ARTICLE IV I give and bequeath the sum of FIVE THOUSAND ($5,000.00) DOLLARS unto my mece, STEPHANIE ANN LIGHTFOOT, or her then-living issue, per stirpes, should she predecease me. ARTICLE V I give and bequeath the sum of FIVE THOUSAND ($5,000.00) DOLLARS unto my niece, JENNIFER LYNN CORKLE, or her then-living issue, per stirpes, should she predecease me. ARTICLE VI I gIve and bequeath the sum of ONE THOUSAND ($1,000.00) DOLLARS unto ALCASE, 1601 Lincoln Avenue, Vancouver, Washington 98660. ARTICLE VII I give and bequeath the sum of ONE THOUSAND ($1,000.00) DOLLARS unto the AMERICAN CANCER SOCIETY, CAPITAL REGION UNIT, 1500 North Second Street, Harrisburg, Pennsylvania 17102. ARTICLE VIII I give and bequeath the sum of ONE THOUSAND ($1,000.00) DOLLARS unto the NEW CUMBERLAND FIRE DEPARTMENT for the purpose of maintaining the 1923 American LaFrance Fire Truck, or for some other uses to be determined by the Department's History Committee, 319 Fourth Street, New Cumberland, Pennsylvania 17070. 2 008965-00003/8.28.01/EGMIKL T/119522.3 ARTICLE IX I give and bequeath my motor vehicle(s), my household and personal effects and other tangible personalty of like nature (not including cash or securities), together with any existing insurance thereon, unto my husband, JAMES R. TRITT, provided that should he predecease me, I give and bequeath the same unto my sister, GEORGIA G. CULLEN, provided that should she also predecease me, I give and bequeath the same in equal shares unto my nieces, STEPHANIE ANN LIGHTFOOT and JENNIFER LYNN CORKLE, to be divided between them by my Personal Representative with due regard for the personal preferences in as nearly equal shares as practical. ARTICLE X I give, devise and bequeath all the rest, residue, and remainder of my Estate, of whatsoever nature and wheresoever situate unto my husband, JAMES R. TRITT, provided he survives me. If my husband, JAMES R. TRITT, predeceases me, I give, devise and bequeath all the rest, residue and remainder of my Estate, unto my sister, GEORGIA G. CULLEN, provided that should she predecease me, I give, devise and bequeath the same unto her then-living issue, per stirpes. ARTICLE XI I name, constitute and appoint my husband, JAMES R. TRITT, Executor of this my Last Will and Testament. In the event my husband, JAMES R. TRITT, fails to qualify or ceases to so act, I name, constitute and appoint my friend, LELA E. SHULTZ, alternate Executrix to complete the administration of my Estate. I direct that no fiduciary appointed herein shall be required to post bond for the faithful administration ofthe duties in any jurisdiction. 3 008965-00003/8.28.01/EGM/KL T/119522.3 IN WITNESS WHEREOF, I have hereunto set my hand and seal, this (So I!L day of ~ 2001. ;X ~/J, 1:.,u - (SEAL) LORA C. TRITT Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. ~KJ~ r. ~ .~ . Ie) -~ C/e-::_~. 4 008965-00003/8.28.01/EGM/KL T/119522.3 ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA :SS COUNTY OF CUMBERLAND We, LORAYNE C. TRITT, ~ L CJ. ~. ~ ~ and ~ ~L Q. ~. C..u..,,:". t\ol3; , the Testatrix and the witnesses, respectively, whose ~ names are signed to 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. ~ /1-,u: / G. /),1. LORA E C. TRITT ~tJ~ Witness l ~ /c2,.