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Home My WebLink About01-1128 CUMBERLAND COUNTY PETITION FOR GRANT OF LETTERS Estate of DOROTHY I. GRAHAM No. dt/- 0/- / / J.. 8" also known as , Deceased Social Security No. 198228754 JOAN E. BRENT AND ROSEMARYA. CONAHAN Petitioner(s), who is/are 18 years of age or older, apply)ies) for: (COMPLETE "A" OR "B" BELOW:) Gl A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut RICES named in the Last Will of the Decedent, dated 7/26/99 and codici/(s) dated N/A State relevant circumstances, e.g., renunciation. death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: o B. Grant of Letters of Administration (c.I.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: r Name Relationship Residence I (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with his/her last family or principal residence at 46 GALE ROAD, CAMP Hill, HAMPDEN TWP. (list street, number and municipality) Decedent, then 72 years of age, died NOVEMBER 27 ,~, at HOLY SPIRIT HOSPITAL (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA All personal property......................................... $ (if not domiciled in PA Personal property in Pennsylvania .................... $ (if not domiciled in PA Personal property in County.............................. $ Value of real estate in Pennsylvania ........................................................................................ $ Total ............................................................... ....... .............. ................................. $ 2,358.00 Real Estate situated as follows: Wherefore, Petilioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of lelters in the appropriate form to the undersigned: 2,358.00 Typed or printed name and residence JOAN E. BRENT 46 GALE ROAD CAMP HILL PA 17011 ROSE MAR 0 AHAN 313 lOPAX ROAD HARRISBURG PA 17112 RW-1 .'I-d(o'~' nc ~ a~ 9 :1 :;:. 0" '" 11", c:::::J r, c-:J --" N U N lf1 J:::a Oath of Personal Representative Commonwealth of Pennsylvania County of CUMBERLAND 21-01-1128 The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer ~te according to I~ Sworn to and affirmed and subscribed a ~ 8_ ~iS /~ '"". day of /;J ~ .tw,/. ~41/ r;:::r~1 ,4. L;' "'- lTJIZ~. e, J&.N)t() ,tJiVL, {/tiyC~ A~'1?L~ DECREE OF REGISTER Estate of DOROTHY I. GRAHAM also known as Deceased No. 21-01-1128 Social Security No: 198228754 Date of Death: 11/27/01 AND NOW, DECEMBER 13, 2001 2001 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters I:zJ Testamentary 0 of Administration fJ.~ are hereby granted to JOAN E. BRENT AND ROSEMARY CONAHAN ((c,t.a., d,b.n.c,t.; pendente lite; durante absentia; durante minoriate) in the above estate and that the instrument(s), if any, dated JULY 26, 1999 described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. FEES Letters. ........................ ........... Short Certificates( s) ........}..... Renunciation .......................... Extra Pages ( 7 ) ............... ................................ ...J.Q~........ I.T.R....................................... JCP Fee ................................. Inventory ................................ Other ..... ...... ..... ........... ........... TOTAL .............................$ $ 25.00 #JJ~{J. X;//~ pk. f!.{J ~:zJ~ -rO/~//Lz;- Register of Wills . $ 9.00 $ $ 2] .00 $ 5.00 $ $ $ $ Signature Attorney: DAVID W. REAGER 1.0. No: 20868 Address: 2331 MARKET STREET CAMP HILL Telephone: 717-763-1383 DATE FILED: DECEMBER 13, 2001 PA 17011 60.00 MAILED TO ATTORNEY DECEMBER 13, 2001 ,nO ,.,. ~'::"" == c.P ::S ~. cr " (C d -" t:::l - C"':J -'" N -0 N iJ1 .j::lo ::0 ,,1.) ~:::~,I. .r 21-01-1128 oC ;;:.. ...,..' - (I) 3 ;'- tY ' S d - c::J - C'? ::o~ to () :c:: 0 t',~ 21 ~:::t:::~ '!