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HomeMy WebLinkAbout01-1170 PETITION FOR PROBATE and GRANT OF LETTERS No. To: 21-01-1170 Estate of IIJ/I"~,y E. tAeY also known as Register of Wills for the . Deceased. County of Cl.l.m ~IQM cl in the Social Security No. J <;q- oS' -7t9SB 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 "Y- in the last will of the above decedent, dated and codicil(s) dated named .O~.%1, 19~ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in C 14\'\'\ 'o..e.rlANlcl heY"'. last family or principal residence at 3 S >>Aw wr-y m~ddlp_hm ""1O\IJ'ott-:.h;p) (list street, number and muncipality) County, Pennsylvania, with n...iW!.. Ct&..t-\"~\I! (Sol<.H1 Decendent, then _~ years of age, died ~ 10 , ~ ZOO I , at C-...'"\\ :!>\I'. -Q1!!.~\D~lJ.L n1~diCA.\ Center . 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: ~ $ less ~ 2S,ct:>O $ $ $ WHEREFORE, petitioner(s) respectfu~est(s) the probate of the last will and codicil(s) presented herewith and the grant of letters ~ me.nho-y (testamentary; administration c. La.; administration d. b.n.c. La.) theron. ~ on ';)' u <: '" ~3 '" .... 00:'" c: -00 t:O:: Cl:S"::: ~'" ~o.. '" '- 30 ~ <: bO Vi 16~to I Ce.nh-/LI :::. ee.i- N~wv;lIeJ PI\- 11:z.l.fl OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF CU...I'YI.J:?E'J2.U'\-I\IP J The petitioner(s) ..uove-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 pl:titioner(s) will well an ruly administer the estate according to law. affirmed and 17th CI) ~. ;:s l::l E' ~ ~ ~o. 21-01-1170 Estate of MARY E FRY , Deceased DECREE OF PROBATE A~D GRANT OF LETTERS AND NOW nF.r.F.MRF.R 2..6...-____ _.., ,_ _ :ilix2001. in ccr:sicieruliul1 ( ': iY';;';.:',:, ')1) the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated DECEMBER 29. ] 9g9 described therein be admitted to probate and filed of record as the last will of MARY E FRY and Letters TESTAMENTARY are hereby granted to p nON A T.n FRY '7vy~w,th,/mJ~<r glster of Ills FEES Probate, Letters, Etc. ......... Short Certificates( ).......... ReRtI&8~tion ................ JCP $ $ $ $ 5.00 TOTAL _ $ 80.00 . . . .OEr:... .17.t. .2001. . . .. . . . . .. . . . . . 60.00 12.00 3.00 ~!!/~:m A TIORNEY (Sup. Ct. I.D. No.) (38S13) (;;, (!Io"ser Rd. /J1edton;cs6'0J /A /7IJS~ ADDRESS Filed 7/7- 7~~ - 020 i PHONE N If) ("V") Cl.., I'- .-- , .I a; a: c....J CJ ,,) , ..a cj:: G) = Uu p N If) M C_ I"'- ..- u CJ (i: ~D ..0 cE ij).... aCS - p , ' " 2J-01-1170 1lI&6t Dill &ub Qf~6t&mtut I, MARY E. ?"?Y, of Upper Fra::kford Township, :.:.rr:L;::rlan county, Pennsylvania, declare this to be my last will and revoke all wills and codicils which I have previously made. T . ... . : give and bequeath the sum of One Thousand Dolla~s ($1,000.00), but not to exceed five percent of my net estate ~vailable for distribution before payment 0: all inheritance and similar taxes becoming due by reason of my death, ~o t~e Big Spring Masonic Temple Association 0: Newville, Pennsylvania, toward the said Association's building fund. II: I give and bequeath to each grandchild living at the time of my death the sum of One Thousand Dollars ($1,000.00), and to ea~h such grandchild an a~ticle or household furnishings or c:her tangible personal property! not including automobiles, as my said grandchildren shall select and amicably agree among themselves. All the rest, residue and remainder of my estate, real and personal, I give, devise and bequeath to my son, 2. Donald Fry, if living, otherwise to his surviving iss~e per stirpes. III: I direct that all taxes that may be assessed in consequence of my death, of whatever nat~re and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part 0: the expens~ 0: the administrati~n of my estate. IV: : appoint as Executor of this my last will my son, , , ~ ~ I 'V r ~ ~ -, ,,' -" P. Donald Fry; and if for any reason he shall fail to qualify or cease to ac: as such during the course of my administration, ~ appoint my three grandchildren, Keith A. Fry, Brian D. Fry, and T~~ot~y K. Fry, as alternate Co-Executors of this my last will. V: ~ direct that no bond shall be re~uired af any fiduciary named herein for the faithful performance of their ~~,~ies i~ a~y jurisdiction. IN W~TNESS W~EREOF, I have hereunto set my hand and seal this 2 0. '11/ 7- day of]J.e~;.. ~ hRJ- 'c C1C;7 ! ~~ C?""' / . ~2"'/"1 ///~d Mar . " c!: --7/ 7.72..<-1 --ts-EAL) o Fry The preceding ins~ru~ent! consisting of this and one other typewritten page identified by the signature of the testatrix, Mary E. Fry, was on the day and date thereof signed, published and declared by Mary E. Fry, the testatrix therein named, as and for her last will. in the presence of ~S, who, __ her request, in her presence, and in the presence of each other h:~e :u:;:ribed/o~'?res ,as witnesses hereto (c~c;?Z;c/'n L(!~--n(/fl- ~ / /0 '7r6 /?7y~-r~/~/Y' ~q-' /j /.//7 '""') -'? - b /1j4iO/J LYz:;; r PT ( 'T ;;J Z,i (tJ,?L/' '/)"4<~~~ j[;p I C;;y( ,/ 1< e ~ //Il- / -:? ;J .;l'y / r- -----00 N ~llJ ::J 0 ~i"1 (1) Ul ~~ ~ ~ ~ '---" 1-'- ::s !-rj 11 11 ~ UJ (1) llJ I I Gl r ~ N~UJ i"1 0 0 l> ~- .4(1) rt3 z z II l> r g; ~-I__L f1l r~ ;U ~ ~ W" (1) .. 0 I ::r:i"1 Z 0 0 3:: ;.u ~ "'r i-- 'oj 'oj CT1 ;U \~r W 'lj 1-'- UJ 'oj 'oj II !'l z 9"1 trj CO ~ '-0 _ - en ~ (J) ~; w ::r'>-3~ ~ OJ Ul I ~~ i"1 m m 1) 0 tJ x l> 0 ~(f.Ic'r' Ol l> -l ~ !-rj ~ ~J )> Z ~ OrtUJ~ 0 r /IJ -.J c.l )> Z H ~ ~= ~i"1 rtm ~ (,) :E W(1) Ol I\) fT1 trj (1) tI:J I 0 .. r t-l , ~ rtC- (J) (f.I 1-'- ~ ~ 1-'- ::J LQ :) N Lf) M CL r- ..- '. c.~ -,~:,f' r..) (I.) Of X c:: c...J C) .- p iu "'-"1 ',:; j:: -:I> = -. ~ ()(j 2] -01-1170 REGISTER OF WILLS OF C U hl t3EJ?/.-AA/.D COUNTY OATH OF SUBSCRIBING WITNESS /}J Nil Y .E. F7e Y codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that he, anti she. tu t::re present and saw /llQ/'v E. ;;. Y I ' the testat..l'.lA-__, sign the same and that h~ &In cI she signed as a witness at the request of testat~_ in h er presence and (in the presence of each other) (i presence of the other subscribing witness(es)). W'I..i/,l-AJ s. ..z>~N/f~me) eWE /4IEST H16# 57; '" (!.HNLlS'~~;4" /7'/3 Sworn to or affirmed and subscribed before me this 20th day of ~IMJJER -"'" 2001 tlt/o/J~~ 1-,</..(1/ 4-, Register ame) ONE ~e&r N/611 S7.j (!/hel.l!>t~ /~ /7p/~ (Address) REGISTER OF WILLS OF COUNTY OATH OF NON-SUBSCRIBING WITNESS (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that familiar with the signature of codicil will testat_ of (one of the subscribing witnesses to) the that presented herewith and codicil believes the signature on the will is in the handwriting of to the best of knowledge and belief. Sworn to or affirmed and subscribed before me this day of 19_ (Name) (Address) Register (Name) (Address) '~,s c" -, >~ <& a: f'l R ':,~~~ cE .-- 5: " "..; o N c..J c::l J.) ..' -D t:s= ,1) = ,-',1'-( ..."