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HomeMy WebLinkAbout01-1165 PETITION FOR PROBATE and GRANT OF LETTERS Estate of Richard D. Lusk, Sr. also known as No. To: 2] -01-1165 Register of Wills for the , Deceased. County of Cumberland in the Social Security No. 487- 26- 8592 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut rix in the last will of the above decedent, dated October 3 and codicil(s) dated named ~XJ-2.OOl The F.xe~lltor, Ri~hi'lrn no T,ll~k, .Tr , i~ llnwillinlJ Tn l}lli'llify r:l5 Execlltor, and has executed the attached renunciation. (state relevant circnmstances, e.g. renunciation, death of executor, etc.) County, Pennsylvania, with C;7~R i'V\=>::JO()1AThrook Dr , rv~cnani c<:::bllrg, PA 17050 ist street, number and muncipality) Decendent, then 77 years of age, died December 14 , X9:. 200] , at Holy Spirit Hospital, Ca.rrp Hill, PA 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 (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: 425,000.00 $ $ $ $ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters Testamentary (testamentary; administration c. La.; administration d. b.n.c. La.) theron. ~ V> ~ <1) u C <1) ~~ V>~ <1) .... i:>::<1) C -00 ~.O ro '0 3~ <1) '- ;:;0 ~ c 00 iJi / -/ biJ Wtt-J ,<- I Gai 1 1. King 5238 ~adowbrook Dr., Mechanicsburg, PA 17050 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA \.. ss COUNTY OF O.JJT1l:).:rlana J The petitioner(s) &bove-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 well and truly administer the estate according to law. ~;';ll4j 4141L t... K o/Ii / and ~ Qq' :::s ~ ..... l: ~ :s: ~o. 21-01-1165 Estate of Richard D. Lusk, Sr. , Deceased DECREE OF PROBATE A~D GRA~T OF LETTERS AND NOW DECEMBER 31 }Qs; 2001 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 October 3, 2001 described therein be admitted to probate and filed of record as the last will of RICHARD D LUSK SR and Letters Testamentary are hereby granted to Gail 1. King >>/7 OJ:f:b~'l''U~~ /~ R ster of Wills FEES Probate, Letters, Etc. ......... $ 340.00 Short Certificates( ).......... $ 30.00 ~-Jh~es 12.00 elation ................ $ 5 . 00 JCP $ 5.00 TOTAL _ $ 392.00 Filed ... P.F;G~}f.~F;~. .2.~. . ?O.Q t. . . . . . . . . . . John P!TRUig; (~~q~\ 1.~611~19 600 N. Second St., 5th FIr., Harrisburg, PA 17101 (717) 236- 8000 ADDRESS PHONE no ,.. . 3~ cr' ("" CJ L.:l N C:~ -0 N ~ o d .... aD :; (0" g,~ (' d --" CJ C""J N -"0 N ~ o :D ::0 C'J r.'D ("J '-"', ';'~I --. I, I; 21-01-1165 LAST WILL AND TESTAMENT OF RICHARD D. LUSK, SR. I, RICHARD D. LUSK, SR. of Mechanicsburg, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make and publish this, my Last Will and Testament, hereby revoking all wills and codicils by me at any time heretofore made. ITEM 1: I direct my Executor hereinafter named, to pay the expenses of my last illness and funeral expenses from the property passing under this will as an expense and cost of administering my estate. ITEM 2: All expenses of administering my estate and all inheritance, estate and succession taxes, including interest and penalties payable by reason of my death, which may be assessed or imposed with respect to my estate, or any part thereof, wheresoever situate, whether or not passing under my Will, including the taxable value of all policies of insurance on my life and of all transfers, powers, rights or interests includible in my estate for the purposes of such taxes and duties, shall be paid out of my residuary estate as an expense of administering and with apportionment, and shall not be prorated or charged against any other gifts in this will or against property not passing under this will. ,--; i. /' \ ':\(.. C'{"-L ./ L~'- d-- k' , l,&-t. ~,,4f .. .. ", ITEM 3: I give, devise and bequeath unto my beloved children, NANCY J. STROTHKAMP, GAIL L. KING, and RICHARD D. LUSK, JR., in equal shares, the rest, residue and remainder of my estate, real, personal and mixed, whatsoever nature and kind and wheresoever situate. Should any of my three children predecease me, then that deceased child's share will be distributed to the survivor(s). ITEM 4: In the event any beneficiary and I die under such circumstances that the order of our deaths cannot be established by proof, or should any beneficiary and I die as the result of a common disaster, it shall be conclusively determined for all purposes of this will that I survived the beneficiary. ITEM 5: I confer on my Executor the right to sell or otherwise convert any real or personal property at public or private sale, at such time or times, in such manner, and for such price or prices, and on such terms and conditions as my Executor shall determine, and to execute and deliver good and sufficient conveyances, assignments, and transfers of the property, without liability of any purchaser for the application of any consideration; to borrow money and to secure its payment by mortgage of real or personal property, pledge of investments, or otherwise, without liability on the part of the lenders to see to the application thereof; to retain any investments at discretion; /\ () f" kL. u) <I' iJ." /..I~~L./! .J;. . =1.,).