~g" --" N -0 N Ui J;::a. REO\ WILJ-S\GRAI;IAMQL. WIL June 16, 1999 21-01-1128 LAST WILL AND TESTAMENT OF DOROTHY I. GRAHAM I, DOROTHY I. GRAHAM, of Camp Hill, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this my Last Will and Testament, hereby revoking any and all prior wills and codicils thereto by me at any time heretofore made. FIRST I direct that all my just debts and the expenses of my last illness and funeral shall be paid from the assets of my estate as soon as practicable after my decease. I authorize my personal representative to expend funds from my estate, in such amounts as my personal representative shall consider necessary and desirable, for the purchase, erection and inscription of a suitable marker for my grave. SECOND I give and bequeath all automobiles, household effects and other tangible personal property, not including cash or securities, owned by me at my death, together with all policies of insurance thereon, to my daughter, JOAN E. BRENT, providing that she is living on the sixtieth (60th) day after the date of my death. Should my daughter, JOAN E. BRENT, not be living on the sixtieth (60th) day after the date of my iY~ Jl,~ bOROTHY~. GRAHAM REC\WIL,LS\(jRAl;lAM~L. WIL June 16, 1999 death, I bequeath such tangible personalty and insurance thereon to such of my two granddaughters, AMY BRENT and APRIL BRENT, as are living on the date of my death, to be divided between or among them as they shall agree. In the event that no agreement is reached, the said personalty shall be sold, in whole or in part, as my personal representative shall determine, and the proceeds shall become a part of my residuary estate. Notwithstanding the above, I give and bequeath the following items of personal property as follows: A. My mother's antique wood chest, the Wright stone Family Bible, and all real estate owned by me at the time of my death to my daughter, JOAN E. BRENT, providing that she is living on the sixtieth (60th) day after the date of my death. Should my daughter, JOAN E. BRENT, not be living on the sixtieth (60th) day after the date of my death, then I give and bequeath my mother's said antique wood chest and the Wright stone Family Bible to my granddaughter, AMY BRENT. B. I give and bequeath my burgundy blanket to my daughter, DEBORAH L. GRAHAM. It is my wish that said burgundy blanket be then passed on to my daughter's youngest child and so on throughout each generation. THIRD I give, devise and bequeath the residue of my estate, of every nature and wherever situate, to my grandchildren as are living on the sixtieth (60th) day after the date of my death, to be divided among them equally, share and share alike. Should one or more of m~lchen not so survive me, then I give, devise and ~)I L<1l{lcht lYtIc.' I J fi~J~. DOROTHY I. GRAHAM 2 RECiWILLS\GR/\.HAMDL. WIL June 16, i999 ' . bequeath each deceaseil chiltPs share of the residue of my estate, of every nature and wherever situate in I ~-~- . ( ~v i}",iU,,/1/k/s equal shares to 'Iiiy grandchildren. FOURTH In the event any beneficiary who is entitled to a share of the residue under Item THIRD has not yet attained the age of thirty (30) years at the time for distribution to him or her, then I give, devise and bequeath the share of each such beneficiary to my trustee hereinafter named, IN TRUST, nevertheless, upon the following terms and conditions: A. The income and so much ofthe principal as may, in the sole discretion of my trustee, be necessary for the maintenance, support, medical expenses, and education of the beneficiary, shall be paid to the beneficiary or shall be applied directly for his or her benefit. B. Any income not so paid or applied shall be accumulated and added to such beneficiary's share of the trust estate. C. Any income and principal remaining in such beneficiary's share of the trust shall be distributed to such beneficiary when he or she attains the age of thirty (30) years. D. In the event any such beneficiary who has not yet attained the age ofthirty (30) years at the time of my death dies before distribution of his or her entire principal share, then such share shall be distributed to such beneficiary's then living descendants, per stirpes, absolutely; or in default of such descendants, it shall be distributed in j}~J.