...... p ,U . . \ 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 FRY P DONALD 7 CENTRAL STREET NEWVILLE, PA 17241 nu____ fold ESTATE INFORMATION: SSN: 199-05-7058 FILE NUMBER: 2101-1170 DECEDENT NAME: FRY MARY E DATE OF PAYMENT: 03/08/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 2/1 0/2001 NO. CD 000938 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $3,325.00 I I I I I I I I TOTAL AMOUNT PAID: $3,325.00 REMARKS: CHECK# 151 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS ~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Mary E. Fry Date of Death: December 10, 2001 Will No. Admin. No. 2001-01170 TO THE REGISTER: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on January 10, 2002: Name Address Mr. Brian D. Fry 1763 Castlerock Road, Frederick, Maryland 21701 7 Central Street, Newville, Pennsylvania 17241 7193 Center Road, Traverse City, Michigan 49686 Mr. P. Donald Fry Mr. Keith A. Fry Mr. Timothy W. Fry 148 Pennsylvania Avenue, Carlisle, Pennsylvania 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: January 10,2002 ~p~~ CHARLES E. SHIELDS, ill 6 Clouser Road Mechanicsburg, P A 17055 Telephone: (717) 766-0209 Counsel for Personal Representative ,1": I ('-..J p , ~ " ...".... ....;.-.. ~ STATUS REPORT UNDER RULE 6.12 Name of Decedent, Jd) :no c: Death: I~C> /-Y t) / Date of ;( /-0/ -//70 Will No. Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes "I... No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. ~.f!~.$1- Date: 10 r~' t:?? Signature c; Charles E. Shields, III Name (Please type or print) 6 Clouser Road, Mechanicsburg, PA 17055 Address f I ',- ", ,;. . (717 ) 766-0209 Tel. No. Capacity: Personal Representative ~Counsel for personal representative (MAH:rmf/AM3) ,-; ~ . ::t' ~eL ~ .v} I~) i.l? .~c., .'.'.'. ',.' '" .... ' 11. I.J:, ; <'I ' ; 4'..( k" 'II ;I :':.<.... ~. :'. ':,} """~~, Ii: ~ , i~;.1 ~i ~ "... ::0 , ~ : " ,. Jt .-J t..:J..1,._.. ii,~ . . ~., -v, "111IIII.: ~I' ., .-',c, " ,." ,~,~,-,:.".:,. ,or> H '<"""....' ~rf" h *' ~ r;rr~" ... ... - ... ....- ,... ... ";.,, III " ... " ... ,,'" ... '.... " .. '... ,-. ....... ... .. ... '... '.... "... "- ,... ....... ...... ...... ...... ~ en- ~ ~~'Oo.O .:B j ~ S ...0 I O,.a u:~~~ ~ >. 1il .- en OJ en l=: OJ l=: ;l ~ 'i:: 1-< 0 il ~ 0 i""i OJ ...o:!j....."", C,)~\O"'" lti!!'\'1I8I!lII' l1J l1J o l'-- ..... ~~~ ~ ! ~ IF- I: i ~ i .. o Eo-I REV.1000EXI6.(1f)) OFFICIAL USE ONLY . REV-1500 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 c /1-.17-9 FILE NUMBER :2-/ --..121- INHERITANCE TAX RETURN RESIDENT DECEDENT D I I 7 t) ----- COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Fr<Y, mt4R.y .s DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) I~ -It) - ~O/ tflfp -lib - 19/8 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) IV/I! SOCIAL SECURITY NUMBER /q9 - {)5 I- Z W C W U W C 705"8 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER IZ] 1 Original Return D 4. Limited Estate ~ 6. Decedent Died Testate (Allacn copy of Will) D 9. Litigation Proceeds Received D 2. Supplemental Return o 4a. Future Interest Compromise (dale of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy 01 Trusl) D 10. Spousal Poverty Credit (datll of death between 12-31-[11 and 1-1-95) o 3. Remainder Return (date of death prior to 12.13-82) o 5. Federal Estate Tax Return Required o 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) w .... ::.:::!fcn u ""< wll.U ",00 U"'~ ll.1ll ll. " .... Z W o Z o ll. " W '" '" o U NAME CflII-ICLE5 E: COMPLETE MAILING ADDRESS iF> CL.OUSE;( J0J.4D ME'CfI"'lV Ie S EtI/C6 /7/1 / ~IIIEZDS 7lL FIRM NAME (If Applicable) /7o~.s- TELEPHONE NUMBER 7/7- 761P-CJ2tJ? (1) - ()- OFFICIAL USE ONLY " (2) -t>- (3) - 0- (4) - 0- (5) 1';;5", ':<7"- 9s (6) ~ /?!?, DiD::?1'0 (7) -0- " 1 (6) //3, 3'1:<, 7~ (9) ,/-, 3S:;. '8'8' (10) ~ ~ 95. ~--V I. Real Eslale (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or SoJe-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non.Probate Property (Schedule G or l) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 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) z o ~ ...J ::l l- ii: <( u w a:: (11) 1 5, o'lS: 38' (12) ,T / OfT, .:;I ~y'. 3 7 (13) ?I. tJO(}...o , (14) . t t) 7, 2 9;r: 37 14. Net Value Subject to Tax (line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o !:i: I- ::l l1. == o u X ~ 15. Amount of line 14 taxable at the spousal lax rate, or transfers under Sec. 9116 (a)(1.2) 0 x .0 fL. (15) 0 11()"0 2'1'1. 37 x .0 g;;: (16) :/ ~ ,9.2 B '2Zj 0 x .12 (17) C 0 i) x .15 (16) (19) f/f, ,f- :U', ..? 'f 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 coilaleral rate 19. Tax Due CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 20.0 Decedent's Complete Address: STREET ADDRESS 3S- STfU/w8EIUe.y lJR.IV€ CITY CffRLISlE I STATE PH I ZIP /7tJ13 (3) CJ (4) 0 (5) % I. 32 f? ~-'I (5A) 0 (58) .1' /, 32;>,;ttj Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) o ,. 3, 3:/5", "0 ~ 17S".II>D Total Credits (A+ 8 + C) (2) 3. InteresUPenalty if applicable D. Interest E. Penalty o o TotallnteresUPenalty ( 0 + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. <r . 1; 8'28: 2,/ tl3, Sllll, ,,0 8. Enter the total of Line 5 + 5A. This is the 8ALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Ves a. retain the use or income of the property transferred;...........................,.............................................................. 0 b. retain the right 10 designate who shall use the property transferred or its income; ............................................ 0 c. retain a reversionalY interest: or.......................................................................................................................... 0 d. receive the promise for life of either payments, benefits or care? ...................,................................................... 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ..................................................................................................n.......... 0 3. Did decedent own an 'in trust fo~ or payable upon death bank account or security at his or her death? .............. 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................... ....................................,........,......,..,......... 0 No ~ ~ ~ ~ IZl ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer er than the personal representative is based on all information of which preparer has any knowledge. DATE go -lif-II> V ADDRESS 1>. PoNlK1> PII.Y Iff LAN7E7(N LAN'E, Sf(I,oPelS.BIN(16,;:J/f /'7.;(S7 SIGNATURE OF PARER OTHER THAN PRESENTATIVE E '~g ADDRESS CHffaiiD E. '5ffllFlDs :ur 6 (!.t.PtfSI!'?'( RtlffD, /JfGt!IIIIII!ICS 11/1t<6, ;:1.4 17~SS' ~f~UW&~~~t;~,;1+:i,~~:,~:~Ji:,:]'W::~;j~Jt:~I_\tk\~~1IJ)ftJmRM.."..._,,,....,._L~ _.,_~i.iiJ1 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)l. For dates of death on or after January 1, 1995, Ihe tax rate imposed on the net value of transfers to or for the use of the surviVing spouse is 0% [72 P.S. 99116 (al (1.1) (ii)]. The statute does not exemot a transfer to a sUlVivlng 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 at 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 10 or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)1. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)). The tax rate Imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99118(a)(1.3)J. 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. DATE ,r. . (j}:z. COMMONWEALT..-i OF PENNSiiLVANIA 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 FRY P DONALD 7 CENTRAL STREET NEWVillE, PA 17241 nnu__ told ESTATE INFORMATION: SSN: 199-05-7058 FILE NUMBER: 2101-1170 DECEDENT NAME: FRY MARY E DATE OF PAYMENT: 03/08/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 12110/2001 NO. CD 000938 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $3,325.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 151 SEAL INITIALS: VZ RECEIVED BY: TAXPAYER $3,325.00 MARY C. lEWIS REGISTER OF WillS ~ev''''8<'('''(* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ffi-~ /J!/!,.€Y ,e:;: , . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 2/-0(- 1170 include the proceeds of litigation and the date the proceeds were received by the estate. All property jointfy-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1, "I, 3. 'I. s. DESCRIPTION 1. ear (j;rj!1Ha/,'pn ;Jayouf ;;".m .6'ard...y;' /J(,M"f /JIA/".re! Fund /Vd 6alan"e due h, t/eur/e"t "Iler (In-ral,p,,, of /asf ~..u/ dut' frpm (Jub, Seh. Eltlployar /1";'~lHenf Syskw. (,tR"e ~ 79. "'I Af,',,". t"e;...~..rsem""f sf 18t., 7Z = bcJ. rel-Ained of., '];J,'s#/bHh'e>I!S ~Af k,qms E/eefr,'c (J"o /JI?ral.'ve, .Inc. a) C LLrre71{ PiUt '0<<..1 6,. ./J) -fz, be po-I'd -oller. PSENS f1ealfh Oph'ofl5 /i1 f T 13f1.NK: Ci) Cheek; d A-ut. #0 I 01 ~ 33 I .J,) "I,tlt, a. CCr' , 'Iv d,o.J. ..... ;t-.e1'Y\ a..) e.) C.D..tl= 31003'110'610(,,284 cJ) I.,t-. Clec:r. -It> d..D,d. 0'" ; h",," c.) c) lI--rna.s C-Iu.b !ket. if' aSoo'tQ;1,%S-f.,'1 J F) 1=-nt a.cer. to cl.o,J 01> ;tel'), e.) ( 5 ee 11L1te..- 0. fhu..hed ne.re;to) l-ur t!tJrp. 1=:,,0.1 {'<<yout n: 1YJ4s)lJAitd CfLrpe.-f Re,I-;rement (adUtZl Cu.r~nt nd che.k f;:,r clrpoSA a.ff,r w/hold;l1a -=;~29.9S) VALUE AT DATE OF DEATH JI' 173.."0 % 9.3. zz fl' <{if. Tt/ I' /7.2. !/ " ;) 8'0..<S' ~ q, 9o.;U,:z. ~;l.:<!f , 1:1, Stlf,lfz ~/t.{..l{2. ~;"S,03 fl .03 ~ 1,037.'1'1 ~/,s:'.oo X. :3 DS;, 00 115'," 9 Pro/fraWl Reh.>td cJ.uJ:: 7. AId proceeds of 11I,#s~It,,/d' I~V" tlI/tI" pel'SOJ1et/f;T 1)."", ~/<: fle>ltelfer; I(ttch,,,, bltr", .sale of ;'p~"I,I lurn,',sh,'Y '/7>...rem flOt:.KI!AiH.r'J,..,t 1.<.><: 011 sa-It! P/ &.rm R/- 35 ark";;"'7 uhve ('see also sdtaI. t::) (;?ock;(f U/tll'r- ~o,,,,,,,: 'l:l<4k - ~."o; .1, L'i!,ts ""i m,'xey_!-o."o " s..1,,- sr>.OO; Cha,;..-~S'."o; /.koIr"om Zk.,rs -/00."0 ==- ~os....) f. '1. If em> "I limit/wi: K(,8/I'" ,f"/lJ-.' 6~C" 1tt6lc/ ~/"{I"IO CQb;,.,e!,: //v/,!! /"(jOHf SUIT; ,,(/;"1/ mON( SUIT TOTAL(Alsoenteronline5, Recapitulation) $'<.s; .17'1, 9S- (If more space is needed, insert additional sheets of the same size) ~ ~M&rBank March 8, 2002 RE; Estate Search The Estate of; Date of Death (D.a.D.) MARY E FRY 12/10/2001 To Whom It May Concern: Identified below is the account information requested. 1. M&T Bank accounts in which the decedent's name appears: Account Type Account Number Account Title CHK CD 1072331 310039]0545169 MARYEFRY MARYEFRY P DONALD FRY MARY E FRY MARY E FRY CD X-MAS CLUB 31003910866284 25004920108691 2. Loans, Mortgages, or other obligations titled in the decedent's name Account Number Amount Owed No Safe Deposit Box titled in the Decedent's name existed at our office. Opening Branch 4344 4344 4344 4344 . , " .' D.O.D. Balances (Includes Accr. In!.) $9902.62 $15,071.94 $12,514.42 $65.03 Account Description ~ij ,t; "N.W =~ Accrued Interest $2.28 $71.94 $14.42 $.03 If you have any questions about the informatiou provided, please coutact our Records Department at (716) 635-40] 0 or 1-800-724- 2440 outside of the Buffalo, NY calling area. Thank you. Sincerely, M&T BANK CORPORATION BY: r3/~A;1.A() b -Ct--~"-- Authorized Signature DATE: 3-1 (- U2- Manufacturers and Traders Trust Company' 1100 Wehrle Dnve. PO. Box 767. Buffalo, NY 14240-0767 REV-1509EX+(1-97) '* SCHEDULE F JOINTL Y.OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATEOF F" Y A I'(. / !J1/Tlty E: FILE NUMBER :2 f- 01- 1170 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S} NAME ADDRESS RELATIONSHIP TO DECEDENT A. p. VMJJl-t.D r=/J.y so", B. c. 18 L-CAnrern LCI"e 2i11;ppensbu.v8J PIf 17;;1:>7 JOINTLy.oWNED PROPERTY: ITEM NUMBER LETTER DATE FOR JOINT MADE TENANT JOINT 1. A. (pls/oo J/~/q7 DESCRIPTION OF PROPERTY Include name of financial inslilulion and bank account number or similar identifying number. Attach deed for jointly-held real estate. wAyjJPIIIIT ~II-A1K (I) cu-t,"f;ca.te iI= 1700015l{~O Pro.Y1c.,p'" &.1. "1::\,1:>'7.71< /fe.Cr. "Int. 370.33 (2.) Cut,'neo.le tF' 171;,13oSffo8' Prine/pal ~al. ~/O, &&0. DD /ll!.er. 7:'nt "30:>.3" (,/S/lIf> (3) t!erf/J\'c4te # Prine//'RI &1. Iher. :r:"f (St:e ktlr ft."", ~. /I 5';';'16 171;, 130 797"1 ,. "II, 115. '10 ~ t.z. ~ WA,Yt"",;nf .d-,f' alfzukel) C."dDm;,,""'" /oc.f>-krl af 3S .sfrauJbU"J Or: &rlis/e, /III 11013. Pf,,~ ,oarf,Gul..Y"Y dese. 1"; bed ,on f!ta-f cu-f4;" deea' f>.o... Hltn F. /Valfllr Rx(!~nrh',?,/, he. 4afe/ 111",. /, 19'10 aI/a' ~&Jra'~"I /1/ t!UI/lkr/lIl/d d,/Olty tJ~ea' LJ_k 3'1-11I, pare 139. l)u~tknf Ok/Pea' an ....nd..v;clecl /HlQ.-I1Jt/f!. il/ter~5f. 7lra oflw. on....l,lI!f /nferl!'st W1S ()wnea' t,,r her s"", p.p ",,,aId IT, t:uuI his w;k., (k;";c/q ,t;.y, '>'$ re,un7S 6)' ;rif.. enf,;"'h"s. ~ f!4I1y &f tt'ew a#,uk...') w;tf,/" a short h;"e afkr deee,/,;"f; d..,.do " c""lrtIef ~,. sqle HNI.J made ,..,fj, :Tent G. M_ I (See ~l1h;'. .5h~d qfhrchd) DATE OF DEATH VALUE OF ASSET %OF DECO'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST ~ l:l, 491f. 1/ SZ:>7. ~ (", ::1'1 'T. 05' ,e ID, 30s. 3" sz,J.. ~ .s; IS~. UJ ., 4'- I7r. zl, 52>/!. ~ClO, 58? /3 ,e 97, tJDtJ, D' Sl>~ ,. '15'; J~.D(J TOTAL (Also enter on line 6, Recapitulation) $ &-8', 0 ~:l. 80 (If more space is needed, insert additional sheets of the same size) " SCI{/Fj). F / ~ht'cl Est: of ,....,v M-U',ev r:- r"-/, r"~ r ~. , .;? /I. e,1lL;;' f1Md She/b].T H-K"",w"y, t:r ""k.,f ~Pj' of ~ A~ru:.mMf {",. sale df /?eal E~ftZre, s~!f/t!ltunf situ/; fhtd t:I !rue Cutd Ci>rrecl ~P'f ,pf:$e cleu' s/r~rI, $Ralul, a.d clel/Yffeel f., Iiq bUYI!rS;S 4lh.cktl nere/&. /III rd/ecf a h;,r h1l1rJ:'d yt:tlue of "97. &Jt>tJ. bO , tJl1e-/ltL/f (Y2-) 01 which /s ~6', ~{).bO 3. A. fYlf T ~ (4ee letter a Irt<,hul tv sdv.d. E ) CI;!llt is 1101 Skrt: .f IV<4tt ditt ~e ~irJt buf h"/;ev6 if r" Be ~II cn "-l(usS of ye<tr bebte J.o.d, (I,fely aJ,..t 10 j'f?4rr) /kd. t!.1>. #: 3/003"'t/o!;'ISI6,9 Pr/lle/pal &J~ "'1'5',071. 't'l 1 -:;::"t Iu,e.r. ~ .I.u.,l 7/.9/f r,1'tt1 I^Alu "IS 1,/3.88 -:-.2 - , ,;( /-0/-1170 ~ 7, 57!. 'J 'f ~. .., WaYJ:tqint i~'" 1[.' ,. , -, c:! cf) LOOK FOR US. WE'LL GET YOU THERE. 