- ' (.... iI-: ,.... ~ ... " to invest and reinvest at discretion, as permitted under Act 28 of 1999, the "Prudent Investor Act"; to make distribution in cash or in kind; to allocate and distribute different kinds or disproportionate shares of property or undivided interests in property among beneficiaries, in cash or in kind, or partly in each; and to do all other acts and things necessary or appropriate in the management, administration and distribution of my estate. ITEM 6: I appoint my son, RICHARD D. LUSK, JR., of Dallas, Texas, to be the Executor of this my Last will and Testament. If my son, RICHARD D. LUSK, JR., is unable or unwilling to qualify as Executor, or having qualified, is unable or unwilling to act, I then appoint my daughter, GAIL L. KING, of Mechanicsburg, Pennsylvania, as Executrix hereof. ITEM 7: I direct that no personal representative, trustee, guardian or conservator, or any successor, shall be required to give any bond in any jurisdiction, and that if, notwithstanding this direction, any bond is required by any law, statute or rule of court, no sureties be required. V~}l ( <~V('~ ,I / I ..J. ~p ~.~.".' ./~.,." i ,-~. , ... . . .' IN WITNESS WHEREOF, I have signed this will on this ~rd day of O(~ , 2001. '~ L ~ /'.. .{ . ,',,:::, TESTATa' - L- I. />,1' J;h, I I.- -' Signed, sealed, published and declared by the above Testator, RICHARD D. LUSK, SR., as and for the last Will thereof, in the presence of us, who, at the request of and in the presence of RICHARD D. LUSK, SR., and in the presence of each other, have hereunto subscribed our names as witnesses thereto. }l~ witness cAe ' . ~ (' 1- L R fJ t-h" ~ \ 0-" ~ (~(' /L/L- Ho-//I J I" () r; I f A I r II( Address /1 S- '1 I~~~ 1~'1 H /11f1.J;;vl A-fo-ul)}.., p/l! 7 ty3 t Address ~ Jt~aA;G(J.A~ ~~MjV1Ai'- Wltness - . , '. COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF DAUPHIN I, RICHARD D. LUSK, SR., Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ; -. ;~\.. '\J l TESTATOR We, k ~ ^^- A c ~ I and ~l\(j/u. ~ ~ f _ +;;1/ AttJ1 /I.A- the witnesses whose names are signed to he at ached br~oregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as Testator's Last Will; that RICHARD D. LUSK, SR. signed willingly and that RICHARD D. LUSK, SR. executed it as Testator's free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the will as witnesses; and that to the best of our knowledge the Testator was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. c/\ L/) , "kl(,/( ,J\. I,-,~ !)v ~- /C/VV\. WI SS ?1G~ ~,tC~A\~ ~ 11f2MuL- WI NE S Subscribed to and sworn or affirmed before me by the above- named witnesses, and subscribed to and acknowled~eg before me by the above-named Testator, this 3~ day of ()~ , 2001. '~~~~ OTARY PUBLIC NOTARIAL SEAL BARBARA E. PALMER, Notary Public Harrisburg, Dauphin County My Commission Expires May 23. 2005 k/p:wills\rlusk.wil r ALL STATE LEGAL, A DIVISION OF ALL-STATE- INTERNATlr FORM NO.: 07152-BF' 07153-Blo 07155-GY' 07156 <' .' ", - - ;;> X ~ 'Tj if: ::0 c:I ;;..- ..... 1:: t'l t'IJ ""' Ij :-:J '~ ~ 0 :s: '""' 7. :>- '-' ~ ;C Z Z :;? S (f) ~ 'L if: H -< >fl 'Z ;.( r; 0- il: C ;p ~ -< 'J) '~ ..... t-< :: Z -: ... - r '2 > 'J) :- '/ C" -: ::: - '1j ;... - n " ~ 0(";; '-$ ::1 r; C'! d ....... :X.l :0 (f) c) f"'; "''I <') c C"J N .U N b:.. o RENUNCIATION 21-01-1165 In Re Estate of Richard D. Lusk, Sr. deceased. To the Register of Wills of Ctnnberland County, Pennsylvania. The undersigned Richard D. Lusk, Jr., son of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters Testamentary be issued to Gail L. King WITNESS hand this day of ,19_. 0 ,,,- ~..k- -:q ,..,...... 0 ;..J.. N 0_ ,_J ) ...... N .' c:..J ~ cu .....~ - '...... Cl .c.) .... i....,' ~.,," .Q C,) ..- ~ s:: Q) p Q) - a:: G .... (J 1!.J..j D /..k /' Richard D. L~~tu!ft. 7154 Walling Lane Dallas, TX 7523] (Address) (Signature) Sworn to or affinned and subscribed before me this ! q day of W~ , 2001. (Address) '711~ ~- /~ Notary hc \ J\V Commission Expires: (Signature) (Address) ~~....'"'"'-...... iI ...- .~ '11\P:t "ui"".~ , '..... ~;.........~/C...,.. Maria G. Hesch ~ {~. ;:'::.4);'\ *\ Notary Public. State of Texas ~ ........~.,.!f\.:.......,...:../ My (O~~m/2m'1's/s2ioOnOEx3Pires 1 "" ,?~,. :~.~.~~ .,' .) ,.:.o~':;1lllF'~".,.,_..,-..,......",._._, T_, ._.,.,..~~~ - '118jrJ! {b ~ ~~~(J,J ~l ~1' ;;U,I{~. .,j4:, /r Iv tdtrt ~ 'tfq, ?/W~ ~ f::i7 I !?t" &,00 )J, ;Zl<.r/ 5'h<.el- I ~~ /It /7 -1tA- It /14'f; 7--.L (~ f~ AtJt)~ ~1V/!lJ ~ Mdz ~ t~~t2YU4l<, k< k i- /f-.1 ~~~I 'L)LUt<.h-il( m -- s::? c' ,-, r~-l 0_ CO ...- z c:c J J (3 ('j,i .0 m . .{'~ <l1 JI ~ "- 1= a: J) G c3 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: ~(lr d D. Lu,) k I Sre. Date of Death: OeL€-~~- i 4. ;;"00 I , Will No. ~ 1-0 1- i) to 5 Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on Name Address N~'1 ~tTld-h\.