~ DOROTHY I. GRAHAM 3 RE~WILLS\6RAHAMDL.WIL June 16, 1999 accordance with Item THIRD of this Will. E. Any income or principal payable to a beneficiary under this Item FOURTH may be accumulated or expended for the maintenance, support, medical expenses, or education of such beneficiary as the trustee, in his sole discretion, may determine. My trustee may, in his discretion, pay the said income or principal directly to the beneficiary, to the person having the care or control of such beneficiary, or to any institution entitled to such payment by reason of services rendered to or to be rendered to said beneficiary, without the intervention of a guardian. FIFTH All principal and income, until actual distribution to the beneficiaries, shall be free of the debts, contracts, assignments, alienations and anticipations of any beneficiary, and the same shall not be subject to any levy, attachment, execution or sequestration. SIXTH I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdic:tion imposed, shall be paid from my residuary estate as a part of the expenses of the administration of the estate. k--~ i~ DOROTHY r GRAHAM 4 REClWILLS\GRi\HAMDf-,. WIL June 16, 1999 SEVENTH My personal representative and trustee shall have the following powers in addition to those vested in them by law and by other provisions of this Will: A. To retain any or all assets of my estate, real or personal, without regard to any principle of diversification, risk or productivity. B. To invest in all forms of property (including stocks or other securities of my corporate fiduciary or its successor, or of a holding company controlling my corporate fiduciary or its successor, and common trust funds and mortgage investment funds, whether maintained by my corporate fiduciary or its successor or others), without restriction to legal investments, as they may deem proper, without regard to any principle of diversification, risk or productivity. C. To purchase investments at a premium or discount. D. To exercise all rights of a security holder or shareholder in any corporation; to give proxies; to join in any merger, consolidation, reorganization, voting trust plan, or other concerted action of security holders; and to delegate discretionary duties with respect thereto. E. To sell at public or private sale, to exchange or to lease, for any period oftime, 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. F. To allocate receipts and expenses to principal or income, or partly to each. #~j~ DOROTHY 1. GRAHAM 5 REC\WIlJLS\GRI~HAMD~.WIL June 16, 1999 G. To borrow money from my corporate fiduciary or others and to mortgage or pledge any real or personal property as security therefore, in their sole discretion. H. To compromise any claim or controversy without order of court or consent of any beneficiary. I. To exercise any option, right or privilege granted in insurance policies or arising from ownership of investments. J. To make any distribution herein provided for in cash, in kind, or partly in each, at valuations fixed by my personal representative or trustee at the time of distribution. EIGHTH I appoint my daughters, JOAN E. BRENT of Camp Hill, Cumberland County, Pennsylvania, and ROSEMARY A. CONAHAN, of Harrisburg, Dauphin County, Pennsylvania, as co-Executrixes, of this, my Last Will and Testament. Should either of my daughters, JOAN E. BRENT or ROSEMARY A. CONAHAN, predecease me or for any reason fail to qualify as such Executrix, or having qualified, fail to serve as such Executrix, then I direct that the remaining appointee shall act as the Executrix of this Will. Should both of said daughters predecease me or for any reason fail to qualify as such Executrix, or having qualified, fail to serve in that capacity, then I nominate, constitute and appoint my son, ROBERT C. GRAHAM, of York Springs, Adams County, Pennsylvania, as Executor of this My Last Will and Testament. ;J-~ J.