02/01/2002 CHARLES SHIELDS III 6 CLOUSER RD MECHANICS BURG P A 17055 The information which you requested on the account(s) of MARY E FRY DECEASED (Social Security Number 199-05-7058) is/are as follows: Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership !TO Name of Joint P DONALD Owner, if any FRY Date Ownefship 06/05/00 Was Established 1700015480 CERTIFICATE 06/05/00 12127.78 1761305408 CERTIFICATE 01/06/97 10000.00 305.36 10305.36 1761307479 CERTIFICATE 06/05/00 411 15.40 62.86 41] 78.26 370.33 12498.1] !TO P DONALD FRY 01/06/97 !TO P DONALD FRY 06/05/00 Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Estahlished Additional Information Requested !i~ SENIOR SERVICES REP. PO Box 1711. HARRISBURG. PENNSYLVANIA 17105-17U . . 646) . wwwwaYPolntbank.com Toll Free 1-866-WAYPOINT (1-866-929-7 . r /.. ")11 (; 1/ .;-. . A-e-';iA . v..c'GL~' School Oist. Cumbo Co., Pa. r.:: ,: . , '. .1.% Real Estate lransferTax / If '.... . "C -/'9u l.j. J'f-' CU')"::':" Data./' Amt. "-- . ,. rt.., \\ I' L< ) 4.'~-{.'4' -- , " u- 7- n Cumb Co. Dist. Col. Agt. /1-2> 90 l'1rtY , " Township 01 S (j7~.iJ[ );;;jf(.t., Cumb. Co.. Pa. Z % R~ Estatellanlfer'lllx /1 Date .) ! '16 Am\. L{.J St. p/ih"-.--;.; /~ Hd-e.e. C'/mb. Co. DiSl. Cor. Agt. ...-<f!:. 1 PPl12 37 DEED :.',-_J .~~ _1 :;.... SO :;Jz --::;~ ~m ~> ",.... ~ ,_~-_->, :-T.; ~ ~: d'.'tJ::' \_~ /(t~il};'< ni 0 ~;',i~'::_../~~ That the said Grantor, for and in consideration of the sum of I ~ ,-" Z Eighty-six Thousand Eight Hundred Thirty-Eight and 00/100 ($86,838.00) I;;:' ~:!. Dollars, lawful rooney of the united States of America, unto it well and trul)b" paid by the said Grantee at and before the sealing and deliver of these ~ presents, receipt whereof is hereby acknowledged, has granted, bargained, . rye; : ;; sold, aliened, enfeoffered, released and confinned, and by these presents Goes:'..., 0> grant, bargain, sell, alien, enfeoff, release and confinn unto said Grantees.;':: i:' : i their heirs and assigns as tenants with the right of survivorship and not as ,,/ tenants in ccmnon, THIS INDENTURE, made this I~'" day of ma.'1 in the year of our wrd one thousand nine hundred and ninety, betwe~n JOHN H. ,': .: , 4 J BILlMAN of Cumberland County, Pennsylvania, and JOHN F. WAI.fIER EXCAVATING,..." c', INC. a pennsylvania corporation with offices at R.D. #4 Carlisle, ;,' Pennsylvania, hereinafter collectively called "Grantor" and MARY E. FRY, widoW: of R.D. 3, Box 1476, Newville, PA, an undivided one-half interest and P. ": II OONALD FRY AND PATRICIA FRY, husband and wife of Newville, Cumberland county,~ d Pennsylvania, an undivided one-half interest, hereinafter individually and :; <0.:; j ~ collectively called "Grantee". 0 !! WI'INESSETH : ALL THAT CERTAIN unit in the property known, named and identified in the Declaration refe=ed to below as "Strawberry Court Condcnninium", located in South Middleton Township, Cumberland County, Pennsylvania, which has heretofore been suhnitted to the provisions of the Pennsylvania Unifom Condominium Act, 68 Pa. C.S.A. Section 3101 et gg. by the recording in the Office of the Recorder of Deeds of Cumberland County of a Declaration dated December 17, 1987 and recorded on December 23, 1987 in Miscellaneous Book 344, Page 318, being and designated in such Declaration as Unit No. 35, together and including the detached garage, said Unit and detached garage, baiLg part of said Unit is rr.ore fully descrj.bed. in said Declaration, together with a proportionate undivided interest in the Ccmnon Elements (as defined in said Declaration) of 1. 613 percent. BEING the same tract of land which William H. Hooke, Jr. and George O. Lebo by deed dated December 15, 1982 and recorded in Cumberland County Deed Book "Z", Vol. 29, Page 650 granted and conveyed to John F. Walter Excavating, Inc. John H. Billman executes this deed to convey all of his equitable interest in the subject property arising from a certain unrecorded Agreement of Sale from John F. Walter Excavating, Inc. to the said John H. Billman. 'I'CGEI'IlER with all singular the streets, ways, water, watercourses, rights, liberties, privileges, hereditaments and appurtenances whatsoever thereunto belonging or in any wise appertaining, and the reversions, remainders, rents, issues and profits thereof; and all of the estate, right, title, interest, eOOirfj 34 PACE 739 property claim and demand whatsoever of said Grantor, in law, equity or otherwise haNsoever, of, in and to the same and every part thereof. TO HAVE AND TO HOlD the said unit, to include the detached garage, above described, and the Hereditaments and Premises hereby granted or mentioned and intended so to be, with the appurtenances unto said Grante~5, their heirs and assigns, to and for the only proper use and behoof of the said Grantee, the,;,Iheirs and assigns forever. AND the said Grantor, for itself and its successors, does by these presents covenant, grant and agree to and with the said Grantee, theirheirs and assigns, that it, the said Grantor and its successors, all and singular Hereditaments and Premises hereinbefore described and granted, or mentioned and intended so to be, with the appurtenances, unto said Grantee,theirheirs and assigns, against the said Grantor and its successors, and against all and every other person or persons whomsoever lawfully claiming or to claim the same or any part thereof, by, from or under them, and any of them, shall and will, subject to the aforesaid, SPEX::IAlLY WARRANT AND DEFEND. IN WITNESS WHEREOF, the said Grantor has caused these presents to be executed and the COIIIlOOIl or =rporation seal hereto affixed. WI'INESS : c ~----- 'uu __===-~-:~ \" ---:;:> r-~-- ~--\.~ -- \ John H. Billman J j '- (SEAL) A'ITES'I': INC. JOHN F. WALTER EXCAVATING, &~~ Kh;t;,v6{/ ~ \ l '.' . ". ., '. '.'.'(SFAL' '" - '~e,.' . .;.1, "" ,;"-i.~\W ','.-;,l '- ~." '"il .-....... ;,,', ~.<~<~ ~:J]' ~,r:::.. , 'c-"-'"'''J'o<. '" -_..o.:,;;~ ~~; .....;:.. ~. L~; \''',;'.1,~I''l'':;:.. , \# 'Ii- .'. .~,,~, ......., .\~ - ~ '1}" s'.' I. .' ".' , .~_? . -- '. 1""", ..~.~.. '*' ,) E"". . -j .y .... '\, , .' p~,/ " \':.\' '; ,., 600~~ 34 PACE 740 ACKNaVLEl:X;EME CDM:iNWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS. On this, the ,..:r day of Y"f"\CU1 , 1990, before me, the undersigned officer , personally appeared John H. Billman and acknowledged that he executed the foregoing instrument for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and "'''', [ ,oid,,'" 38al Ste-,~en~. ~i:;(imnn. Notary Public Ca:':!~le tsart.:'. Cumberland County ~:.~.::.::~. E_~p;ras July 20, 1991 MOII:t.'fY., PC$/lr1syjvanl~ ,t'ssodation 01 Notaries CDM:iNWEALTH OF PENNSYLVANIA SS. '-1-- . . /" .:',..',' :\~:'~.;><. ofhc~~ ~~;~. ~:;.c,"{h,., ~ T ,lor::; --:1\\ ~., :"''l''><.." )t)" . . _ . ,-"I} .'._. ~'. ""'''"'''-",. :,. '-,~";," "':e>,',O.-:.~(4"\::l: . ~J <,~;~7"'<~:"h..~;' / ~ -'J.1\."tl.;->4t,t~.ln.", ~:: ";'~-'-"""-c' " n :." ,>-0 I 'In ". Notary Public My ccmnission expires: COUNTY OF CUMBERLIIND On this, the I ~ r day of ~ ' 1990, before me, the undersigned officer, personally appear John D. Walter who acknowledged himself to be the president of Jo F. Walter Excavating, Inc., a corporation, and that he as such president being authorized to do so, executed the foregoing inst~ent for. the purposes ~erein contained by signing the.,;: d , name of the corporat~on by himself as pres~dent. . .,....'