-~ Witness(// ~ Subscribed, sworn to and acknowledged before me by LORAYNE C. TRITT, Testatrix, and subscribed and sworn to before me by ~ ~ "'. --.......,~ and '~~.... Q ~ _ ~ h~ ' witnesses, this ~ ~day of ~~~ ,2001. ~. ~ 4~ Notary Public ~ NOTARIAL SEAL DIANNE LENIG, Notary Public Lemoyne Borough Cumberland Co. My Commission Expires Dec. 21, 2001 5 TO Register of Wills Office Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 SUBJECT: Estate of Lorayne C. Tritt No. 21-01-01081 000: October 28, 2001 FROM JOHNSON, DUFFIE, STEWART & WEIDNER Attorneys at Law P.O. Box 109 Lemoyne, PA 17043 (717) 761-4540 DATE: January 18, 2002 Enclosed is a check in the amount of $2,500.00 as a payment on account on account of Inheritance Tax, being made within the 90 days to allow for the 5% discount. ; ;'~'ql1ln:J >u;s~J SIGNED: Edmund G. Myers lAW OFFICES JOHNSON, DUFFIE, STEWART ~ WEIDNER 301 MARKET STREET P. O. BOX 109 LEMOYNE, PENNSYLVANIA 17043-0109 817: L d ZZ N11r ZOo csh to jG8 -'i,)~)a}j _.~'e (: \ I, J "',,?c:'.? ~1',:;fY ......... >.,......,,,..,""'~ ,....~....~,........'-,,.,. .."..-.""''''.-.....:J'.ii:.---...,.,...,,_~_..::...:;. .,...'~, . ~~-...." "-'..... ......o,g;:...._,. fitrr1"''''''-~:-' " Ret-n..~1 Ae, ..... - "'i'",""".-";'_~ of is 'O? JAN 22 ~) 3 :11 REGISTER OF WILLS OFFICE C CUMBERLAND COUNTY COURTHOUSbl i 1 COURTHOUSE SQUARE CARLISLE, PA 17013-3387 . L,CUI PA i rti i ~:;;:;:3.32 "" /II" ,Ill."" ,1/"1/,, ,'L, ,11,1,1" "1,1/1,, 111,11/1, "I COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: MYERS EDMUND G 301 MARKET STREET POBOX 109 LEMOYNE, PA 17043 _____n_ fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: SSN: 161-32-4070 FILE NUMBER: 21-2001- 1081 DECEDENT NAME: TRITT LORAYNE C DATE OF PAYMENT: 01/22/2002 POSTMARK DATE: 01/18/2002 COUNTY: CUMBERLAND DATE OF DEATH: 10/28/2001 ACN ASSESSMENT CONTROL NUMBER 101 TOTAL AMOUNT PAID: REMARKS: JAMES R TRITT C/O EDMUND G MYERS ESQUIRE CHECK# 0101 SEAL INITIALS: CW RECEIVED BY: REV-1162 EX(11-961 NO. CD 000777 MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS AMOUNT $2,500.00 $2,500.00 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: LORA YNE C. TRITT Date of Death: October 28,2001 Will No.: 2001-01081 To the Register: Admin. No.: 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 1/')..2-/0 t..-- Name Georgia G. Cullen Mettie C. Six Stephanie Ann Lightfoot Jennifer Lynn Corkle ALCASE American Cancer Society, Capital Region Unit New Cumberland Fire Department James R. Tritt Address 1011 Bay Harbor Dr., Englewood, FL 34234 809 Viadel Sol, North Fort Myers, FL 33903 1590 Pottshill Road, Etters, PA 17319 671 Andersontown Road, Dover, PA 17315 1601 Lincoln Ave., Vancouver, WA 98660 1500 N. Second St., Harrisburg, PA 17102 319 Fourth St., New Cumberland, PA 17070 611 High Street, Enola, PA 17025 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None. Date: II '2--?-/ O},/ lJ\ If) .-- E:T: r-r) N z = -:> ') ;<:: -g ii:i= ..,.- ..., :,JU I ,"; m 0:: ~ ~b~ Signature Name: Edmund G. Myers, Esq. Johnson, Duffie, Stewart & Weidner Address: 301 Market St. P. O. Box 109 Lemoyne, PA 17043-0109 Telephone: (717) 761-4540 Capacity: Personal Representative X Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } ss: James R. Tritt b~ing duly sworn according to law, deposes and says that he is Execu tor of the Estate of Lorayne C. Tritt late of __~_as ~E;nn~~<?_~.~._Town~hip , Cumberland County, Pa., deceased and that the within is an inventory made by James R. Tritt , the said Executor of the entire estate of said decedent, consisting of all the personal propo!rty and real. estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. I / K? ~;/ F;~ Sworn to 2002 Eneutor . Ao'ministra or Trltt, Executor 611 Hiqh Street before me, Date of Death NOTARIAL AL DIANNE LENIG, Notary Public Lemoyne Borough Cumberland Co. . My Commission Expires Dec. 21, 200! ' 28th Enola, PA 17025 Addr.ss Day October Month. 2001 Y..r INSTRUCTIONS ,. