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01-1173
PETITION FOR/PRROBATE Estate of _ ~ /f~~ A ~ ~/~'/ ~`~ ~~ also known as Deceased. Socia! Security No. ~ 0% - ~1 ' ~l ~2 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut~L' , named in the last will of the above decedent, dated ~^~!~k'~~!'~~/ ~'..~' f:' ~>~ , 19 and codicil(s) dated (state relevant circumstances, el.g. renunciation, death of executor, etc.) Decendent was domiciled at death in w~»~~~ ~,p~ d Count Penns lv n ,with hc~~- ast fa~} ily or principal rtisidence at 3 i ~/z~~< ~.~~a~ ~~r~h /7~1,% (list street, number and muncipality) years Of age, diet) ,~~cr~i J~i~ ~/ ~ ~ 2G~ , at ~1~1~~',~~i ~Lsdii.d-i ~-N,ro f~ ~~ ~r i-a . 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: c/G~ ~''~'~~~%" Cie ~'~ ~ /~/tic - - - /~'.~~~,~ .// /,~ i 7t it WHEREFORE, petitioner(s) respectfully_request(~ the probate of the last will and codicil(s) presented herewith and the grant of letters, A~~'~" ~'~f (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. .~_ b .~ /t~ n.GL>`ia /~ Hi J/yv v~ ~v G -oo >>®. ~~v ~ ~,>~ z i N ~° OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OIL CU'_~13FRLAND The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed ~ ,/~~c~~1 ~/f,~~~~ ~, and GRANT OF LETTERS No. 21-01-1173 To: Register of Wills for the County of CUMBERLAND in the Commonwealth of Pennsylvania OG~ U before me this .27th day of DECEMBER _ ~~4 2001 9 ~~-- Register A Np. 21-01-1173 Estate of THELMA E WILSON ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS .4ND NO« DECEMBER 28 x~_2D.D1, :: C:;:a:cieraiur, : ,. :; : ~~,: the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated Februar~~., l 991 described therein be admitted to probate and filed of record as the last wilt of THELMA E WILSON , and Letters TESTAMENTARY are hereby granted toRONALD M WILSON R iszer of ~'~i s FEES Probate, Letters, Etc. ......... ~ 200.00 Short Certificates( ) .......... ~ 15.00 pa~~s . 6.00 ehu ciauon ................ ~ JCP S 5.00 TOTAL ~ 226.00 Filed . A~G>;1~>1R. 2.7., .200.1 ............ . ATTORNEY (Sap. Ct. LD. No.) .ADDRESS PHONE :7 O ~~ = ~, Q r C7 fV --.3 .t~ ...i , '. y, ~, . ~ ~ y~nq,SUCDia<irW]cNrlcprirpy an•N. SnxYq Man laJur• iAppYaunala -ART 11: OUNr apnAiclN mndlgnaeNWaKAey ba•W.DUI Lal oNy pr• cauN on •afJr Yrr• I ntMrY DNMNn np naY%aq n m• urla•rNPp elrN pNNr n RVTT I 1 , arraN era a•Yn YMKOIAT! CAUSE tFryl y, r Oaalla•arcpgagn ~ ~ 1 n ~ ~/ 1 r••Ir•rrq rlaMAl-~ a. 1 LAS. Lb _ DVE TOIOR AS ACq oL/f~-E OFI: ~r'f•(I ~L.Iv _ 5•plrarlEy IN Carann! D. r E any. MaWrq m alKn•dau • caab. EnLN UNDERLYWO DOE TO IOR A$ A CONSEQUENCE DF): i CAUSE IDlswr p ayurY c.. _ _ , • auL+aNYa•was raauYp n a•anl LAST • WETO (OR ASACONSEOUENCE OF)'. I a. _ _ WAS AN AUTOPSY PERFORMEO7 WERE AUTOPSY FINDINGS AVNIAEKE PRIOR 70 MANNER OF DEATH DATE OF INJURY TIME OF INJURY IWURY AT WDRK7 DESCRIBE HOVIIWURY OCCURRED. COMPLETION OF CAUSE OF DEATN7 p{/ NNwY /rJ H ^ (Hoop, Day. YeNI omcw ^ V•• ^ Na^ Accd•M P•rWxg lnvNpiwn ^ 'Ila• ^ No YH ^ NO ^ ^ $,rlcra! ^ Couq ml a a•Nrmmsa 70a. r ]». M. ]0e. PLACE OF INJURY AI rom.. I! m, vreN. IaL?ory, oMC• LOCRION rsdaN. C,ry/T .n $WN xM. xpD, x/. prWWq, we ISpacuvl ]W. ,a,. CEIpTIF1ER:Crec. cvnv rnN 'CERTIFYING PHYSICIAN IPnva¢,an cwuymq eauve ur Deem wean arwlner onvYC,an nes pores..ncN Jeein ,nN CUmpuneo non 2]I To tlN W1 of m Y I a a A SKNATVRE TITLE OF CERTIfl ~ ^, / A t / / •1 ^ . y • ror/ •al occurrl0 Ow b rA• <luaflal !rb manner a• alalla......... 9•. _ _ - ~ ~YI . J l • , ]ID. 'PRONOUNCING AND CERTIFYING PNYSKIANII+nyscun nra!':norvur+:~rw,ur.rln .up~erMyngla ~:au:e nl ~Ieert~I IICENS I 1MYER DATE SIGN I Oay. vaan ((NEyyDL~' ] 7 / . ' C//// (((( ~~ //~ r ~ ToIM p•ll al myYrowlla~A. OeaIN OCCUrr•a a1lM llm•.Nle. arM pllc•,lna au•IOIM Cawalal •na manner as nalea. i__~ , ' "' `J ` I '' II~y~ ]tc. VL' W ]Ia.,~ / ~. NAME AND ADOR SS OF PE SON WHO COMPLETED CAUSE dF DEATH E • 'MEDICAL E%AMINERICORONEp On IA! DNIa of ealminaL a!or in N inion aNOn I a IN Inem Typ•w Pnn1 ~ `~' ^ '- • ~~ , y , y p occurrea al ID<Ilme. Gale, ana place, and aue to Ine cluaelal Ina f manner as ]litea .. .. ~ ]I!. .. ..... .. ~ ~ ~ ~ r _ n ~l 1~ l Y T~h~~ l~ Ft`s t ~S 1~1I ~l L REGIS iRAR 5 SIGNATURE ANC NIiMRER / --- ~~ )) "'~~ , , . lx CATE FILED 'n r , `. ~~.