{-l1(NLp --RiJr\IL~ J. ~k.. ~ (< 6A-\' \ L. K;NS ,........ { l -,L i C\l I ber+ Ave I (<DG\( ~'ll At) ~ 31'tCf LfA.~\e I Dlt Hb-~ -\. ~ 1.5 131 l\~'~ WlL\l~~ 'VYte.eu:io w bvv D k PR.. Ihuhan It S bu.~~ PF' ) oSO 523~ Notice has now been given to all persons entitled thereto under Rule 5.6(a) except #!n. . Date: Signature .,.' ~_." (; l'i) \l.lcC a: ~ -",) ,; -'@ 6)= fJc Name .~ '/ ~ I Address ,2 3 g r)fLubu~<- ~ meJ,~ PA /70H) Telephone c7 '1 1 ~ I - fJ' / Lj 'f o N rr'\ c~_ co ..- ~ J Capacity: --$ Personal Representative _Counsel for personal representative J ,. ~ L:;, \ ~ ~ ~ I "" ~ Cr"1 , - (' F~~ - ~ ~ ~\ t~ ~ \r) ........ ~ " ~ ..,- ..- .,.- ........ ...- ..- ".- .,,- ,0'- ... ...- ........ ....... ...- ...- .,,- ...- ...- ,.,- .!"'- -- :::= ...- ,,':1 (.\ ,:':1 i':1 ..\.. . ,":1 .,..1 C) \'.. .,..1 March 5, 2002 '02 I'll\f~ -6 1\11:J 3 Gb Cl!lnL< Dear Register of Wills, Enclosed is check 115 for the pre-payment of Pennsylvania Inheritance Tax for Richard D. Lusk, Social Security Number 487-26-8592. Please send the receipt ofthe pre- payment to: Gail King, Executrix 5238 Meadowbrook Drive Mechanicsburg, P A 17050 Sincelely, JcUl~'~>: Gail King ~7 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 KING GAIL L 5238 MEADOWBROOK DRIVE MECHANICSBURG, PA 17050 _nhn_ fold ESTATE INFORMATION: SSN: 487-26-8592 FILE NUMBER: 2101-1165 DECEDENT NAME: LUSK RICHARD 0 SR DATE OF PAYMENT: 03/06/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 12/14/2001 NO. CD 000929 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $21,647.40 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: GAIL KING CHECK# 115 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS $21,647.40 MARY C. LEWIS REGISTER OF WILLS REV-1500 EX (6-00) w Co ::.:::~CI) U"'O< Wo.U IOO U"'~ 0.'" !l: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY /1-;)1---1 -< I- Z W o W Co> w o DECEDENTS NAME (LAST, FIRST, AND MIDDLE INrTl'.L) Richard D. Lusk DATE OF DEATH (MM-DD- YEAR) DATE OF BIRTH (MM-DD- YEAR) FILE NUMBER 1.L - .Q i. --L _L..!. 2-_ COLNTY CODE YEAR N...MBER SOCL'\L SECURITY NUMBER 487-26-8592 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SDCl'.L SECURITY NUMBER N/A D 3. Remainder Retum (date of death rmr to 12-13-82) o 5. Federal Es1a1e Tax Retum Required _ 8. Total Number of Safe Deposit Boxes o II. Election to tax under Sec. 9113(A){""oh""o) z o !ci: I- ~ 0. :!!: o Co> S 12-14-2001 09/06/24 (IF AFPlICABUE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDUE INITL'\L) N/A IX] I. Dnginal Retum o 4. limijed Estate IX] 6. Dececenl Died Testate (A',o, copy of \,;I~ o g. Litigalion Prooeeds Received o 2. Supplemenlal Retum D 4a. Future Interest Compromise (dale of death aller 12-12-82) D 7. Decedent Maintained a living Trust (AltachcopyofTrusl) D 10. Spousal Poverty Credit (date of death between 12--31-91 an:! 1-1-95) NL'\ME Edward E. Wa oner, CPA FIRM NAME (If Applcab.) Seli man, Friedman & Com an , P.C. TEUEPHONE NUMBER 717-761-0211 COMPLETE MAILING ADDRESS 1027 Mumma Road Wormleysburg, PA 17043 OFFICIAL USE ONLY I. Real E~ale (Schedule A) 2. Stocks and Bonds (Schedule B) (I) (2) (3) (4) (5) 0.00 622,508.04 0.00 0.00 119,804.48 0.00 0.00 742,312.52 239,363.69 502,948.83 (14) 502,948.83 (8) 11,785.69 227,578.00 (II) (12) (13) z o !ci: ...J ~ I- ~ Co> W e::: 3. Closely Held CorpOfatiOl1, Partnership Of Sole-Proprietorship 4. MOOgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaleous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separale Billing Req~ed 7. Inter-VIVOS Transfers & Miscell00e0us Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total lines I . 7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debls ot Decedenl, Mortgage liabilijies, & liens (Schedule I) II. Total Deductions (total lines g & 10) (g) (IO) 22,632.70 (17) (IB) (19) 22,632.70 (6) (7) 12. Net Value of Estate (line 8 minus line 11) 13. Charitable and Govemmental Bequests/See 9113 Trusts for which an electiOl1totax has no! been made (ScheduleJ) 14. Net Value Subject to Tax (Une 12 minus line 13) SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of line 14 taxable at the spousal tax rale, or transfers under Sec. 9116 (a)(1.2) X.O_ (IS) 502,948.83 x.o 45 (16) 20 'x' lia1ilellk1JlSllE,l/'i:i\<r"~RiI!':'''IiW''''''''1 S'"i':-''', ilik!"F:A~""i\1"""'i1iMi' "ill Ll>J , " ~ ~. .,.",,1iI ,,",~-FIlI!.w"''''''''~,E!!"''' IiN,,', r- , , 'iid i'::, 'dili?'i'llil!"SIIlRl;:lfO:A:'fl R,~bl.;liIlIeS11lKilJIISl:Qi',j,!, ~EISIDE:JIiIl/tl-'RElOOiiQll:iM:A:~M<<" STFPA42021F.1 16. Amount of Line 14 taxable at lineal rate 17. Amount of line 14 taxable at sibling rate x .12 18. Amount of Line 14 taxable at collateral rate x .15 19. Tax Due ;;:f:':';';bF',;: !),]U!jj;!]j]!;;jj:!'ji) Decedent's Complete Address: STREET ADDRESS 5 2 3 8 Meadowbrook Drive CITY Mechanicsburq I STATE PA I ZIP 17050-6834 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 22,632.70 21.647.40 1.131.63 3. InteresUPenalty if applicable D. Interest E. Penalty Total Credits (A + 8 + C) (2) 22,779.03 TotallnteresUPenalty (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) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE, (5) 146.33 0.00 A. Enter the interest on the tax due. (SA) 8. Enter the total of Line 5 + SA. This is the BALANCE DUE, (58) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS No I1Q I1Q I1Q I1Q I1Q [iJ contains a beneficiary designation? .. .. . . . . .. . .. .. .. .. . .. .. .. .. . ... 