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. CV'l "'" 0 Ol l"-- .r-! .-I ..c:: en ..:C C 0... ~ 0 E-< -ci ()) >- Gl C I- W 0 III >. .-I ~ ~ I- H lQ 0 W ;5 Q) ex) e.. 0 u E 0 0 0 Vl E-< .0 Q) Gl >-()) .-I w ~ w E-< en C 01 Gl~ J: lQ I l- e.. u. H C e.. en c: .-I Z I- -J 0:; C lQ H .. < 0 a.. 0 ~ 0 U. -J E-< ()) OJ :t: CT\ w < W I > 0 ~ 0... .;. >.<0 .-I Z .... ::8 '.-I N Z 0 c: C U .j.J ::I 0 Vl Z en 0 . ~ ~ < ~ CO U C9 0 Z W 4111- e.. Z ~ "'tl o:l >t c "0 ..:C lQ C . - i: 0:; 0 Q) ;:j 0 0 ..Q ~ E ~ Q) E "'tl "0 .... Gl 0 lQ ::I 0 ~ 0... ...J () u: r:D Inventory of the real and personal estate of LORAYNE C. TRITT deceased 1. Real Estate - No. 611 High Street, East Pennsboro Township, Cumberland County, PA (Deed Book Q, Volume 30, Page 583) Assessed value 38,210 00 2. 1998 Chevrolet Venture Minivan Date of death value 11,045 00 3. 79.0961 Shares - Pepsico @ $48.5619 per/share 4. 7 Shares .Tricon (YUM) Common @ $49.6050 per/share 3,841 06 347 23 5. 47 Trust Interests - MetLife @ $27.26 per/share 1, 276 52 6. ING Pilgrim - Domestic Equity Funds - Account No. 92628 Date of death value 2,126 51 7. 200 Shares - CareerCom Corporation Common @ $.68750 per share 137 50 TOTAL 156,98_ 82 r · f/. \:: '" ~" . _ " ~" ., . :ci ~ ,....---.-....---.- , '; i 111i'.'."J I..., , '{/ ,~ I ) f"" ,.... I II ~::; -, . ;.".J \."\,t , :)!U!;~'; ...... : ~~~i::' II! ; r~t---. .-- . , ~~:::"(';:-:~,--7 NI....:. '" I'.tJJ.:.--<'i ~V:,,\... "\ ,"." \ / ... ." . o ~~.~ ;.~i \ ":~ r. 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COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT EDMUND G MYERS ESQUIRE 301 MARKET STREET POBOX 109 LEMOYNE, PA 17043 -------- fold ESTATE INFORMATION: SSN: 161-32-4070 FILE NUMBER: 2101-1081 DECEDENT NAME: TRITT LORA YNE C DA TE OF PAYMENT: 06/26/2002 POSTMARK DATE: 06/25/2002 COUNTY: CUMBERLAND DATE OF DEATH: 10/28/2001 REMARKS: EDMUND G MYERS CHECK# 115 SEAL ACN ASSESSMENT CONTROL NUMBER 101 TOTAL AMOUNT PAID: INITIALS: AC RECEIVED BY: REGISTER OF WILLS REV-1162 EX(11-96) NO. CD 001335 MARY C. LEWIS REGISTER OF WILLS AMOUNT $293.42 $293.42 /?-c2 03 - /~ '\: BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISIDN DEPT. Z8D6Dl HARRISBURG, PA 171Z8-D6Dl COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX '02 1(' , _.' DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN EDMUND G MVERS JOHNSON ETAL PO BOX 109 LEMOVNE ESQ 08-12-2002 TR ITT 10-28-2001 21 01-1081 CUMBERLAND 101 *' REV-l547 EX AFP lOl-D21 LORAVNE C #"1 PA 17043' Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=is4-j-E3f-AFj'--foY=02Y-NCfficE--OF-YNHEifiTAifCE-YAX-A-PPRA-isEi"-ENT~--Ar.rOWANCE-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF TRITT LORAVNE C FILE NO. 21 01-1081 ACN 101 DATE 08-12-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED 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 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 (9) (10) (1) (2) (3) (4) (5) (6) (7) 138.210.00 7.728.82 .00 .00 11. 045.00 .00 270.110.62 (8) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 427,094.44 97.063 44 330,031.00 3,000.00 327,031. 00 NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. 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 11,487.77 85.575.67 (11) (12) (13) (14) 302,031.00 X 00 = .00 5,000.00 X 045 = 225.00 10,000.00 X 12 = 1,200.00 10,000.00 X 15 = 1,500.00 (19)= 2,925.00 TAX CREDITS: . ~ "._n. n___.. l+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-18-2002 CDOO0777 131.58 2,500.00 INTEREST IS CHARGED THROUGH 08-27-2002 TOTAL TAX CREDIT 2,631.58 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 293.42 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 1.44 TOTAL DUE 294.86 · 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.) /?