~ DOROTHYLGRAHAM 6 REC\WILLS\GR.J~HAMI?L. WIL June 16, 1999 NINTH I appoint my son ROBERT C. GRAHAM, as the trustee of the trusts created under this my Last Will and Testament. TENTH My Executor and Trustee shall not be required to post security in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of seven (7) typewritten pages, the first six (6) of which bear my signature in the /)/ !'f-I\.. I /) margin for the purpose of identification, this ~4" day ~f "''';--tA_^_~ ' 1999. X )~f".V1_i~J~ DOROTHY I. G~AM, Testatrix Signed, sealed, published and declared by the above-named Testatrix, DOROTHY I. GRAHAM, as and for her Last Will and Testament, in the sight and presence of us, who, at her request, in her sight and presence and in the sight and presence of each other, have hereunto subscribed our names as witnesses. '/ ~ ~ /.:e/~-p.. ~ , r / J21W~ Address c:? c;J? /~ P /7 ~ ~~I? ,~:/d~~- ( 7 REC\WI.LLS\GR~HAMDL.WIL June 16, 1999 COMMONWEALTH OF PENNSYLVANIA ) : SS: COUNTY OF CUMBERLAND ) I, DOROTHY I. GRAHAM, THE TESTATRIX, WHOSE NAME IS SIGNED TO THE FOREGOING INSlRUMENT, HAVING BEEN DULY QUALIFIED ACCORDING TO LAW, DO HEREBY ACKNOWLEDGE THAT I SIGNED AND EXECUTED THE INSTRUMENT AS MY LAST WILL AND TESTAMENT; THAT I SIGNED IT WILLINGLY; AND THAT I SIGNED IT AS MY FREE AND VOLUNTARY ACT FOR THE PURPOSES THEREIN EXPRESSED. COMMONWEALTH OF PENNSYLVANIA ) : SS: COUNTY OF CUMBERLAND ) THE ~~:~;;;~~~;;: ~I~ Ti~~~<;;;d IN~~~BEING DULY QUALIFIED ACCORDING TO LAW, DEPOSE AND SAY THAT WE WERE PRESENT AND SAW THE AFORESAID TESTATRIX SIGN AND EXECUTE THE INSlRUMENT AS HER LAST WILL AND TESTAMENT; THAT SHE SIGNED WILLINGLY AND THAT SHE EXECUTED IT AS HER FREE AND VOLUNTARY ACT FOR THE PURPOSES THEREIN EXPRESSED; THAT EACH OF US IN THE HEARING AND SIGHT OF THE TESTATRIX SIGNED THE WILL AS WITNESSES; AND THAT TO THE BEST OF OUR KNOWLEDGE THE TESTATRIX WAS AT THE TIME EIGHTEEN (18) OR MORE YEARS OF AGE, OF SOUND MIND AND UNDER NO CONSTRAIl'IT OR UNDUE INFLUENCE. . ?f- I, &~ORN OR AFFIRMED TO AND SUBSCRIBED TO BEFORE ME, THIS ;m.. '--nAY OF V-tl..~r ,1999. .' /7 '. /~~~ h~~~' ~ess /l ./ \:::::rllMLLd.L:f L- 7'~')L Notal)' Public Notarial Seal Monica D. Zercher. Notary Public Camp Hili Boro. Cumberland County My Commission Expires Jan. 14,2002 Member, PennsylVania Association of Notarias r- ::0 t:::I 0 fT1 ~ () I\l :l> 0 ~ W Gl t-'l 2t 1J ~ fT1 ::0 = t-<l ! ~ ::0 H r :l> Q:l . S .r :0 1JA)> 0 :l> fTl 0 ~ _ -l ~ -.J (f) r ~ o -l fT1 ~ ::: :0 ::0 i> fTl . Ol fTl "U ~ -l I\l ' 0 \.'{.1 ,- r _~;; !8qUIt~ ) ":'-\'~'f-Je,l:) us: Zd ZL ::110 10. SIP" JO :+.: "' >-"~"ba1::l .: ~i ,i" .:h<:i . . , PJO.lOOSij CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Dorothy I. Graham Date of Death: November 27,2001 Will No. 21..01-1128 of 2001 Admin. No. To the Registl~r: I certi1y 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 January 21,2002: \ Name Address Joan E. Brent 46 Gale Road Camp Hill, PA 17011 Deborah L. Graham 902 Allendale Drive Mechanicsburg, P A 17050 Notice has now been given to all persons entitled thereto under Rule 5.6 (a) except N/A Date: / /~~ 1/ DaVii~Uire Reager & Adler, PC 2331 Market Street Camp Hill, PA 17011 (717) 763-1383 Counsel for Personal Representative __r If) tv', "J ~~ -, (.) ('1".. <DOC a: C"'J P " ., ~ ..~~ ~j~ S ''\'-'' -" '-- ~ IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF DOROTHY I GRAHAM , Deceased No. 2120011128 of 2001 To the Clerk of the Orphans' Court: Enter the claim of CAPITAL ONE Accl. 4121741354689841 In the amount of $2,063.58 , against the above entitled estate. The decedent, who resided at 46 GALE RD CAMP HILL PA 17011 died on . Written notice of said claim was given to JOAN BRENT ,if known to claimant, at (Personal Representative or counsel) 46 GAIL RD, CAMPHILL, PA 17011 on March 12,2002 (Date) --1_o.u lL _ ~p l. ' \I\A.O vo--- (Claimant) ~ Address: 5330 East Main Street, Suite 200 Columbus, Ohio 43213 .tV / A Claimant's Counsel Address STATE OF VIRGINIA ) ) ss: ) INDEPENHENT epY LIMITED POWER OF ATTORNEY Now comes Mike Stevens, a representative of Capital One, and hereby appoints Estate Information Services, Inc. as its attorney-in-fact for the purpose of executing, filing, amending, and/or withdrawing estate claims with probate courts and/or executors throughout the United States on behalf of Capital One. Be it known that this Limited Power of Attomey will be abolished upon the termination of the contractual agreement between Estate Information Services, Inc. and Capital One. DATED this \d-~ daYOf~r'\b/ .2001. CAPITAL ONE/""" / By: d-~A~ It D. ~ s: Irector Printed Name: Michael Stevens Sworn to an subscirbed before me this ~(7, day of September, 2001, a Notary Public in and for the State of Virginia. xpires: lfb fctt~, f}(J:J,~ / V () )> ): "'U )> ~ ~ :c 0 )> m 0 0 z Cf) -< Z :::0 --l E 0 m m en 0 Cf) m ......... Cf) Z :::0 =+; Q) )> 0 "'U ......... ~ " :c u co CJ1 u ....... w m 0 )> ~. ....... w 0 Z '-" 0 Cf) C" ....... m () :::0 () CD -" )> 0 '-" ~ ~ "'U --l 0 )> ~ C') :c c z w z r- -< :::0 0 ....... r )> --l w Cf) --l <0 .