0 IZI 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 pena~jes of perjury, I declare that I have examined this return, induding accompooying 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 00 all information of which preparer has any knowledge. SIGNATURE OF P SON ~E9fON I LEFOR FILING RETURN 'tV..J 'jC .L-r..;; 7~ f F..u;/;r.; ADDRESS 5238 Meadowbrook Lane SIGNAT E PR il\RER ER T Yes o o o o o o Mechanicsburq, PA EPRESENTATIVE 17050-6834 "'-9- ADDRESS Sel 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. 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. !l9116 (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 retum are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The lax 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 rale 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 lax 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. STF PA42021 F.2 REV-1502 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Richard D. Lusk 21 01-1165 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, ne~her being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DEseRI PTION VALUE AT DATE OF DEATH None o STF PA42021F.3 TOTAL (Also enter on line 1, Recapitulation) $ (If more space IS needed, Insert additIOnal sheets of the same size) 0.00 REV-1503 EX + (1-97) (I) COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Richard D. Lusk FILE NUMBER 21 01-1165 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1. VALUE AT DATE OF DEATH 1 2 3 4 5 6 2000 Shares Citigroup, Inc. 172967-10-1 4000 Shares Conseco, Inc. 208464-10-7 3104 Shares IBM 459200-10-1 4000 Shares Micron Technology 595112-10-3 2000 Shares Xerox Corporation United States Savings Bonds (See Attached Schedule) 93,250.00 13,900.00 373,861.28 119,520.00 16,870.00 5,106.76 STFPA42021F4 TOTAL (Also enter on line 2, Recapitulation) $ (If more space IS needed, Insert additional sheets of the same size) 622,508.04 Slack Name Citigroup Inc. Conseco Inc. International Business Machines Micron Technology Inc. Xerox Corporation Total Value Cusip # 172967-10-1 208464-10-7 459200-10-1 595112-10-3 984121-10-3 ESTATE OF RICHARD LUSK, SR. STOCK VALUATION 12/14/2001 Number of High Low Average Shares 12/14/2001 12/14/2001 Price12/14/01 2,000 4,000 3,104 4,000 2,000 47.25 3.69 121.48 30.50 8.57 46.00 3.26 119.41 29.26 8.30 46.63 3.48 120.45 29.88 8.44 Value 93,250.00 13,900.00 373,861.28 119,520.00 16,870.00 617,401,28 ESTATE OF RICHARD D LUSK LUSK 5238 MEADOWBROOK DRIVE PO BOX 984 MECHANICSBURG, PA 17050 26-6001061 Redemption Date: 01/24/2002 Transaction Number: 2752940 Issue Interest Redemption Serial Number Series Denom Date Issue Price Earned Value Q6400748013 E $25 03/1980 ' $18.75 i $60.25 $79.00 I Q6371889004 E 25 09/1979 18.75 61.08 79.83 Q6395282009 E 25 02/1980 18.75 60.25 79.00 Q6392890537 E 25 12/1979 18.75 61. 83 80.58 , Q6360055608 E 25 11/1979 18.75 61. 83 80.58 Q6328187597 E 25 02/1979 18.75 61. 71 80.46 Q6354430487 E 25 06/1979 18.75 62.68 81. 43 Q6364565694 E 25 08/1979 18.75 61.08 79.83 Q6336146563 E 25 03/1979 18.75 61. 71 80.46 Q6353972334 E 25 05/1979 H(75 62.49 81.24 I ! Total number of bonds redeemed: 10 ", Total Price Total Interest Total Value ?,o Vll 1oQS.OI 1..2.oq.3'f 5.106.7" COMMERCE BANK HARRISBURG NA' 100 SENATE AVENUE PO BOX 8599 CAMP HILL, PA 17011 800-937-2003 ESTATE OF RICHARD D LUSK LUSK 5238 MEADOWBROOK DRIVE PO BOX 984 MECHANICSBURG, PA 17050 26-6001061 Redemption Date: 01/24/2002 Issue Interest Redemption Serial Number Series Denom Date Issue Price Earned Value Transaction Number: 1711846 Q6265296454 E $25 05/1978 $18.75 $ 63.71 $82.46 Q6248673186 E 25 03/1978 18.75 68.25 87.00 Q6226250724 E 25 02/1978 18.75 77.68 96.43 Q6226255813 E 25 12/1977 18.75 80.57 99.32 Q6106008954 E 25 08/1976 18.75 93.08 111. 83 Q6312803003 E 25 12/1978 18.75 63.30 82.05 Q6305526085 E 25 11/1978 18.75 63.08 81. 83 Q6292952174 E 25 09/1978 18.75 62.31 81. 06 Q6282713704 E 25 08/1978 18.75 62.31 81. 06 Q6265317624 E 25 06/1978 18.75 63.92 82.67 Q6212310995 E 25 11/1977 18.75 80.30 99.05 Q6193360586 E 25 09/1977 18.75 89.25, 108.00 Q6192106894 E 25 ! 08/1977 18.75 89.25 108.00 Q6185851180 E 25 06/1977 18.75 92.51 111.26 Q6122209018 E 25 05/1977 18.75 92.28 111. 03 Q6162689951 E 25 03/1977 18.75 91. 19 109.94 Q6156121872 E 25 02/1977 18.75 91.19 109.94 Q6144188275 E 25 12/1976 18.75 94.49 113.24 Q6099419112 E 25 06/1976 18.75 95.34 114.09 Q6119608772 E 25 09/1976 18.75 93.08 111. 