-&:2J -/c::? BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REY-1U7 EX AFP 101-021 ESQ 'C): OJ ~~; DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-12-2002 TRITT 10-28-2001 21 01-1081 CUMBERLAND 101 LORAYNE C EDMUND G MYERS JOHNSON ETAL PO BOX 109 LEMOYNE .' "I I Allount Rellitted \; ., PA 17P~3 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'ifi-i;f-AFP-('oY:02Y------...--fNirERITANcE--fA;f-STA-fEME-tif-oF'-Accouiff--...--------------------- ESTATE OF TRITT LORAYNE C FILE NO.21 01-1081 ACN 101 DATE 08-12-2002 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-12-2002 P R I NCI PAL TAX DU E : ................................................................................_.........._............................................................................................................................. 2,925.00 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-18-2002 CDOO0777 131. 58 2,500.00 06-25-2002 CDOO1335 .00 293.42 TOTAL TAX CREDIT 2,925.00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 II 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. ) ~/ 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: LORAYNE C. TRITT Date of Death: OCTOBER 28, 2001 Will No.: 2001-01081 Date: 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 ~ The Executor. husband of the deceased. was the sole beneficiary of the residue of the Estate. D. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. tj{1d,r./ ~b~ Signature Edmund G. Mvers. ESQ. Johnson, Duffie, Stewart & Weidner 301 Market Street, P.O. Box 1 09 Lemovne. PA 17043-0109 Address (717) 761-4540 Telephone No. Capacity: Personal Representative ~ Counsel for Personal Representative 1'lEV-'.500~(5-00l COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128.0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT ~ -=",. ~a:~ Uo.u woo "''''.... Uo.lIl 0. .. I- Z IJJ o IJJ t) IJJ o DECEDENT'S NAME (lAST, FIRST, AND MIDDLE INITIAL) TRITT, LORAYNE C. DATE OF DEATH (MM.DIJ.YEAR) DATE OF 81RTH (MM.DO.YEAR) 10/28/2001 2/15/1940 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) James R. Tritt o t Original Return . D 4. Limited Eslala l[] 6. Decedent Died Teslela {AIb'" "pY of ""J D 9. Litigation Procaeds Received D 2. Supplementsl Return .0 4a. Future Interest Compromjs~ {date or death aller 12-12-82} D 7. Decedent Maintained a Living Trust '^""'''PYofTMl) o 10. Spousal Poverty Credit (dale 01 dealh balwBn 12-31-91 ancll-1-95j OFFjCIAL USE ONLY e.- /? -c:L3 - /0 FILE NUMBER 21_0101081 -- -- ----- COUNn' CODE YEAR NUMBER SOCIAL SECURITY NUM6ER 161 - 32 4070 THIS RETURN MUST BE FILED IN DUPLICATE WJTH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Return (dale or dealh prior to 12-13-82) D 6. Federal Eslale Tax Return Required 8. Total Number of Safe Deposit Boxes D 11. Election 10 lax under Sec. 9113(A) 1"""'''''' OJ z o ~ I-' :J c.. ::E o u g !z w o z o ; o U NAME Edmund G. M FIRM NAME (' """'"') Johnson Duffie stewart TELEPHONE NUMBER (717 761-4540 (11) (12) (13) (14) x.o~ (15) x .0 45 (16) x .12 (17) x .15 (16) (19) 97,063.44 330 .031. 