~~/ K :~ ~~ G:7 t::~. N ~ -~~,, ; `` ~ C~ C ; +~~ ~' ~. ' ~ '~ ~ t,.,J ?~~~Y mill ~n~ (~T. P~Y~mPttt OF THELMA E. WILSON I, THELMA E. WILSON, of the Township of East Pennsboro, County of Cumberland and State of Pennsylvania, being of sound and disposing mind and testamentary disposition, do make, publish and declare this my Last Will and Testament, hereby revoking all Wills by me at any time heretofore made. ITEM 1. I direct that all just debts and funeral expenses be paid by my Executor or Executrix hereinafter named as soon after my death as may be found convenient. ITEM 2. I give, devise and bequeath all of my property real, personal and/or mixed of whatsoever nature and wheresoever situate to Ronald M. Wilson forever and absolutely. ITEM 3. In the event that the aforesaid Ronald M. Wilson should predecease me, I then give, devise and bequeath all of my property real, personal and/or mixed of whatsoever nature and wheresoever situate to the issue of Ronald M. Wilson who shall survive me, their heirs and assigns, per stirpes and not per capita. ITEM 4. In the event any part of my estate should vest in a minor or minors, I then appoint Cumberland County National Bank & Trust Company to be the guardian of the financial estate of said minor or minors until they reach their respective majorities. ITEM 5. All inheritance and succession taxes due shall be paid out of the proceeds of my estate. ITEM 6. This Will consists of two (2) pages. ITEM 7. (a) I authorize and empower my Executor or Executrix, for the payment of debts or for any purpose of administration or distribution, at any time within two years from the date of my death, to sell all or any of my real estate, at public or private sale, for such prices and upon such terms as to 4 ~4 A t{` 1 ~t ~~ i 1 ,~ . , .t cash and credit as he may deem best, and to execute deeds of conveyance thereof, without liability on the part of the purchasers to see to the application of the purchase monies. This power shall not be construed to work a conversion of my real estate, unless and until the power is actually exercised, nor shall this power be construed to extend the lien of debts. (b) I authorize my Executor or Executrix to retain all stocks, bonds and other investments made by me for distribution in kind, or in his discretion to sell and transfer the same, either in person or by attorney, without liability on the part of the purchasers to see to the application of the purchase monies. ITEM 8. I nominate and appoint Ronald M. Wilson to be t Executor of this my Last Will and Testament and if he be deceased o incompetent to serve I then appoint Evelyn G. McAulay to be the Executrix of this my Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal this .;~5 'D-'day of f~ b,-~~~~,,y 1991. --, :' . f ~ , /f ~ %~ _. l~~~ Thelma E. Wilson Signed, sealed, published and declared by the Testatrix above named as and for her Last Will and Testament, in the presence of those wh have hereunto, at her request, subscribed their names in her presence and in the presence of each other as witnesses hereto. lt'~ ~..,~ '"~ J .~ tc t e ,~ ~ l y~' ~ t~ ~.L l ~-!c'-vm-/~- ~C,t~1 Jk 'Name Address '~ ' amo ~ ~'~ ~~ ddr s 2 .. .. COMMONWEALTH OF PENNSYLVANIA . SS: COUNTY OF ~ ~ r143~_ 2 ~_.a N:, We, Thelma E. Wilson, ~~ ~3~:. r2T ~S, %,i~c~ and .