83 Q6134776871 E 25 11/1976 18.75 94.17 112.92 Total number of bonds redeemed: 21 COMMERCE BANK HARRISBURG NA.' 100 SENATE AVENUE PO BOX 8599 CAMP HILL, PA 17011 800-937-2003 ESTATE OF RICHARD D LUSK LUSK 5238 MEADOWBROOK DRIVE PO BOX 984 MECHANICSBURG, PA 17050 26-6001061 Redemption Date: 01/24/2002 Issue Interest Redemptio,"_ Serial Number Series Denom Date Issue Price Earned Value Transaction Number: 2622916 L158467617 EE $50 01/1984 $25.00 $51.10 $76.1C L145665068 EE 50 09/1983 25.00 52.70 77.7C L136375715 EE 50 05/1983 25.00 54.48 79.41: LI08939089 EE 50 09/1982 25.00 70.02 95.02 L91515627 EE 50 03/1982 25.00 71. 92 96.92 L83291454 EE 50 11/1981 25.00 73.86 98.86 L100223141 EE 50 05/1982 25.00 71.92 96.92 L87301101 EE 50 01/1982 25.00 73.86 98.86 L67079929 EE 50 07/1981 25.00 75.84 100.8~ L77537068 EE 50 09/1981 25.00 73.86 98.86 L129496761 EE 50 03/1983 25.00 57.08 82.01: L143559672 EE 50 07/1983 25.00 54.48 79.41: L150409516 EE 50 11/1983 25.00 51.10 76.lC L22891416 EE 50 07/1980 25.00 94.56 119.5E L30449562 EE 50 09/1980 25.00 92.201 117.2C L62631716 EE 50 05/1981 25.00 75.84 100.8~ L50330497 EE 50 03/1981 25.00 80.32 105.32 L7869909 EE 50 05/1980 25.00 94.56 119.56 L42163656 EE 50 11/1980 25.00 82.44 107.4~ L47342081 EE 50 01/1981 25.00 82.44! 107.4~ L115294407 EE 50 11/1982 25.00 63.92 88.92 L121242415 EE 50 01/1983 25.00 63.92 88.92 COMMERCE BANK HARRISBURG NA-' 100 SENATE AVENUE PO BOX 8599 CAMP HILL, PA 17011 800-937-2003 .. ___.t:= ,.., ESTATE OF RICHARD D LUSK LUSK 26-6001061 Redemption Date: 01/24/2002 Issue Interest Redemption Serial Number Series Denom Date Issue Price Earned Value Transaction Number: 2622916 L102078556 EE i$50 I I 07/1982 $25.00 I 71. 921 96.92 Total number of bonds redeemed: 23 COMMERCE BANK HARRISBURG NA., 100 SENATE AVENUE PO BOX 8599 CAMP HILL, PA 17011 800-937-2003 REV-1504 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP or SOLE-PROPRIETORSHIP ESTATE OF Richard D. Lusk FILE NUMBER 21 01-1165 Schedule C-1 or C-2 (Including all suppcrting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information 10 be submitted for sole-proprietorships. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH None o STFPA42021F,5 TOTAL (Also enter on line 3, Recapitulation) $ (If more space is needed, Insert additIOnal sheets of the same size) 0.00 REV-1507 EX + (1-97) (Il COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE OF Richard D. Lusk FILE NUMBER 21 01-1165 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1. VALUE AT DATE OF DEATH None o STFPA42021F.B TOTAL (Also enter on line 4, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 0.00 REV-1508 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Richard D. Lusk FILE NUMBER 21 01-1165 Include the proceeds of migation 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. 1 2 3 4 5 PSECU Savings Account # 8501469194-1 PSECU Checking # 8501469194-4 World Savings # 704318823 Bank of America # 0002 7238 7423 1998 Dodge Durango 1,366.13 28,137.16 59,109.77 12,386.42 18,805.00 STFPA42021F.9 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 119,804.48 PSE(~ the financial link", - January 24, 2002 Gai~ L Lusk 5238 Meadowbrook Drive Mechanicsburg Pa ~70S0-6834 RE : Richard D Lusk Account #8 501 46 9194 To Whom It May Concern: As of December 14,2001, Richard D Lusk account balances were as follows: Savings Sbare (S 1) Checking Share (S4) $ 1,366.13 $ 28,137.16 If you have any questions, you may reach us between 7 a.m. to 5 p.m. Monday through Friday or between 8 a.m. to noon on Saturdays. Call 234-8484 in Harrisburg or call our toll-free number (800) 237-7328. When you come to the menu prompt, enter 5 and then enter 5 again. One of our Member Service Representatives will be glad to assist. Sincerely, ,~~ 5 ~an Bauer Member Service Advisor Member Services . PENNSYLVANIA STATE EMPLOYEES CREDIT UNION Main Address: 1 Credit Union Place, Harrisburg, PA 17110.2990 . (717) 234-8484 . (800) 237-7328 Mailing Address: P.O. Box 67013, Harrisburg, PA 17106-7013' (717) 777-2100 (TOO)' (800) 472-1967 (TOO) Web Address: www.psecu.com Savings federally insured up to $100,000 by the National Credit Union Administration. < . ~ . Q WORLD SAVINGS' , 02/05/2002 Gail L King 5238 Meadowbrook Drive Mechanicsburg, PA 17050 Dear Ms. King: I am writing in response to your request for information regarding accounts owned by Richard D Lusk, Sr., who passed away on 12/14/2002. I was sorry to learn about Mr. Lusk 's death, and I would like to convey my condolences to his family. Of course, I understand the importance of obtaining accurate financial information at this time, and the attached chart should address your needs. Thank you for giving me the chance to be of assistance. Mr. Lusk was a valued customer, and we are grateful to have had the opportunity to serve his financial needs. Sincerely, J!