00 3.000.00 327,031.00 -0- 225.00 1,200.00 1.500.00 2,925.00 z o ~ :J !:: c.. c:( U IJJ 0:: 1. Reel Estate (Schedule A) 2. Slocl<s end Bonds (Schedule B) 3. Close~ Held Corporation, Pertnershlp or Sole.Propdelorshlp 4. MortgSgee & Notes Reoelv.b~ (Schedule D) 5. Cash, Bank Deposlls & Mlsoellaneous Personel Propedy (Schedule E) 6. Jolnt~ OWned Propedy (Schedule F) o Seperala Billing ROquesled 7. Inlar-VIvos Transfers & Misoelleneous Non-Probala Propedy (Schedule G or L) 6. Total Gross Assets (Iolal Unes 1-7) 9. Funeral Expenses & Admlnlslraw. Cosls (Schedule H) 10. D.bls of Deoedant, Modgage Uabllllies, & Liens (Schedule i) 11. Tolal Deduction ) 12. Net Value of Eslate (Une B minus Une 11) 13. Chadlable and Govemmenlal6equeslslSec 9113 Trusls for which en eiecUon to lax has nol been made (Schedule J) 14. Net Value Subject to T.x (Une 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Arnounlof Un. 14 Iaxable allhe spousal lax rale, or transfers under Sec. 9116 (a)(1.2) 302.031.00 5,000.00 10,000.00 10.000.00 16. Arnounl of Une 14lexable sllineal rala 17. Arnounl of Une 14 wable al Sibling rale 1 B. Arnount of Une 14 lexabla at oollaleral rate 19. Tax Due 20.0 De'cedent's Complete Address: STREET ADDRESS 611 Hiqh Street CITY Eno1a I STATE PA I ZIP 17025 Tax Payments and Credits: 1, Tax Due (Page 1 Line 19) 2, Credits/Payments A. Spousal Poverty Credit 8, Prior Payments C. Discount (1) 2,925.00 2,500.00 l11.SR Total Credits (A+ B + C) (2) 2,631.58 3. InteresUPenalty ~ applicable D. Inleresl E. Penalty -0- TotallnteresUPenalty ( 0 + E ) (3) 4. If Line 2 is greater .than Line 1 + Line 3, enler the difference. This is the OVERPAVMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater Ihan Line 2, enlerthe difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line S + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 293.42 -0- 293.42 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS .<l~ 1. Did decedent make e transfer and: Ves a. retain the use or income of the property transferred;.......................................................................................... 0 b. retain the right 10 designate who shall use the property transferred or its income; ...............:............................ 0 ~. retain a reversionary interes~ or,..,....,,,..........................,,,.........................................................,........................ D d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 2. if death occurred after December 12, 1982, did decedenl transfer property within one year of dealh without receiving adequale consideration? .....................,....,....,......................................,....................................... 0 3. Did decedent own an "in trust for" or payable upon death bank accounl or security al his or her death? .............. 0 4. Did decedenl own an individual RetiremenlAccount, annuity, or other non-probate property which contains a benefi~ary designation? ........................................................................................................................ []I No IX] IX] ~ IZI [XJ o 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 !hall have examined this relurn, including accompanying schedules and statements, and 10 !he besl of my knowledge and,belief, II is true, correct and complete. DedaraUon of preparet than the personal representative is based on alllnformaUon of which pmparer has any knowledge. SIGNATURE PE ON RESPOt21i~Oafll,II'lG RETU~N ~ '-------e-:.'/1I6J;C UtdV r <cu/rL- ADDRESS mes R. Trlt 11 High Street, Eno1a, PA 17025 SIGNATURE OF ~ o.b~~ REPRESENTATIVE ADDRESS Edmund G. Myers, Esq. 301 Market st., P. O. Box 109, Lemoyne, PA 17043-0109 ~ ~i' '~.\;.,',','" ~~~_~~_",!;: '..,'''~~' j' 'Ei_~1&RT~ 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. 99116 (a) (1.1) (i)). l:~ 0-L.