~^'l.'..".. , '.1\ -- . .:( ~ if ,'. -.\,,:I,~::,..,.~,J/~,. IN WI'INESS WHEREOF, I have hereunto set my hand and offiS~ ,s~h::}~~':'~', ~ ---~'''i''/~iw::.r' -, ~ '--" \-;'~,'~~!:'~"} Notary Public '. . ',-' ~ 'F (l '] 1/\ "'.' N0!3rb! Seal steven .J. Fishman, ~jotary Public Carlisle 8or0, Cumberiand County MV CommissKIn Expiie5 July 20, i 991 Member, P$nnsyl~ania Association 01 Notaries BOOK-f\ 34 PAGE 741 My cornnission expires: CERTIFICATE OF RESIDENCE I hereby certify that the precise address of the within Grantee is 3.;- S~&;e"7 C<<>"", c"'-eL,.r<6, p~ '~'~. '. ?/~~~ . .~ Attorney for Grantees: CXMmWEALTH OF PENNSYLVANIA SS. COONTY OF CUMBERLAND RECORDED on this \ 'S t day of ~~ th~ Recorder's Office of said County, in Deed Book 1\ QG A.D., 19 ,in vo1.34 ' Page '/3~ Given under my hand and the seal of the said office, the date above written. q:>c37~ ~'~~':.""'\ - . .- "I' ". "-' ... ~ 4' . _ n ~, Recorder -' ":,i:}".,~~\(~,~.,~.f.~,:~>_\ ~I;.' ';) ~ ;' ~'a ~ .. J '_'+"""""'''#'', ~.~.: '~~i.._<t{~_", ',~ 'fl ,<'; _ "~'_._ "',.-,"t.f- ....-.J: t (j ~"-r if . c..- :- r ...)), - t..~ .' '),' ~_ ~~, I;'''' . " \ ~J\\) ..:: , * '~,'..... ," -"'. '''' ....... .'ill,."................ aOOK 0:34 PAtE 742 \ HUD" 1 UNIFORM SETTLEMENT STATEMENT OMS Approval No. 2502-0265 A U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT B. TYPE OF LOAN 6. File Number: 7. Loan Number: 1. FHA 2. FmHA 3. Conv. Un ins. 4. VA 5. Conv. Ins. 8. Mortgage Insurance Case Number C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.D.C.)" were paid outside the closing; they are shoWTl here for informational purposes and are not included in the totals. NOTE: TIN - Taxnaver's Identification Number D. NAME AND ADDRESS OF BORROWER: E. NAME, ADDRESS AND TIN OF SELLER: F. NAME AND ADDRESS OF LENDER: JEM G. HOCKENBERRY P. DONALD FRY Ni'A SHELBY J. HOCKENBERRY PATRICIA FRY 35 STRAWBERRY DRIVE 18 LANTERN LANE CARLISLE, PA 17013 SHIPPENSBURG, PA 17257 G. PROPERTY LOCATION: H. SETTLEMENT AGENT NAME, ADDRESS AND TIN 35 STRAWBERRY DRIVE LISA M. GREASON, ESQUIRE 02-0532562 CARLISLE, PA 17013 50 EAST HIGH STREET CARLISLE PA 17013 PLACE OF SETTLEMENT I. SETTLEMENT DATE GREASON LAW OFFICE 06/28/2002 CARLISLE PA 17013 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DIIE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 10 I. Contract safes nrice 97 000.00 401. Contract sales nrice 97 000.00 102. Personal nronertv 402. Personal nronertv 103, Settlement charl!es to borrower (Line 1400) 1 595.50 403. 104. 404. 105. 405. Ad'ustments for items naid hv seller in advance Adiustments for items naid hv seller in advance 106. Citv/town taxes 406. Citv/town taxes 107.Countvtaxes 06/28/2002 12 31/2002 115.33 407. Countv taxes 06/28 2002-12/31 2002 115.33 J 08. Assessments 408. Assessments 109. 409. 110. School Tax 5.92 410. School Tax 5.92 III. Rent 15 da s at S20.00 300.00 411. Rent 15 davs at S20.00 300.00 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 99 016.75 420. GROSS AMOUNT DUE TO SELLER 97 421. 25 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 20 I. Oennsit or earnest monev 202. Princinal amount of new loan s) 203. Existinl!: loan 's) taken subiect to 204. 205. 206. 207. 208. 209. 2 500.00 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 50 I. Excess dennsit 502. Settlement char2es to seller (Line 1400) 503. Existinl!: ]oan(s) taken subiect to 504. Pavoff of first mortEage loan 505, Pa off of second morte.a2e loan 506. 507. 508. 509. 1 036.00 Adiustments for items unnaid bv seller 2] O. Citv/town taxes 2] I. County taxes 2] 2. Assessments 213, 214. 215. 2]6. 217. 218. 219. 220. TOTAL PAID BYIFOR BORROWER 2 500.00 Ad'ustments for items un aid bv seller 510. Citv/town taxes 511 . Countv taxes 512. Assessments 513. 514. 515. 516. 517. 518. 519. 520. TOTAL REDUCTION AMOUNT DUE SELLER 1 036.00 300. CASH AT SETTLEMENT FROM/TO BORROWER 30 I. Gross amount due from borrower (Line 120) ! 102. Less amount aid by/for borrower (Line 22m I .103. CASH FROM BORROWER 99 016.75 2 500.00 96 516.75 600. CASH AT SETTLEMENT FROMrrO SELLER 601. Gross amount due to seller (Line 420) 602. Less reduction in amount due seller (Line 520) 603. CASH TO SELLER 97 421. 25 1 036.00 96 385.25 SELLER'S STATEMENT The information contained in Blocks E, G, H, and J and on line 401 (or, ifline 401 is asteriskcd, line 403 and 404) is important tax information and is being furnished to the Internal Revenue Service (see Seller Certification). If you are required to file a return, a negligence penalty or other sanction will be imposed on you if this item is required to be reported and the IRS determines that it has not been reported. You are required 10 provide the Settlement Agent with your correct taxpayer identification number. If you do not provide the Settlement Agent with your correct taxpayer identification number, you may be subject to civil or criminal penalties imposed by law, Under penalties of perjury, 1 certifY that the number shown on this statement is my correct taxpayer identification number. (Seller's Signature) P. DONALD FRY (Seller's Signature) PATRICIA FRY '-} EASY SOfT. lnc, ]999 Previous editions are obsolete Page I form HUD41 (3/86) ref Handbook 4305.2 Z-I;Ot17 ){OoqpuBHJaJ (98/t) !-QOH WJoJ Z a~lld ala[Osqo aJl! SUO!l!pa sno!AaJd 6661 ":)UI 'ld05 ASY3Q1 .OWI UO!I:)as pUll roOI uO!):las apo.) YO 81 a[l!l :;;Ias SI!B):lp JOd "lUaWUos!Jdwl PU1l au!} 1l apnpu! U1l0 UO!P!AUO:) lJodn sapl1lu;;Id 'lWOJ J'III!W!S Jal!lo AU'll JO S!41 uo sal'lllS pdl!UO a1.J) 01 sluawalBls as[BJ a Afau~ou)j 0) aW!JO 0 S! H :ONlNW M ::Iloa 3'dIOOS3 INOS'Ii "~'liSI'I / )uamU::I '\U::IS f/" ~/"m"'s"." 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PJ1l'Z'eH to6 JOJ WIlIWdJd a::luwnSUr;) e )JoW .Z06 WOJJ lSaJa'UI .\ 06 3::JNYAOY NI mYd 38 OL 1I30N3'1 ,1.8 <1311111 311 Sl;tUl .006 '!lg 'OIg '60g '808 aad uon WnSSV"LDY o~ 0;;1.:1 UO!)Il:)!1 V :l:,mBJnsul ;) 'U 1-I0W '908 ;):).::( UO!):)d SUI S,J;;)pu:y] '~O!l 01.J,JO dJ l!p:lJ,J "1'08 0./.:;;1;),-:1 [BS!1:lJ Y"tcfl luno:)S!G ul101 .ZOg :la.:l UOflUU! ,JO UBOl "lOg NYO'1 HLIMNOIL::J3NNO::J Nl318YAYd Sl;t3LI .008 'VOL juaw:m.j.as III P!B UO!SS!WWO.) 'tOL. $ "ZOL $ 'IOL OO.OOS 00' L6 :SM.OIIOJ Sll DOL dU!1 UO!SS!wwo:JjO UO!S!A!G v 00"000 L6 $ ~JJ.I UO pd!i8q NOIS U\lJ..