--l 0 3: G> z )> z ~ 0 "'U Cf) m "'U --l :c I'\) r m )> -" I'\) () I'\) ~ 0 )> 0 0 0 .0 -" OJ m -" r () () -" m I'\) 0 m co r )> C Cf) ~ m OJ 0 C Cf) 0 :c ~ w I'\) -" w ; . .. ~ STATE OF PHILADELPHIA PROBATE COURT CUMBERLAND COUNTY FILE NO: STATEMENT AND PROOF OF CLAIM 21011128 Estate of DOROTHY GRAHAM I, Howard A. Enders. Esq. on behalf of COLLECT AMERICA located at 1999 BROADWAY. SUITE 2180. DENVER CO 80202-5744 submit the following claim against the estate for the sum set forth. DECSRIPTION VALUE COLLECT AMERICA ACCOUNT# 5490999999037970 AMOUNT DUE $ 8,096.49 There is now due on the claim, above all legal set-offs, the sum of: $ 8,096.49 o Notice to interested persons: This is a claim by a personal representative. This claim will be allowed unless notice of an objection by an interested person is delivered or mailed to the personal representative not later than I declare that this claim has been examined by me and that its contents are true to the best of my information, knowledge, and belief. ~~A-~I &ll ~ Authorized signature Howard A. Enders. Esq.. General Counsel Name (type or print) The Creditor's Rights & Bankruptcy Group A Division of Phillips & Cohen Associates, Ltd. 695 Rancocas Road Address Westampton. NJ 08060 609-518-9000 City, Stat~~, Zip Telephone j . IPROOF OF SERVICE OF CLAIMj I served upon DAVID REGLE ESQ. Name fiduciary, a copy of this claim on MAY 15.2002 by CERTIFIED MAIL Date State manner and address of service 2331 MARKET ST. CAMP HILL PA 17011 I declare that this proof of service has been examined by me and that its contents are true to the best of my information, knowledge, and belief. ~~.A-~ S--lj-C,d- Date Signature !ACCEPTANCE OF SERVICEI Service of the attached claim is accepted. Date Signature [~~ ~ I REV.1S00EX + (13-00) .~.'. .~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128.0601 DECEDENT'S NAME {LAST, FIRST, AND MIDDLE INITIAL} I- Z W C W U W C GRAHAM, DOROTHY I. DATE OF DEATH (MM.DD-Year) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY f\ VI 11-J.f.,..1I FILE NUMBER 2 - 0 1 2 8 ""'OO'UNTYCOiiE" --vEA~ - - NUM'iiER-- SOCIAL SECURITY NUMBER DATE OF BIRTH (MM-DD-Year) 98-22-8754 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 11/27/2001 11/28/1928 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL) W I- ::.:::~cn U"'>: w"U ,,00 U"'~ "al .. <( [R] 1. Original Return o 4. limited Estate [R] 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received SOCIAL SECURITY NUMBER o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy orTrust) o 10. Spousal Poverty Credit (date of death between 12.31.91 and 1-1-95) o 3. Remainder Return (dateofdeath prior to 12-13-82) o 5. Federal Estate Tax Return Required .Q... 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sell 0) I- Z W C Z o .. (J) w '" '" o U THIS.SEC"'IOHIlilUS!f'BE.co1lill!l;jmi:i,.jilil...C~RUsl!iilNllEiiI(!ll!'." NAME DAVID W. REAGER FIRM NAME (If Applicable) REAGER & ADLER, P.C. TELEPHONE NUMBER 717763.1383 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) z o i= <C ...J ::l l- ii: <C u w a: .Ni:!iciillilj:'11l."iil'FIAIi:"I'~.liilIfOR1IiIA'I'IOiilisIl0tlI;jD.BEil!lIREC!fEDi'fO: COMPLETE MAiliNG ADDRESS 2331 MARKET STREET CAMP HILL PA 17011 OFFICIAL USE ONLY 2,358.00 (8) 2,358.00 10. Debts of DBcedent. Mortgage Liabilities, & Liens (Schedule 1) (10) 7,864.39 35,208.78 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) (11) (12) (13) 43,073.17 .40,715.17 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ I- ::l D.. == o u ~ 15, Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a){1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due (14) .40,715.17 X _(15) X ~(16) X .12 (17) X .15 (18) (19) 0.00 0.00 > > 8e URe l'A;IilSW CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT UA;lili.RiIllIil!l1m . 