~. `,~*, L. ?.1'~~ +:~i' -~' , the Testatrix and the Witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly (or willingly directed another to sign for her) and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix signed the Will as a witness and that to the best of his or her knowledge, the Testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence, and I, the said Testatrix do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament, that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. ~ ~ ~; /,0 Subscribed, sworn to and acknowledged before me by Thelma E. Wilson, the Testatrix and subscribed and swo/rn to before me by and /~,a y ~~.. ]~.-~--~ r- ~- , witnesses , this _~ ~ %~ day of ~-`E..~ .. ~. ~... A. D., 1991. ,~,,~~. of'~ry Public T t~t~1 c p~. 9 ... _._._~A I ~~C'11 t1L Jk7'1 ni`u ~' char a~e1l. Fo;',IFr,CJ~~~.ru r a ~. ~ p C',ii u ~, ~ _/~ ~~~ Testatrix ` fitness /r "_ -- ~; , ~ ~ Wi~ ess :. ~.~~,. j ~~~ a~i ~~ ~~~ ~~. ;; ri m D z ~ ~ A r N ~ O C 0 y N ~ m o Q] ~ -~ ~ r z ~ i Z V N _~ D -NC 0 ~ ~ ~ D z X ~ Z y ro ~ J ~ '~ (D ~ m ~~~~,~ trZ: ~~~ LZ ~4Q lQ. ~3 .'~ r ~7 H r O z O ~~ ~"'~~ L G~ CERT/IFCATION OF NOTICE UNDER RULE 5.6(A) Name of Decedent: ~h ~~h1/9~i l3'zSit~ Date of Death: ~cc~~/E2 2/ ~G6/ Will No.: ~~ / - lt.1// )3 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 Arlrlracc Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: '~ S~b.Z ,,a ~~/~2~y- Signature Name ~d s .G,iyb~~(i' ~1zJl~C Address Telephone ~' Capacity: ®Personal Representative ~~ ; ^ Counsel for personal representative .~. .,, co ' , rJ CERTIFICATION OF NOTICE UNDER RULE 5.6(a Name o f Decedent : j ~-~,~~,~.~,e ~ , /~//,r.. s ~ n~ Date of Death: ! ~ - ~/ --- ~ o i Wi 11 No . ~ ~- c r - ~ ~ 7,3 A~~.~,=~--P1~e . 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 ttie following beneficiaries of the above-captioned estate on I=LL,-r. l,3~ s~oo,2 Name Address /~oN.a~D /~J, IM~L.SO~J /ds ~/i/.Ar=~ ~/Zf~/,a' C'/g sir /-~~ <~ / ~r+ ~ 7 4L/ -- 7~~ a Notice has now been given to all persons entitled thereto under Rule 5 . 6 (a) except ~o,~,g Date: g ~.a a ooh Signature Name /~o ,6 tr ~ /' `c .., c r~' Address ~~ r ~. ~~- ~? ~f ,~ Telepllone(7i~) 73 ~ _~~~gj _. Capacity: Personal Representative ~ Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX111-961 N0. CD 001543 ROBERT TRACE 331 N 28TH STREET CAMP HILL, PA 17011 folA ESTATE INFORMATION: ssN: 2o~-is-4saz FILE NUMBER: 2101-1 173 DECEDENT NAME: WILSON THELMA E DATE OF PAYMENT: 08/20/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 2/ 21 / 2001 REMARKS: ROBERT TRACE ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 53,236.57 TOTAL AMOUNT PAID: CHECK# 2567 INITIALS: AC SEAL RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS 53,236.57 REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBl1RG, PA 17128-0601 RONALD M WILSON 105 LINDEN DR CAMP HILL PA 17011 REV-1547 EX 4FP (01-02) DATE 09-30-2002 ESTATE OF WILSON THELMA E DATE OF DEATH 12-21-2001 FILE NUMBER 21 01-1173 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WILSON THELMA E FILE N0. 21 01-1173 ACN 101 DATE 09-30-2002 TAX RETURN WAS: [ X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) .00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) _ 74,912.27 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this form with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 9,986.25 tax payment. 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. Totai Assets [g) 84,898.52 APPROVED DEDUCTIONS AND EXEMPTIONS: 12,974 .86 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00 11. Total Deductions (11) 12.974.86 12. Net Value of Tax Return (12) 71,923.66 13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) [13) .00 14. Net Value of Estate Subject to Tax [14) 71,923.66 NOTE: If an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) •00 X 00 __ .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 71,923.66 X 045. 