- DATE (, /2..6f."V For dates of death on or after January 1,1995, the lax 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 nol exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assels and filing a tax relum 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 oftransfers to or for the use of the decedent's lineal benefi~aries 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 nel value of transfers to or for the use of the decedenl's siblings is 12% [72 P.S. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at ieast one parent in common with the decedent, whether by blood or adoption. REV.'~""".'" . COMMONWEALTH OF PENNSYLVAN<A INHERITANCE TAX RETURN RESIOENT OECEDENT SCHEDULE A REAL ESTATE FILE NUMBER TRITT, LORAYNE C. 21-01-01081 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 having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survlvorshln must be disclosed on Schedule F. ITEM NUMBER 1. . DESCRIPTION VALUE AT DATE OF DEATH ESTATE OF Real Estate - No. 611 High street, East Township, Cumberland County, PA (Deed Book Q, Volume 30, Page 583) pennsboro Assessed value 138,210.00 TOTAL (Also enter on line 1, Recapitulation) $ 138, 2 1 0 . 00 (If more space is needed, insert addIt,onal sheets of the same size) TAX YEAR 2001-02 REAL ESTATE TAX EAST PENNSBORO AREA MAKE CHECKS PAYABLE TO: EAST PENNSBORO SCHOOL PO BOX 769 98 S ENOLA DRIVE ENOLA PA 17025 DATE NOTICE .. SCHOOL.. JULY 1 2001 SCHOOL DISTRICT DISTRICT I JANE E BIDDLE, TAX . MON,TUES,THURS,FRI ROOM 101 CLOSED WEDNESDAYS, PHONE 717-901-9392 ASSESSMENT BILL NO.C 1 138,210 COLLECTOR 8-1,2-4 OCT 8-12, 447 NOV 6 CHOOL R E 10 "pI0. 75 M 1,456.04 1,485.76 1,634.34 ACCT NO 45-16-1049-014 "p M " "p M DURING THIS PERIOD 31 2001 'I SCOUNT . CE NALTY ULY-AUGUST EPT-OCT FTER OCT31 1 456.0 , .76 1 634.34 mrff -BILL-&, LORAYNE C 6 1 EAST PENNSBORO AREA SCH. DIST. HIGH STREET 611 HIGH STREET WEST FAIRVIEW PA 17025 LOT 1 PB 48 PG 73 IF _1~~'.lwPft,.~~~~.;w'~J~mw- THIS BILL TO YOUR MORTGAGE COMPANY IF UNPAID BY 12/31/01 fAXES WILL BE TURNED OVER TO CUMBERLAND CO. TAX CLAIM BUREAU. $1.00 FEE FOR ADD'L RECEIPTS REQUESTED REV-I503E!\'(l-91} ESTATE OF '* SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETLRN RESIDENT DECEDENT FILE NUMBER 21-01-01081 TRITT, LORAYNE C. All property Jolntly.owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. 2 . 3. 4 . 5. DESCRIPTION 79.0961 Shares - pepsico @ $48.5619 per/share 7 Shares Tricon Common @ $49.6050 per/share 47 Trust Interests - MetLife @ $27.26 per share ING Pilgrim - Domestic Equity Funds Account No. 92628 200 Shares - CareerCom Corporation Common @ $.68750 per share VALUE AT DATE OF DEATH 3,841.06 347.23 1,276.52 2,126.51 137.50 TOTAL (Aiso enteron line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 7,728.82 REV.lsoeEX.(\.S1) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANtA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF TRI'IT, LORAYNE C. FILE NUMBER 21-01-01081 Include the proceeds of litigation and the date the proceeds were received by the estate. AU property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DEseRI PTION VALUE AT DATE OF DEATH 1998 Chevrolet Venture Minivan Date of death value 11.045.00 TOTAL (Also enter on line 5, Recapitulation) $ 11, 04 5 . 00 (If more space is needed, insert additional sheets of the same size) REV.1510EX+ll-9Tj '* SCHEDULE G INTER.vIVOS TRANSFERS & MISC. NON.PROBATE PROPERTY COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEOENT ESTATE OF TRITT, LORAYNE C. FILE NUMBER 21-01-01081 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the raverse side of the REV-1S00 COVER SHEET is yes. ITEM NUMBER 1. DESCRIPTION OF PROPERTY INCLUOE1HE flAME OF THE TRANSFEREE, TIiEIR REU,110HSHlP10 DECEDENT AND THE DATEOF~SFER. An....CHACOPV OF lliE CEEO FOR REAl ESlATE. DATE Of DEATH VALUE Of ASSET %OF DECD'S INTEREST EXCLUSION 1IFAPl'\.ICABlEl TAXABLE VALUE A11first Bank - Individual Retirement Account No. 8-700-002-4108001 Beneficiary: James R. Tritt, husband 7,856.39 7,856.39 2 . Nationwide Life Insurance Company 401K Retirement Plan Beneficiary: James R. Tritt, husband 262,254.23 262,254.23 TOTAL (Also enler on line 7, Recapitulation) $ 270, 110 . 