20. D Decedent's ComDlete ress: STREET ADDRESS 46 GALE ROAD CITY I STATE PA I ZIP 17011 CAMP HILL Add Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 Total Credits (A + 8 + C) (2) 3. interesVPenally it applicable D. Interest E. Penalty 4. TotallnteresVPenalty ( 0 + E) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (3) to: REGISTER OF (4) (5) (5A) (58) AGENT 0.00 5. If line 1 + Line 3 is greater than line 2, enter the difference. This is the TAX DUE. A. Enler the interest on the tax due. 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Yes No 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; ........................................................................... D b. retain the right to designate who shall use the property transferred or its income; ........................................ D c. 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?.............................................................................................. 0 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? ....................................................................................................... 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. Urlder perlalties of perjury, I declare thaI I have examirled this retum, irlcludirlg accomparlying schedules arld slatemerlts, and to the best of my knowledge and belief, it is true, correct and complete Declaration of pre parer other tharllhe personal representative is based on all irlformatlorl of which pre parer has arlY know e, OF PERSON RESPON LE FOR FILlN RETURN Ii DATE ~ 'ai/ct/o2- PA 17050 DATE ADDRESS 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 PS ~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. ~9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116(a)(I.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. ~9116(1.2) [72 P.S. ~9116(a)(I)]. 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. ~9116(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. ''''~.'':'''''. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF GRAHAM DOROTHY I FILE NUMBER 21 01 1128 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 NUMBER 1. DESCRIPTION MEMBERS FIRST FEDERAL CREDIT UNION Checking Account VALUE AT DATE OF DEATH 1,600.00 2. MEMBERS FIRST FEDERAL CREDIT UNION Saving Account 758.00 TOTAL (Also enter on line 5, Recapitulation) $ (It more space IS needed, Insert additional sheets of the same Size) 2,358.00 REV-'511,EX+11-97)~_ . ''!J:lfI)lI COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF GRAHAM DOROTHY I FILE NUMBER 21 01 1128 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. MYERS HARNER FUNERAL HOME 7,655.00 37 E. MAIN STREET, MECHANICSBURG, PA B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) WAIVED Social Security Number(s) f EIN Number of Personal Representative(s) Street Address City State lip Year(s) Commission Paid: 2. Attorney Fees REAGER & ADLER, P.C. 0.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS 60.00 5. Accountanfs Fees 6. Tax Return Preparer's Fees 7. CUMBERLAND LAW JOURNAL - legal advertisement 75.00 8. THE SENTINEL - legal advertisement 74.39 TOTAL (Also enter on line 9, Recapitulation) $ 7,864.39 (If more space IS needed, Insert additional sheets of the same size) REV-151;'>EX'(1.971~_ . . ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF GRAHAM DOROTHY I. FILE NUMBER 21 01 1128 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 3,495.95 1. VISA - FIRST UNION 2. BOSCOVS STORE CREDIT CARD 213.83 3. VISA - CAPITAL ONE 2,074.98 4. PNC BANK - MASTERCARD 8,091.49 5. DIRECT MERCHANTS BANK - MASTERCARD 4,746.25 6. WOODLAND CENTER NURSING HOME October, 2001 payment 1,200.00 7. DEPARTMENT OF PUBLIC WELFARE - CLAIM 15,386.28 TOTAL (Also enter on line 10, Recapitulation) $ (If more space IS needed, insert additional sheets of the same size) 35,208.78 REV-1:13~X+(9-~ ..~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER I ?1 n1 11?R RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 101 11.2)] 1 JOAN E. BRENT DAUGHTER FAMILY HOPE CHEST 106 EASTERLY DRIVE FAMILY BIBLE MECHANICSBURG, PA 17050 2. DEBORAH L. GRAHAM DAUGHTER BURGUNDY BLANKET 902 ALLEN DALE DRIVE MECHANICSBURG, PA 17050 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheefs of the same size) CUMBERLAND COUNTY ~J INVENTORY Estate of GRAHAM, DOROTHY I. , Deceased No.21 01 1128 Date of Death 11/27/01 Social Security No. 198228754 also known as 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 placed opposite each item of said inventory represents 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 made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. I.D. No.: DAVID W. REAGER ?