\jO::>S,lIJ)lOllH/S~i'1VS'V.lO.L"OOl. S3~IIYH::J ,LN3l;t3~ll3S ''1 .' AGREEMENT FOR SALE OF REAL ESTATE THIS AGREEMENT, made this,J .RL' day of r4~;2IL , A.D., 2002, between P. DONALD FRY and PATRICIA FRY, his wife, currently of 18 Lantern Lane, Shippensburg, Cumberland County, Pennsylvania, the Sellers and JEM G. HOCKENBERRY and SHELBY J. HOCKENBERRY, his wife, the Buyers. AS FOLLOWS, TO WIT: The said Sellers agree to sell and convey to the Buyers who agree to purchase: ALL THAT CERTAIN Condominium Unit known as 35 Strawberry Drive, Carlisle, Cumberland County, Pennsylvania. ON THE TERMS AND CONDITIONS FOLLOWING, TO WIT: I. The Buyer agrees to pay for the said property the sum of Ninety-seven Thousand and nollOO ($97,000.00) Dollars as follows: a. Two Thousand Five Hundred and nollOO ($2,500.00) Dollars on the signing of this AGREEMENT, said deposit to be held by Buyer's attorney, Lisa Greason, in escrow, (which deposit may be retained by the Seller at their option, as liquidated damages in case of default by the Buyer in the performance of terms of this AGREEMENT); and b. The balance of the purchase money as follows: Ninety-four Thousand Five Hundred and nollOO ($94,500.00) Dollars in cash or by certified, cashiers or previously agreed to attorney's or title agent's escrow account check at the time of the settlement. (I.) There is no financial contingency or other contingency other than those expressly set forth herein. 2. RE: INSURANCE: Seller shall maintain the currently existing insurance in full force and effect until final settlement has been made. Seller shall bear risk of loss from fire or other casualty until time of settlement. In the event of damage to the property, by fire or other casualty, Buyer shall have the option of rescinding this AGREEMENT and receiving back the hand or earnest money paid at the signing hereof or otherwise upon account or of accepting the property in its then condition with the proceeds of any insurance recovery obtainable by the seller. Buyer is hereby notified that she may insure her equitable interest in this property as of time of the signing of the AGREEMENT. There is currently general condominium insurance in effect. 3. RE: LIENS AND ENCUMBRANCES: The premises are to be conveyed in fee simple, free and clear of all liens and encumbrances and easements except those, if any, other than mortgage and judgments, which are of record or which are visible on the premises or known to the Buyer, provided the same do not prohibit or substantially impair the Buyer's intended use of the property which is a residence. 4. RE: FIXTURES AND APPLIANCES: Washer, dryer, refrigerator, stove, microwave, dishwasher, one (I) ceiling fan. a. LEAD PAINT DISCLOSURE: Seller hereby states that the premises were built after 1978. b. STANDARD DISCLOSURE: Seller attached a standard Seller's disclosure form hereto. 5. RE: POSSESSION: Possession is to be given at the time of settlement. 6. RE: TRANSFER TAXES: State Realty Transfer Tax shall be paid by Seller and local Realty Transfer Tax shall be paid by Buyer. I 7. RE: APPORTIONMENT: Local real estate taxes, water, sewage, and the like shall be pro-rated at settlement, using the various fiscal years or other billing periods of the governmental or other authorities or entities involved. Utilities shall be paid by Seller up to date of settlement. 8. RE: TITLE: Title is to be good and marketable and such as will be insured by title insurance companies at regular rates. Deed shall be by special warranty deed. 9. RE: PERFORMANCE: Settlement to be on or before July 1,2002, said TIME TO BE OF THE ESSENCE OF THIS AGREEMENT, unless extended by mutual consent in writing. a. RE: TENDER: Tender of an executed deed and purchase money is hereby waived. 10. RE: ZONING: The property is in compliance with all current zoning ordinances. II. RE: TERMITE INSPECTION: Buyers, at Buyer's cost, shall have a termite inspection performed within ten (10) days of the date of the signing hereof. In view of the nature of termites and their activities and the general need for treatment, Seller will pay for any treatments needed because of termites and/or their activities. 12. RE: HOME INSPECTION: Buyers, at Buyer's cost, shall have a home inspection performed within ten (10) days of the date of the signing hereof. In the event such inspection reveals any problems which, in the opinion of Buyers or Buyers' professional home inspector, is in need of correction, replacement, or repair, Buyers shall so notity Sellers within five (5) days of the receipt of the inspection results. Buyers and Sellers shall then discuss and determine who shall pay and/or in what proportions payment shall be split between them for any such corrections, replacements or repairs. In the event that they cannot agree, this agreement shall be considered null and void and Buyers shall have return of their down money and each of the parties shall pay their other costs themselves, e.g., attorney's fees, inspection fees and the like. Sellers were part owners of the premises being sold hereunder. They are not aware of any defects, latent or patent and have provided a disclosure statement to the extent of their knowledge. Sellers make no warranties other than the special warranty of title in paragraph 8 above. Buyers accordingly rely only on the inspections made by themselves and those in their employ. Sellers shall maintain the present condition until settlement. Sellers shall provide a resale certificate from the Condominium Association in a timely manner and in proper form. 13. RE: ENTIRE AGREEMENT: This agreement contains the whole agreement between the Seller and Buyer and there are no other terms, obligations, covenants, representations or conditions, oral or otherwise, of any kind whatsoever. 14. RE: ASSIGNMENT: No assignment without written consent of Seller. 15. RE: BROKERS' FEES. ETC.: There are no brokers nor commissions involved in the sale of this property. 16. RE: RECORDING: This agreement shall not be recorded in the Office for the Recording of Deeds or in any other office or place of public record. IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seals the day and year first above written. Witnesses: La1, ,Ji);J"Lk~1 p~~~~ (SEAL) 2 l1i'ufi- /) j.LLL.y_ /l",,, ~ U PATRICIA FRY Ifl-tIJ I) ;LL6<~O f) !)u L ,0. ;J~JK~ ~ . ,d. . '() - S ELB 3 (SEAL) (SEAL) (SEAL) . h DEED Made the ;l. f>/t, (2CXJ2). day of ~t1R- in the year two thousand and two Between P. DONALD FRY and PATRICIA FRY, his wife, of Shippensburg, Cumberland County, Pennsylvania, Grantors, and JEM G. HOCKENBERRY and SHELBY J. HOCKENBERRY, his wife, of Carlisle, Cumberland County, Pennsylvania, Grantees. WITNESSETH: That the said Grantors, for and in consideration of the sum of Ninety-Seven Thousand and 00/100 ($97,000.00) Dollars, lawful money of the United States of America, unto it well and truly paid by the said Grantees at and before the sealing and delivery of these presents, receipt whereof is hereby acknowledged, have granted, bargained, sold, aliened, enfeoffed, released and confirmed, and by these presents do grant, bargain, sell, alien, enfeoff, release and confirm unto said Grantees, their heirs and assigns as tenants by the entireties, ALL THAT CERTAIN Unit in the property known, named and identified in the Declara- tion referred to below as "Strawberry Court Condominium", located in South Middleton Township, Cumberland County, Pennsylvania, which has heretofore been submitted to the provisions of the Pennsylvania Uniform Condominium Act, 68 Pa. C.S.A. Section 3101 d gm. By the recording in the Office of the Recorder of Deeds of