3,236.57 17. Amount of Line 14 at Sibling rate (17) .00 X 12 - .00 18. Amount of Lina 14 taxable at Collateral/Class B rate (18) .0 0 X 15 - .00 19. Principal Tax Due (1q)= 3,236.57 TAY CQFflTTC• DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 08-20-2002 CD001543 .00 3,236.57 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX TOTAL TAX CREDIT 3,236.57 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on ar before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoynent to Class 6 (collateral) beneficiaries of the decedent after the expiration of any estate for life ar 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 NILLS, 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 far forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 CTT 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 an this Notice must object within sixty (607 days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, DR --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 an 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 (7171 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Oecedent^ (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 CS%) discount of the tax paid is allowed. PENALTY: Tha 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 tine period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent an and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate anncunced 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 lgg7 9% .000247 2001 9% .000247 1988-1991 11% .000301 2002 6% .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUlIBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becanes delinquent will reflect an interest calculation to fifteen (15l days beyond the date of the assessment. If payment is made after the interest computation date shown an the Notice, additional interest must 6e calculated. .~ f '~ ,.alM AA .~ ! ~' ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 7 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EXI11-96) N0. CD 001980 WILSON RONALD M 105 LINDEN DRIVE CAMP HILL, PA 1701 1 ACN ASSESSMENT AMOUNT CONTROL NUMBER fold ESTATE INFORMATION: ssN: 2o~-is-4632 FILE NUMBER: 2101-1 173 DECEDENT NAME: WILSON THELMA E DATE OF PAYMENT: 12/23/2002 POSTMARK DATE: 12/20/2002 COUNTY: CUMBERLAND DATE OF DEATH: 1 2/21 /2001 REMARKS: RONALD M WILSON SEAL CHECK# 2688 101 ~ 54,050.00 TOTAL AMOUNT PAID: INITIALS: CW RECEIVED BY: DONNA M. OTTO 54,050.00 DEPUTY REGISTER OF WILLS REGISTER OF WILLS ' I /-a.9 L ,f 4 f ~~ i ~1 \ ~' h +~ ,K O ~ v ~ `~~ ~ ~ V 1~ ~` ~ F r ` ~ M `e "_V\l ~~ ~ F'N h _~ ~ j '~ v~ ~o r. S~ ~` 1 ~~ 1 1 1 1• 1 ~~ ti~ y ~~ ~~.F ~1,1 .+. ~1~F .~ ~~F •rF '~( c O1 V COMMONWEALTH OF ` / ~ /~ 0 O V ~ f OFFICIAL USE ONLY ' PENNSYLVANIA V ~~ ~~ ~~J DEPARTMENT OF REVENUE DEPT. 280601 RITANCE TAX RETURN __ ------ -- - _ FILE NUMBER HARRISBURG, PA 11128-0601 RESIDENT DECEDENT 21 _ O1 1173 ~tl~NTyeobE Y~R -NUMaER -- ~ DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Z Wilson, Thelma E. 201 _ 16 _ 4632 W ~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE V 12 - 21 - O1 09 - 19 - 08 REGISTER OF WILLS ^W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER w ©1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return lane maeam vrmrm iai~~aal ~ z x ^ 4. Limited Estate 4a. FuWre Interest Com romise aa~a of cream aner i2~1PAP ^ P 1 1 ~ 5. Federal Estate Tax Return Requiretl ~ i m ~ 6. Decedent Died Testate fanam tour of vriq ^ 7, Decedent Maintained a Living Trust fanam wvr or>•rv:p 1 8. Total Number of Safe Deposit Boxes a ^ 9. Litigation Proceeds Receivetl ^ 10. Spousal Poverty Credit toaia of aeain oarxaen izsi_sr ana i~i~ssl ^ 11. Election to tax under Sec 9173(A) la~urn sun of z i o NAME Ronald M. Wilson COMPLETE MAILING ADDRESS H ~ FIRM NAME O~avWKZaeI 105 Linden Drive ~ ~ TELEPHONE NUMBER (717j 737 - 7973 Cam) F?ill, PA 17011-7220 1. Real Estate (Schedule A) (1) _ OFFICIAL USE ONLY 2. Stocks and Bonds (Schedule B) (2) 74 ~ 91 ~ ~ 7 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Modgages 8 Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (S) 9986. 