-D'6(P~; Name of Attorney: Address: 2331 MARKET STREET CAMP HILL Dated PA 17011 Telephone: 717763-1383 Description Value Stocks & Bonds Closely-Held Corporation, Partnership or Sole-Proprietorship Mortgages & Notes Receivable Cash, Bank Deposits, & Misc. Personal Property MEMBERS FIRST FEDERAL CREDIT UNION Checking Account 1,600.00 MEMBERS FIRST FEDERAL CREDIT UNION Saving Account 758.00 Total (Attach Additional Sheets if necessary) 2,358.00 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 17~~b - /1 ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRIS8URG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-30-2002 GRAHAM 11-27-2001 21 01-1128 CUMBERLAND 101 DAVID W REASER REAGER 8 ADLER 2331 MARKET ST CAMP HILL PA 17011 '* REV-1547 EX AFP (Dl-D2) DOROTHY I Anount Renitted CHANGED (l) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 2,358.00 .00 .00 (8) 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':is4i-E3f-AFP-foY':o:2Y-NoTicE-oF-YNHEifiTAifcE-TAx-jrPPRAisEifENT~--AL.l-OWANCE-oi------------ -- --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GRAHAM DOROTHY I FILE NO. 21 01-1128 ACN 101 DATE 09-30-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED 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. Hortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adn. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule IJ 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governnental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax If an assessment was issued previously, lines reflect figures that include the total of ALL ASSESSMENT OF TAX: IS. Anount of Line 14 at Spousal rate 16. Anount of Line 14 taxable at Lineal/Class A rate 17. Anount of Line 14 at Sibling rate 18. Anount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS. NOTE: (9) UO) 7,864.39 NOTE: To insure proper credit to your account, subnit the upper portion of this forn with your tax paynent. 2,358.00 43.073 17 40,715.17- .00 40,715.17- 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. US) (6) (7) (8) .00 X 00 = .00 X 045= .00 X 12 = .00 X 15 = (9)= 35.208.78 Ul) (2) (3) (4) .00 .00 .00 .00 .00 . "........... . l+J AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 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 PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGISTER OF KILLS, AGENT REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and I or speaking needs: 1-800-447-3020 (TT only). OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (inclUding discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 20% .000548 1992 9% .000247 1983 16% .000438 1993-1994 n .000192 1984 11% .000301 1995-1998 9% .000247 1985 13% .000356 1999 n .000192 1986 10% .000274 2000 8% .000219 1987 9% .000247 2001 9% .000247 1988-1991 11% .000301 2002 6% .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. 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. Cf,l STATUS REPORT UNDER RULE 6.12 "'~.... ,,,", " Name of Decedent: Dorothv 1. Graham . .r'j c:i I..N Admin. No.: L_ 2 N ~ Date of Death: November 27.2001 Will No.: 21-01-1128 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the 1Qllowin.g_with respect to completion of the administration of the above-captioned estate: co 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is yes, state the following: A. Did the personal representative file a final account with the court? Yes No X B. The separate Orphans' Court No. (if any) for the personal representative's account is: C. Did the personal representative state an account informally to the parties in interest? Yes No X 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. Date: -fiYJ/ Q > Da~d~~re Reager & Adler, P.C. 2331 Market Street Camp Hill, PA 17011 (717) 763-1383 Counsel for Personal Representative ~