~&~~ Judy Columbus Assistant Branch Manager Enclosure 10659 Grand Avenue Suitel Sun City, Arizona 85351 (623) 815.9022 Member of Golden West Fin.1ncW COrpor.llion - -... BALANCES IN WORLD ACCOUNTS ,. AS OF: 12/14/01 704318823 $ 58,534.49 $ $ $ $ $ $ $ $ S $ $ $ $ $ $ $ $ $ 575.28 $ 59,109.77 S $ $ S S $ $ S $ S $ $ s $ DETAILED INTEREST EARNINGS FOR WORLD ACCOUNTS OWNED BY .- BankofAmerica ____ ~--- ~ fll RICHARD D LUSK RICHARD D LUSK JR Page 2 o( 2 Statement Period 12-11.01 through 01.10.02 Number of checks enclosed: 0 B 06 0 A 06 0020109 Account Number: 0002 7238 7423 The monthly maintenance fee for your Interest Checking Account # 0002 7238 7423 will be waived when your average daily balance in combined checking and linked savings, Money Market Savings, CD or IRA accounts meets the balance level stated in the Personal Schedule of Fees. Your combined deposit balance for the statement cycle was $12,022.89. As an Advantage customer, you also have other options such as using loan, line of credit and mortgage balances with us, to avoid the monthly maintenance fee. Please contact us if you would like to talk with us about your account. Online Banking at bankofamerica.com lets you bank anytime, anywhere you have Internet access. View updated account information, transfer money, rc-orcler checks and morc 4 all in one secure place. You can even receive and pay _ your bills online from one easy screen. in just seconds. Get started today at bankofamerica.com/bankonline. Increase your wealth in 2002. Beginning in the 2002 tax year, the maximum you can contribute to a traditional or Roth ffiA increases to $3,000 annually; $3,500 in the tax year you turn 50 or older. Remember, you can contribute to an IRA even if you're covered by a retirement plan sponsored by your employer. For more information, please call the number above. College...The possibilities are endless. Live what you dream. Bank of America Student Loans. Call us at 1.800.344.8382 or visit www.bankofamerica.com/studentbanking. Interest Checking Additions Deposits and Other AdditIons Deposit Interest Earned Date Posted 12-20 01.10 Amount($) 31.58 2.04 $33.62 Total Deposits and Other Additions Interest Checking Subtractions Checks Posted Check Date Number Posted 597 12-18 Amount($) 518.80 Total Checks Posted $518.80 Daily Balance Summary Date Balance Date Balance Beginning /12.18 DJo.-..\~ 12,386.42 11,867.62 1- ' ' 0-4/ . - I 2} ISt/i~~( r -1....1 12.20 01-10 11,899.20 11,901.24 ;e Book Used Car Values .a ~Bl_ Book _. .' ,. The Trutited Resource . ., ".. '_e_____ <W,amt ~ew car Pricing ; Build" c..r ! _~e".n.~~~J My C....'~ val..., ! ~-.~.~_.-.~U.,.i:l! Ilut .. N'lw tar BIlY .. 1,1l,,,d car S;!1I YOv' OiIr ( "'qror~,,' I , ~- ~ Financing ~ Insurance ~ L..mon ~ck! Warr''''ti....' A<:,-<:e_ie~1 car R$vil!Wli 'I l;"" Pr......icwti . DOOsWn Guidf!~ ' AdYlee ! ; About kill> i H&ft1a ~ Do vour HEW eln homework Click on the image above to visit this advertiser Blue Book Private Party Report Pennsylvania. February 16, 2002 1998 Dodge Durango Sport Utility 40 Buv a New Car Buv a Used Car List Your Car For Sale Online .EiDQm;lrH:tQJ.!ote Insurance Ouote Warranty Ouote pavment Calculator Engine: VB 5.9 Liter Tlans: Automatic Drive: 4 Wheel Drive Mileage: 20,200 Equipment SLT Air Conditioning Rear Air Power Steering Power Windows Power Door Locks Tilt Wheel Cruise Control Leather AM/FM Stereo Dual Power Seats Cassette Roof Rack Compact Disc Privacy Glass Premium Sound Towing Pkg Dual Front Air Bags Alloy Wheels ABS (4-Wheel) Consumer Rated Condition: Excellent "Excellent" condition means that the vehicle looks great, is in excellent mechanical condition and needs no reconditioning. It should pass a smog inspection. The engine compartment should be clean, with no fluid leaks. The paint is glossy and the body and interior are free of any wear or visible defects. There is no rust. The tires are the proper size and match and are new or nearly new. A clean title history is assumed. This is an exceptional vehicle. Private Party Value ' $18,805 Private Party value represents what you might expect to pay for a used car when purchasing from a private party. It may also represent the value you might expect to receive when selling your own used car to another private illlp://www.k.../kw.kc.ur?kbb;020655&;p& 722;Dodge; 1998%20Durango&5;DT;DW 02/16/2002 REV-1509 EX + {l-9?} (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Richard D. Lusk FILE NUMBER 21 01-1165 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S} NAME ADDRESS RELATIONSHIP TO DECEDENT A. B. c. JOINTLY -OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name of finarcial instilutionalll barkaccolln\ IlJ11berorsinilar identifying nlJT1ber. DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT AlIaclldeedforjoirtly-heldrealestale VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A. None 0.00 0 0.00 TOTAL (Also enter on line 6. Recapitulation) $ 0.00 STFPA42021F.10 (If more space is needed, Insert additional sheets of the same size) REY.1510 EX + (1-97)(1) COMMONVV'EALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Richard D. Lusk