25 Z (Schedule E) ~ ' ~ 6. Jointly Owned Property (Schedule F) (6) ^ Separate Billing Requested ~ - 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) a Q U W n. Total Deductions (total Lines 9 8 10) 12. Nel Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to lax has not been made (Schedule J) 14. Net Value Subject to Taz (Line 12 minus Line 13) 8. Total Gross Asss4Ytotal Lines 1-7) (B) 9. Funeral Expenses & Administrative Casts (Schedule H) (9) _ 1 7 974 8 6 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule p (10) (11) 12974.86 (12) 71 Q~~ fifi (13) 1141 71923.66 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 0 15. Amount of Line 14 taxable al the spousal tax ~ rate, or transfers under Sec. 9116 (a)(1.2) z 0 (15) 16. Amount of Line 14 taxable al lineal rate 719 2 3 . 6 6 x .0 (16) d 17. Amount of Line 14 taxable at sibling rate - _ _ x 12 (17) V 16. Amount of Line 14 taxable at collateral rate x 15 (16) 19. Taz Due ~ (ig) ~ zo. ^ ~ . 84898.52 3236.57 3236.57 Decedent's Complete Address: STREET ADDRESS 39 Circle Drive clrv Camp Hill SrnrE ZIP - PA 17011 [ax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InteresVPenalty if applicable D. Interest E. Penalty (1) 3236.57 Total Credits (A + B + C) (2) Total InteresVPenalty (D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box an Page t Line 20 to request a refund 5. If Line i + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) 3236.57 (SA) (5B) 3236.57 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :................._...........,...........,....,...........__...........__..... ....... ^ b. retain the right to designate who shall use the property transferred or its income;..........._ ........................ ....... ^ c. retain a reversionary interest; or ......................................................................._....................................._... ....... ^ d. receive the promise for life of either payments, benefits or care? ............................................................. _ ....... ^ Q 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ........................................................_....,.....................,........ ......... ...... ^ ^R 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ........ ...... ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ......................................._..._..............._.......................,............_......,..... ...... ^ 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 pepury, I tlechre Thal I have examinetl this reWrn, in<lutling accompanying schetlules and sWtemenls, and to the best of my knowledge and belief, it is Ime, wrred and complete. DedaraUOn of preparer oNer Ihan the perwnal representative is based on all information of which preDarer has any knowledge SIGN~7j1RE OF PE,E2SDN RESPQNSI~LE FOR FILING RETURN nnrF ADDRESS ;;~~ ' /GS~ ~i ti ~c/x:' /Xrvx- C."i/vv /I/i r ~~y /%~ // SIGNA E OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS (/ For dates of death on or aNer July 1, 1994 and before January 1, 1995, the lax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)J. 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 PS. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and fling a tax reWrn are still applicable even if the surviving spouse is the only benefciary, For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child Iwenty-one years of age or younger al death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is-0% [72 P.S. §9116(a)(1.2)). The lax 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 PS. §9116(1.2) [72 PS. §9116(a)(1)J. The tax rate imposed on the net value of transfers to or for the use-o! the decedent's siblings. is 12% [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption, gv.iso [x.