Cumberland County of a Declaration dated December 17,1987 and recorded on December 23,1987 in Miscellan- eous Book 344, Page 318, being and designated in such Declaration as Unit No. 35, together and including the detached garage, said Unit and detached garage, being part of said Unit is more fully described in said Declaration, together with a proportionate undivided interest in the Common Elements (as defined in said Declaration) of 1.613 percent. BEING the same tract of land which John H. Billman and John F. Walter Excavating, Inc., a Pennsylvania Corporation, by deed dated May I, 1990 and recorded in Cumberland County, Deed Book "N," volume 34, page 739 granted and conveyed to Mary E. Fry, widow, P. Donald Fry and Patricia Fry, his wife, as joint tenants with rights of survivorship, and not as tenants in comon. The said Mary E. Fry departed this earthly life on December 10,2001 whereupon full and absolute title vested in the said P. Donald Fry and Patricia Fry, his wife, the grantors herein. TOGETHER with all singular the streets, ways, water, watercourses, rights, liberties, priv- ileges, hereditaments and appurtenances whatsoever thereunto belonging or in any wise appertaining, and the reversions, remainders, rents, issues and profits thereof; and all of the estate, right, title, interest, property claim and demand whatsoever of said Grantors, in law, equity or otherwise howsoever, of, in and to the same and every part thereof. TO HAVE AND TO HOLD the said unit, to include the detached garage, above describ- ed, and the Hereditaments and Premises hereby granted or mentioned and intended so to be, with the appurtenances unto said Grantees, their heirs and assigns, to and for the only proper use and behoof of the said Grantees, their heirs and assigns forever. AND the said Grantors, do by these presents covenant, grant and agree to and with the said Grantees, their heirs and assigns, that the said Grantor, all and singular Hereditaments and Premises hereinbefore described and granted, or mentioned and intended so to be, with the appurtenances, unto said Grantees, their heirs and assigns, agaiust the said Grantors, aud against all and every other person or persons whomsoever lawfully claiming or to claim the same or any part thereof, by, from or under them, and any of them, shall and will, subject to the aforesaid, SPECIALLY WARRANTY AND DEFEND. IN WITNESS WHEREOF, the said Grantors have hereunto set their hands and seals the day and year first above written. Signed, scaled and delivered in the presence of: ~I!~JJ ~pM)f tU~~A$ JtJt1;: A TTE~ 1 : :> <;;.j f. Po",a.lcll'::;''1 HONALD FRY '5/ -'l1/r/C-IC- (-;'-1 PATiUCIAFRY / ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYL VANIA : SS. COUNTY OF CUMBERLAND On this, the day of __, before me, the undersigned officer, personally appeared P. DONALD FRY and PATRICIA FRY and acknowledged that he executed the foregoing instrument for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. Notary Public CERTIFICATE OF RESIDENCE I hereby certify that the precise address of the within Grantees is 35 Strawberry Court, Carlisle, PA 17013. Attorney for Grantees COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND RECORDED on this day of Office of said County, in Deed Book ~, Vol. ~, Page _' ,2002, in the Recorder's Given under my hand and the seal of the said office, the date above written. Recorder REV.1511EX+(1-97) '* SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Frey, /J//I,ey E: FILE NUMBER dll-ol- 1170 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Uru/,'fl! wtJrks -/l/ttcl!nfMf of date sfz,"'1! ~ 1i:6y 011 85:00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) 'P. n."...ld Fry 4JAIV€]) Social Securtty Numbe~s) I EIN Number of Personal RepresentaUve(s) Street Address 16 Lantl!rn Lane City Sh,'/}J(1/!h$b",rq State 'pI'! Zip /7:<S7 - Year{s) Commission Paid: IJ/A I 2. Attorney Fees CharleS E. 5h;e.fds 17T 3,90&,&0 - 3. Family Exemption: (If decedents address is not the same as claimants, attach explanation) Claimant j1//J #€ AI""'E Street Address City State Zip Relationship of Claimant to Decedent IlNlJ ;",1,'0.' ISSLle of shorT cerT; h"a.T/!S ~ 4. Probate Fees &-0 . 00 5. Accountants Fees 6. Tax Return Preparer's Fees FI"yc/ F4hn/!shuk, /feounhml Iz,,... clore.".1 ~ 2LJo.olJ (P'IP jl/l 'If) Fsrah rdurn I" 'II . ;2,4- "II I e7Z . (e3f,in. ) , ~ 7. ,1dvu!. /1/ t:U/It 6u'/"""t L4HJ .;rp~n;a( 7S.a:> 8'. ,4"'r~rf. ~Ct/n"l- &/<IJ' //kfrr /ties/ ~ /1] I 79.6.3 9. r-:/:(j .Tn her. Ta.x I!eh.rn ;:'0 -fr> p"-J' pi tv/lis /. IS~DO Ie. ;(e/AtJ u.rsetY/(JI& ~ Charles ~. Sh:e/tfi N #r I"rlar, p/vJ~- , IR. is- &p/e~/ etG. TOTAL (Also enter on line 9, Recapitulation) $ '/, 3 s <? 8'!S (If more space is needed, Insert addltronal sheets of the same size) ''''''''''''.1'''". COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES. & LIENS FILE NU MBER FIl~ Ilt/l-I<Y e .;2.1-01-/170 Include unreimbursed medical expenses. ITEM NUMBER J. DESCRIPTION Adl//uS re: tJ1u/'-ca! p:;sisfana, nurs/nJ hOllfe d.airy //4.h'me hy Charle5 Eo S/';e/d$ JI[ SfJ~fh m:dd/efr,wn T,;p. tvah- tt<<cI dwer .bill AMOUNT 1. CtLm re.n der..d "//2. J7J 3. ~.s. Tr-eo..s...."y - X.t?S. .btl/./QJ1U cl"e on f1ersbntJ,! ~. Ta,>< (O'fO ~ 99.00 , if tf'/. {)Q TOTAL (Also enter on line 10, Recapitulation) $ {, 'f 5'. ~-o (If more space IS needed, insert additional sheets at the same size) REV-1513 EX+ (1.97) '*' SCHEDULE J BENEFICIARIES ESTATE OF NUMBER I. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT /=;e y. /1/ #t€ Y FILE NUMBER 2/-01-1/70 AMOUNT OR SHARE OF ESTATE " 1,000.00 " , 00 J DOO. rr '.. DoO.~ I'eS id u.e. ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX is NOT BEING MADE ~ NAME AND ADDRESS OF PERSON(S) RECEiVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) RELATIONSHIP TO DECEDENT Do Not List Trustee(s) 1. mr. is,.:,,,,, D. Fr'Y /7(" 3 CA~t{eroGk Roo.d, Fred",,; d<, I"i1D ~1701 ifrand.soVJ ;I. /J1r, T, mofiJ}/ UJ. R-y /'1/ flennsylllPnlQ /fYe/7ue, Car-lisl"" 1",4 /70/3 'trand.son 3. /IIr. Ke//I, /I. f:;-y 7/'13 Center' /(oa,l, trauerse C;/y, /UI. '/'i' &, (fra..nd:;.oYJ 1. p. OMald ff.J IS Lpnf~m kne; Sh/ppensbury )1'11 /7:rS"7 -,,"'.., 1. 1. B CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS B'g Spring Mllson;c 7eJ1lp/e ASSoc.,'ah'on of Newv;II", PA- C/o i'nr. P. ~d Fry. ~crero..r'f 7 C"-nrr...1 Sheet Ne.wv; /Ie, PI! 17 Ollf I TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space IS needed. Insert eddltional sheets of the same size) 1f I, 000.00 " f!JDO.DO 1EClst Bill Club Wtstattttut 1, MARY E. ??7, c: ~?per ?