FILE NUMBER 21 01-1165 This schedule must be completed and filed If the answer to any of questions 1 through 4 oolhe reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF rTEM IN:LlDE M Nl\ME OF M TRANSFEREE, MIR RELATlONSHP TO DECEDENT ANJ M DAlE DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER OF TRANSFER ATIACHA COPY OF M DEED FOR REAL ESTAlE. VALUE OF ASSET INTEREST (IF APPUCABLE) 1. None 0.00 0 0.00 TOTAL (Also enter on line 7, Recapitulation) $ 0.00 STF PA42021 F.11 (If more space IS needed, Insert additional sheets of the same size) . REV-1511 EX+(1-97)(I} COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Richard D. Lusk FilE NUMBER 21 01-1165 Debts of dececlent must be reported on Schedule J ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Cocklin Funeral Home 1,669.66 2 Webster Hills Church 275.00 3 Funeral Dinner 314.83 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) I ErN Number of Personal Representative(s) Street Address City Slate lip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (ff decedent's address is no! the same as claimant's, attach explanation) Claimant Street Address City Slate Zip Relationship of Claimant to Decedent 4. Probate Fees 340. 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Copies 52.00 8 Postage 25.57 9 Capital Self-Storage (Storage) 223.24 10 PennDot (Duplicate Title) 22.50 11 Sunoco (Auto Expense) 6.00 12 Firestone Transmission (Auto Repair) 284.18 13 Auto Locator (Advertising) 48.00 14 PAtriot News (Advertising) 68.50 15 Mailboxes Etc. (Postage) 23.21 16 Todd Pelleschi (Medical) 29.80 17 See Attached Schedule with Items 18 to 34 8,403.20 TOTAl (Also enler on line 9, Recapitulation) $ 11 785.69 STF PA42021 F.12 (If more space is needed, insert additional sheets of Ihe same size) . --- Estate of Richard Lusk Supplemental Schedule to Schedule H Funeral Expenses and Administrative Costs 18 Health South (Medical) 19 Physicians of Rehabilitation (Medical) 20 Sun Health (Medical) 21 Moffit Heart & Vascular (Medical) 22 Nephrology Asociates (Medical) 23 Associated Cardiologists (Medical) 24 Pulminary & Critical Care (Medical) 25 Internists of Central Pennsylvania (Medical) 26 Pinnacle Health Medical Services (Medical) 27 Neurology Center (Medical) 28 Wes Shore EMC (Medical) 29 Quantum Imaging (Medical) 30 Sentinel (Advertising) 31 Prudential Insurance (Auto Insurance) 32 PA Department of Revenue (2001 Taxes) 33 AZ. Department of Revenue (Taxes) 34 Department of Treasury (2001 Taxes) Total Lines 18 to 34 26.90 478.08 44.95 364.62 73.42 2.05 214.18 3,137.36 69.05 50.28 148.76 39.92 77.63 116.00 333.00 724.00 2,503.00 8,403.20 e.. ..~.... ~w~ '-Cl'" M =e 0- \D .cD:0 N u>::o ~ eWe ~...J...J ~ =Cl!:!! <:> oi:!u.. ... .... "3D: &'} "Ulw ::0 I- ..8Ul :o...w o",:J: >...U Eo< ~ ... 0 0 0 M - U ... U l"l - -< M ... II ... I 0 <Il -< ii. <II 0 Ul = :;; -; e E U ;;>- < 0 u 1: ....1--' <wE = -Cl@ Q Uz 0 Eo< z - ... c:c-GJ.... ~ ... z3"~ -< e. -...1.-..... ::1 -; ... 3M D:~~ U .... Q So::...ca Eo< W.,M i= >~I-e ~ 0 ~ in' 1ft >!: ,.:. M '" 8 co . ... - .... ..J iX D: w ::0 g co . ... ., .!! ,. <0 e <0 .. . ~ Q 0 (\/ ! (\/ (\/ (\/ .. (\/ (\/ ., '" . > '" - e '" ., '" " E ~ '" '" ~ ~ .. '" '" ... .., .., '" Ul '" '" c. " 1II "c :2 g'o I- lII'- lIIC .,'- ::08" Ul Z 0 ~ i= .. Ul E w ::l E 0- :0 Ul W ., U E :;; 0 u D: .: w Ul D: w ::0 0 'it. I- Ul ::l .. U :0 D: ~ 0 ... ~ 0 ... ~ ., ... N ~ 'it. ... .. 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"CO 0.... >-co 51? 0'" ",g: "0 CO .2 OP "li- E= ..~ J1 .!: :i .... 0" u."Q. ". u .~ " CIl ~ " E o iij " U .,; "'" u " .c o .. o '" "0 ~ .. o .. '" :> Iii o iii .. o iij .9 oa ~ & ~ C) ~ ~ r ~ ",-...,. - .. o 0. " ~ {:. G' It) .... .... ~ .., co o <> "i' - .... .... ii: 0: w ::;; o o co o - '....::" ,.. '" '"' " " " c ~ o c , . 1 i , , < , ( ., ( Q 'i , E 2- << U. w o in w V> " '" 0 ~ J:. '" w ~.) ~4 ~ ...J Q. J REV-1512 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Richard D. Lusk FILE NUMBER 21 01-1165 Include unreimbursed medical expenses. ITEM NUMBER 1. 1 DESCRIPTION AMOUNT Merrill Lynch Margin Account # 557-11741 227,578 STFPA42021F.13 TOTAL (Also enter on line 10, Recapitulation) $ (If more space IS needed. Insert additional sheets of the same size) 227,578.00 - REV-1513 EX + (g.OO) COMMONVVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES .. ESTATE OF Richard D. Lusk NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY L TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Gail L. King 1. 5238 Meadowbrook Drive Mechanicsburg, PA 17050-6834 2 Richard D. Lusk, Jr. 7154 Walling Lane Dallas, TX 75231 3 Nancy Strothkamp 1124 Gilbert Avenue Rock Hill, MO 63119 FILE NUMBER 21 01-1165 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Daughter Son Daughter AMOUNT OR SHARE OF ESTATE 167,649.61 167,649.61 167,649.61 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 11- 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) STFPA42021F.14 . /-?