(Lsn COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE B STOCKS & BONDS. es r a r t yr FILE NUMBER Thelma E. Wilson 21-01-1173 All propertyjolntly~owned with right o(survivorehip must lro disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 1820 shares Boeing Common $38.74 per share $ 70506.80 1'31 shares Fer:n2oi1-Quaker State 13.92 $ per bare 1823.52 3. 58 shares Devon Energy Corp. $38.75 per share 2247.50 "~ 131 shares Bat.tie Mt. Gold 334.45 '' 10 shares Nugget Bench P1ac:E:r No Value ' TOTAL (Also enter on line 2, Recapitulation) I S 74.412.2 7 more space is needed, insert additional sheets of the same size) w,we Ex.licn COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE E CASH, BANK DEPOSITS, & MISC. i ^ ~vr - Thelma E• Wilson FILE NUMBER 21-01-1173 Inducts Ne proceeds of litigation and the dale the proceeds were received by Ne estate. All property Jolnttyrowned wRh the right of survNorship must be discbsad on &hedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH ~. 1991 Chrysler New Yorker - M & T Barak Checking Accoru~r; ;;.:676015973 '~• Household Goods $1500:00 7986.25 500.00 TOTAL (Also enter on line 5, Recapitulation) I s 9 9 8 6.25 more space is needed, insect rEVnsusx. nsn COMMONWEALTH OF PENNSYLVANIA INHERITANCE TA% RETURN SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS w ~ n ~ ~ yr FILE NUMBER _ Thelma E. Wilson 21-01-1173 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT Fackler-Wiedman Funeral Home 23rd and Derry Street, Harrisburg, PA 17104 $3945.00 Flowers-Royers Flower Shop, 3105 Gettysburg Rd. Camp Hill, PA 58.00 Galen Russell III Pastor, Chapel Hill Church of Christ 50.00 Food and Refreshments 40.00 ADMINISTRATIVE COSTS: t, Personal Representatlve's Commissions Name of Personal RepresenfaEve (s) Ronald M. Wilson Sorial Seadty Number(s) / EIN Number of Personal Representatlve(s) sveet Address 105 Linden Drive 4244.93 City Camp Hill state PA n 17011 P Year(s) Commission Paid: 2 0 0 2 p. Attorney Fees 4244.93 3, Family Exemption: (If decedents address is not the same as GaimanYs, attach explanalion) Claimant SVeet Address DitY State Zip NONE Relationship of Claimant to Decedent q, Probate Fees 2 2 6. 0 0 5, I AaountanYsFees I NONE g, Tax Return Preparers Fees NONE ~ Cumberland Law Journal I 75.00 8. The Sentinel 91.00 TOTAL (Alsoenteronline9,Recapitulation) I $ 12974.86 (If more space is needed, insert additional sheets of the same size) aEV.~sio ex. psn COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN OF SCHEDULE) BENEFICIARIES Thelma E. Wilson 21-01-1173 NUMBER O Di C SDENT AMOUNT OR SHARE NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RE l I Do Not Llst T TAXABLE DISTRIBUTIONS (include outright spousal distributions) ~) OF ESTATE 1 Ronald M. Wilson son 100% 105 Linden Drive Camp Hill, PA 17011 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17 AS APPROPRIATE ON RE II. , , V 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE 1. ` NONE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. NONE TOTAL OF PART II -ENTER T07ALNON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET f E NONE (If more space is needed, insert additional sheets of the same Inventory of the real and personal estate of Thelma E. Wilson deceased 1. 2. 3. 4. 5. 6. 7. 8. 1820 shares-Boeing (common) ~ $38.74 per share 131 shares - Pennzoil-Quaker State ~ 13.92 per share 58 shares - Devon Energy Corp. C 38.75 per share 131 shares - Battle Mt. Gold C 2.55 per share 10 shares Nugget Bench Placer Checking Account #2676015973 M & T Bank 1991 Chrysler New Yorker (Fair condition) Household Goods 70,506 80 1,823 52 2,247 50 334 45 No V lue 7,986 25 1,500 00 500 00 Total ~~ 84,898 52 COMMONWEALTH OF PENNSYLVANIA 'l ~. COUNTY OF CUMBERLAND f Ronald M. Wilson being duly sworn according fo law, deposes and says that he is the EXECUTOR of the Esta+e of Thelma E. Wilson Edst PennsbOro Townshl -- Cumberland County, Pa., deceased and That the la+e of - - ---- - -- - - - _ _ P within is an inventory made by _- him _- _ ., the said EXECUTOR of the entire estate of said decedent, consisting of all the personal proparty and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of 4he Inventory represent it's fair value as of the date of decedent's death. sworn to and subscribed before me, .