62 (If more space is needed, insert additional sheels of the same size) R=,V.',S11 EX.. (12-99) . . , u..~.,<j 6<:,,&, :'r- '~,;.;0'~l:- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF TRITT, LORAYNE C. FILE NUMBER 21-01-01081 Debts of decedent must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. parthemore Funeral Home 3,706.32 2 . Deissler's Flowers 49.82 3. Pamela's Flowers 49.82 B. ADMINISTRATIVE COSTS: I. Personal Representative's Commissions Name of Personal Representative{s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State _ Zip Year(s) Commission Paid: 2. Attorney Fees - Johnson, Duffie, Stewart & Weidner 3,500.00 3. Family Exemption: (If decedent's address is nol the same as claimant's, attach explanation) Claimant James R. Tritt 3,500.00 Street Address 611 High Street City Enola Stete~ Zip 17025 Relationship 01 Claimant 10 Decedent Husband 4. Probate Fees - Register of Wills, Cumberland County 255.00 5. Accountant's Fees - Tinnes & Albright - 2001 tax returns 155.00 6. Tax. Return Preparer's Fees 7. Legal Advertisement - Cumberland Law Journal 75.00 8. Legal Advertisement - The Patriot-News 96.81 9. Register of Wills - file Inv. & Inh. Tax Return 25.00 10. Reserve for close-out costs 75.00 TOTAL (Also enter on line 9, Recapitulation) $ 11,487.77 (If more space is needed, insert additional sheets of the same size) ''''."''".,,.,,'. ~f >'- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS TRITT, LORAYNE C. FilE NUMBER 21-01-01081 Include un reimbursed medical expenses. ITEM NUMBER 1. 2 . 3. 4 . 5. DESCRIPTION Pennsylvania State Bank - Line of Credit Account Number: 700462501 Date of death balance Waypoint Bank - Mortgage Account Number: 09800053313 Date of death balance Hospice of Central PA - account balance Bank of America - Visa Account Date of death balance West Shore Health & ReHab - account balance AMOUNT 50,728.84 33,004.84 360.00 1,344.52 137.47 - TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 85,575.67 REV.\S'Jcx.ti.g7) *' SCHEDULE J BENEFICIARIES ESTATE OF NUMBER I. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT TRITT, LORAYNE C. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (Include outright spousel distributions) 1, James R. Tritt - 611 High St., Enola, PA 17025 FILE NUMBER 21-01-01081 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Husband sister Mother Niece Niece AMOUNT OR SHARE OF ESTATE Tangible personalty Residue $10,000.00 cash bequest $5,000.00 cash bequest $5,000.00 cash bequest $5,000.00 cash bequest ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTlDNS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 2. Georgia G. CUllen 1011 Bay Harbor Dr., Englewood, FL 34234 Mettie C. Six - 809 Viadel Sol, North Fort MYers, FL 33903 Stephanie Ann Lightfoot 1590 Pottshill Rd., Etters, PA 17319 B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. ALCASE - 1601 Lincoln Ave., Vancouver, WA 98660 2. New CUmberland Fire Dept. - 319 Fourth St., New CUmberland, PA 17070 3. 4. 5. Jennifer Lynn Corkle 671 Andersontown Road, Dover, PA 17315 1. 3. American Cancer Society, Capital Region Unit 1500 N. Second st., Harrisburg, PA 17102 . $ 1,000.00 1,000.00 1,000.00 TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size)