~~=k~~=d TCW~3hipl ..... "." ~ "" ,- ~ ~.,...." _ _.u____ _ ......... county, Pannsylva~i~, ddc:a~~ t~is ta ~s my :ast will an2 revoke all THills and codicil3 w~~ch I ~372 . . - p:-evl.ol:3_7 ~2.G.e. T . - ;~ve a~d bequea:~ the sum of OLe ~~ousaDd Dclla~~ ($1,000.00), ~ut net to e:tcsed five percent of my net estate availa~12 fc~ dist~i~~tio~ be:c~e payment 2: a:l inhe~itance and ~imila~ taxes beccmi~g cue by reason of my deat~t ~o t~e 3ig Sp=lng Ma3o~ic Temple Associatio~ cf Newville, Pennsylvania, toward the said Association's bui:ding f~nd. I:: . give a~~ bequeat~ to each grandchild liviilg at the -:.:..:ne of my deat21 r.ne SUIT: 0:: C::e -'I'~ousand ~olla;:-s ($l,OOO.OO) a~~ to ea~~ 2UC~ ~ran~chi:~ an a=ti~le c~ household fu~~~shings C~ c~2e~ tang~ble pe~3onal i).t"one;:-t?, - - - . ~ot incluci~g automobiles, as my said g~andc~ild~en shall select and amicably ag~ee among '::l.e~T;32: ~JS:S. A:: t~e ~2Stf ~esid~2 and remainde~ or my estate, ;:-ea~ a~d per3onal, i g~ve, devise and bequeath to my SOL, Donald ::':7, i: l:'~Ji:1g, 8t::er-:l::".3 e :. c 'h': ~ J.J.~';;; .:ur7:" 'J:'~"'lg ':S3:.:e :;2:': stirpes. TTT. ..L.i...i.. I di:-ect that , . a...;..:" taxes that may be assessed i~ consequence of ~y de~~~, o~ ~hateve~ ~a~:.:=s anc _~ what2ve~ ~:.:.:::-i,.3r_:=-_.-:=-~~.;. =-.':":pC.3ec., 3~a:: D(~ ?a::~ :::lJm :my r'::'!sidua::y ~5t3.t2 as :;:.ar.... :::.e -== t~:e ::;:. -- ^~', ..::.',~ '0: ,::.. -'~'~"-~~- . -'. .... - ~....,., ----- -,- -.-- ~- :1;:~ est.ate. -~7: 3.?..9C_~:'-: 3...3 :2:~::2C~-::...::::: ~.- -::.:.':'3 :ny :3.st ',<jl... _ :-;;'OI 30n, .~ ~ ~ ;5 ~ ~ '" '. . '- :::'cnald ?::;{.: ~~Q i: fo~ a~y reason ~e shall fail to quali=~/ c:- :;2a..3e . ~ '- '.-I """ _ ~ = <,;,c:: c.:.:.:: :.:.:;r; tne cou:r-se c = .ll.i a':.mil::.s-::-a:::.or.., 7 -~.,...,"',.., - ~ - ~!::=,V~~l '- ~:-:.::2'2 ,; :.:--s..::.-:..c:c;....i l d:- en, R2: :.:-::. A. Fr:Yr Brian D. F:::y, ar:d ':' :~:':c:.:: -- \! ~:t2~~a~2 Co-Executo~2 of this xy last wi~~ 'l: d~~2Ct t~at no bone s2all :::2 ., .""...~~', -; '-0,' - - -, -,- - .- ~ :::,.::'''':Cl :12.17:e(.:. ...., <:;.'-;:;:: ~ ~ ......-- ,~-~- fo!:" th~ -F: ~ +- ~ r,l' ...........- --..- ....- pe::-:ar:n3.DCe ,-',- -:::ei::: .-::.~,::..:.. 2:.3 3. ::-~' 7 ~L.::-:3C.:.,:::'t:':Jr.. =~ W=~:TESS WEE~EOF, = have he:':-2~~to set my hand and 2 9 1.!/ ~-::::v ~~. 0:: .]Jec,-.,., )>,;- " c, .C'7' ~~ C-' . ~'<:;:::;;:.- :'::':'2 '"7~/" ///~'-z.,. Mard- ~ L/ -~ __' 0--, ,//'?--<--/ o ( "-EAL ) Fry T22 p~=ced:.ng i~3t~~~e~~: CCTI3:.s~i~g of +-~-~ a~c one othe:: typewritte2 page identifiec by the signat~re c: the tes~at~~x, Mary E. Fry, was cn ~he day a=d da~2 tbe~ecf s~gned, publishec a~c decla~ed by Ma~y E. Fry, the testatrix tnerei~ ~amed, a3 ~nd ~o= h2~ last w~::. i= ~~e ?~aSeLCe o~ ~Sr ~tc. ~2= request; i~ te~ presence, and i~ the presen=e n~ eact ct~e= '- - have .3ubsc::ibed ou~ .,_~2mes as ;lii t::esses he=eto. ... i / j ",/, // L./ y/ / . / ,~-;,., 'I''''':: /' {.' Vc-:c!'r..-:::c.-'-r;n -',./C2'-7?c.~L~ / " ,. ',ft '''oj ( ,"1.1. "'t // /' ),(: ~/ I/i'/I ..(01.(.(( C.-=.> " ~ / u '7-'0 /;?7:J.1<' ....r b-/y /<t'L.. G1/~'O;J.L7z<:; r/72 / ?-7>ZLj i " / /' cL/" I~ " 2 I /- ') ~;7(';.(/;1;~~; ~ "./." j/ ' - C;Ir',/(,/" / / 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 SHIELDS CHARLES E III ESQUIRE 6 CLOUSER ROAD MECHANICSBURG, PA 17055 ______n fold ESTATE INFORMATION: SSN: 199-05-7058 FILE NUMBER: 2101-1170 DECEDENT NAME: FRY MARY E DATE OF PAYMENT: 08/19/2002 POSTMARK DATE: 08/17/2002 COUNTY: CUMBERLAND DATE OF DEATH: 12/10/2001 NO. CD 001537 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,328.24 I I I I I I I I TOTAL AMOUNT PAID: $1,328.24 REMARKS: P DONALD FRY C/O CHARLES E SHIELDS III ESQ CHECK#105 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS - (/ i/ STATUS REPORT UNDER RULE 6.12 IJIIR'-I c. Name of Decedent: #/ff ~ ~ Date of Death: 1:2 - /0 - ;2001 f:RY Will No. Admin. NO.;( / -Of ~ //7cJ Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State,yhether administ=~tion of t~e estate is complete: Yes-6- No 2. If the answer is No, 3~ate when the personal representative reasonably believes t~at the administration will be complete: 3. If the answer ta No.1 is Yes, state the following: a. Did the personal <~resentative file a final account with the Court? Yes No . b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal ~epresentative stafe an account informally to the parties in i~terest? Yes~ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: 08 -/-:Lj - 02- s&r~ ~ ~c49 CI/I)ZLE 5 E. SIl/~LD S -rJI Name (Please type or print) o C/Ot(.f, 1E.e ? d AI EeJl6q f Pt1 A:ddres s .-/ (7/7) 7 t, t - 0 J. 09 Tel. No. Capacit.y: personal.Representative Counsel for personal representative (MAH: rmf/AM3) \. /?-D2P- f' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX CHARLES E SHIELDS III 6 CLOUSER RD MECHANICSBURG PA 17055 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-30-2002 FRY 12-10-2001 21 01-1170 CUMBERLAND 101 *' REY-1547 EX AFP '01-02> MARY E Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=i5'4-j-EX-AFP--foY':02Y-NOYicE--OF-YNHEifiTANCi-i"-A'x-jrPPRAisEifENT-,--AL.i-OWAifci-'(fi----------- - ----- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FRY MARY E FILE NO. 21 01-1170 ACN 101 DATE 09-30-2002 TAX RETURN WAS: [X) ACCEPTED AS FILED ) CHANGED NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate [IS) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: .00 X 00 = .00 107,294.37 X 045 = 4,828.24 .00 X 12 = .00 .00 X 15 = .00 (19)= 4,828.24 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 .00 .00 .00 25,279.95 88,062.80 .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/Governmental Bequests; Non-elected 9113 Trusts [Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 4,352.88 695.50 (11) (12) (13) (14) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 113,342.75 5.048 38 108,294.37 1,000.00 107,294.37 n...~n ,,~...~~. . [+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID [-) 03-08-2002 CDOO0938 175.00 3,325.00 08-17-2002 CDOO1537 .00 1,328.24 TOTAL TAX CREDIT 4,828.24 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) 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: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). 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 HILLS> AGENT 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). 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. 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. 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. 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 is charged beginning with first day of delinquency, or nine (9) months and one (I) 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: Vear Interest Rate Daily Interest Factor Vear 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 llZ .000301 2002 6Z .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 intarast must be calculated. o ~f, STATUS REPORT UNDER RULE 6.12 Name of Decedent: ~~ 1 maAAf E. Date of Death: 1~;lO/~1 Will No. Admin. No. ;2/- 0/- 1/70 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes 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 X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date, II- /-0;;" ~ E ~~ Signature - - ~ Charles E. Shields, III Name (Please type or print) 6 Clouser Road, Mechanicsburg, PA 17055 Address (717) 766-0209 Te 1. No. Capacity: Personal Representative x Counsel for personal representative (MAH:rmf/AM3)