-cS29-Y ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX EDWARD E WAGONER SELIGMAN HAL 1027 MUMMA RD WORMLEYSBURG DATE ESTATE OF DATE OF DEATH FILE NUMBER 'CO~"'TY ACN 10-22-2002 LUSK 12-14-2001 21 01-1165 CUMBERLAND 101 '* REY-1547 EX AFP 101-02> RICHARD D Allount Rellitted PA 17043 .. 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=i5'4-j-Ex--AFP--foY:02Y-NoTicE-oF-YNHEifiTAifcE-TAx-A-ppRirisEirENT:--ALrOWAifcE-cfi-------------- - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF LUSK RICHARD D FILE NO. 21 01-1165 ACN 101 DATE 10-22-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED 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 TAX CREDITS: 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 (1) (2) (3) (4) (5) (6) (7) .00 622,508.04 .00 .00 119,804.48 .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) (10) 11.785.69 227.578.00 (11) (12) (13) (14) NOTE: .00 502.948.83 .00 .00 X 00 = X 045 = X 12 = X 15 = (19)= NOTE: To insure proper credit to your account. subllit the upper portion of this forll with your tax paYllent. 742.312.52 239.363 69 502.948.83 .00 502.948.83 .00 22.632.70 .00 .00 22.632.70 ,,'-...'-~. (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-06-2002 CDOO0929 1.131.64 21.647.40 TOTAL TAX CREDIT 22.779.04 BALANCE OF TAX DUE 146.34CR INTEREST AND PEN. .00 TOTAL DUE 146.34CR · 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 HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM 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 [5X) discount of the tax paid is allowed. PENALTY: The 15X 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 [6X) 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 20X .000548 1992 9X .000247 1983 16X .000438 1993-1994 ]X .000192 1984 llX .000301 1995-1998 9X .000247 1985 13X .000356 1999 ]X .000192 1986 lOX .000274 2000 8X .000219 1987 9X .000247 2001 9X .000247 1988-1991 llX .000301 2002 6X .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. 1,}-/29- Y ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-1U7 EX AFP IDl-OU EDWARD E WAGONER SELIGMAN ETAL 1027 MUMMA RD WORMLEYSBURG DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-18-2002 LUSK 12-14-2001 21 01-1165 CUMBERLAND 101 RICHARD D 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 =i6o-j-E3CAFP--fol--02y------...--iNifERITANc'E--TA3f-sTA-fEM'E-NT-o'F-AcCOlitff--...---------------- - - --- ESTATE OF LUSK RICHARD D FILE NO.21 01-1165 ACN 101 DATE 11-18-2002 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: 10-15-2002 P R I NC I PAL TAX DU E : ........................................................................................................................................................................................................................... 22,632.70 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-06-2002 CDOO0929 1,131.64 21,647.40 11-01-2002 REFUND .00 146.34- TOTAL TAX CREDIT 22,632.70 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 If 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. ) PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. If RESIDENT DECEDENT make check or money order payable to: REGISTER OF WILLS, AGENT, If NON-RESIDENT DECEDENT lIake check or money order payable to: COMMONWEALTH OF PENNSYLVANIA, 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-13l3). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices or froll the Department's 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), REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, phone (7171 787-6505, 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 cOllputed 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. 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 7% .000192 1984 11% .000301 1995-1998 9% .000247 1985 13% .000356 1999 7% .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 NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becolles delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is lIade after the interest computation date shown on the Notice, additional interest must be calculated. .. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Ki L ~(1r d D { L U 51(. Date of Death: J 2. f 1'-1 /0 I Will No.: ~ 1-0 I - / I h 5'" Admin. No.: GV {'K .-- Pursuant to Rule 6.12 of the 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 ri No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal r,ewesentative file a final account with the Court? Yes _ No ~ b. The separate Orp,hans' Court No. (if any) for the personal representative's account is: --I5L D r\/ t... c. Did the personal ~resentative state an account informally to the parties in interest? Yes IR No 0 ~ Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk ofthe. Orphans' Court and may be attached to this report. Date: 47/03 . Yla;e ~ t!j SIgnature 6/11'/ L. k/1 Name ~r~ ,dO ~ ~~ cJL~~ .~ Capacity: Address 5233 ~ 7/7 -71, /~t /Yf Telephone No. ~A 1A~ PIf 17/J S-r) D<f Personal Representative U Counsel for personal representative