{q 2002 Date of Death - ~0~1~' ~rJ~"'" _ Executor - AdwiwiMra/er 105 Linden Drive NOTARIAL SEAL RGARETT. FOSTER, Notary b16: Camp Hill, Cumberland Coun My Commission Expires Dec. 27, OO~t Day December Month Camp Hill, PA 17011 Address 2001 Year INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Arficle IV, Fiduciaries Aet of 1949. , M C` 1 O I N O Z W 1 Z ~ w C ~ w Q a r- W ~ W LL J W C• D Z K D Z w Q o_ LL .~ N C 3 C E+ O m ~ ~ ~ ~ N •ti O u 3 A oa U1 W I O o_ U1 b' 0.~ T E; C r-1 a.1 ~ ~ Ut O ,o ro U F W ~ A O y I ,p E ~ U 0 O~ ~ 'a d C O Q w ~ ~ m o - o iL m ~~t i1 ' OF THELMA E. WILSON t~ I, THELMA E. WILSON, of the Township of East Pennsboro, County of Cumberland and State of Pennsylvania, being of sound and disposing mind and testamentary disposition, do make, publish and declare this my Last Will and Testament, hereby revoking all Wills by me at any time heretofore made. ITEM 1. I direct that all just debts and funeral expenses be paid by my Executor or Executrix hereinafter named as soon after my death as may be found convenient. ITEM 2. I give, devise and bequeath all of my property real, personal and/or mixed of whatsoever nature and wheresoever situate to Ronald M. Wilson forever and absolutely. ITEM 3. In the event that the aforesaid Ronald M. Wilson should predecease me, I then give, devise and bequeath all of my property real, personal and/or mixed of whatsoever nature and wheresoever situate to the issue of Ronald M. Wilson who shall survive me, their heirs and assigns, per stirpes and not per capita. ITEM 4. In the event any part of my estate should vest in a minor or minors, I then appoint Cumberland County National Bank & Trust Company to be the guardian of the financial estate of said minor or minors until they reach their respective majorities. ITEM 5. All inheritance and succession taxes due shall be '. paid out of the proceeds of my estate. ITEM 6. This Will consists of two (2) pages. ITEM 7. (a) I authorize and empower my Executor or Executrix, for the payment of debts or for any purpose of administration or distribution, at any time within two years from the date of my death, to sell all or any of my real estate, at public or private sale, for such prices and upon such terms as to cash and credit as he may deem best, and to execute deeds of conveyance thereof, without liability on the part of the purchasers to see to the application of the purchase monies. This power shall not be construed to work a conversion of my real estate, unless and until the power is actually exercised, nor shall this power be construed to extend the lien of debts. (b) I authorize my Executor or Executrix to retain all stocks, bonds and other investments made by me for distribution in kind, or in his discretion to sell and transfer the same, either in person or by attorney, without liability on the part of the purchasers to see to the application of the purchase monies. ITEM 8. I nominate and appoint Ronald M. Wilson to be t Executor of this my Last Will and Testament and if he be deceased incompetent to serve I then appoint Evelyn G. McAulay to be the $xecutrix of this my Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal this .2•S~day of Fe.b~~,a.y 1991. ~, J / ~ ~- ~e% Thelma E. Wrls n Signed, sealed, published and declared by the Testatrix above named as and for her Last Will and Testament, in the presence of those wh have hereunto, at her request, subscribed their names in her presence and in the presence of each other as witnesses hereto. .~ L.,.-~ ~ 33 i x..28 ~1~ ~-~-,~ ''Name Address ' ~- ddr s COMMONWEALTH OF PENNSYLVANIA . SS: COUNTY OF L U M 13E R L4 N~ We, Thelma E. Wilson, f~c (ic i;r .5, j,iAcc and I<AV u• ~ w u ~r-_-_•; the Testatrix and the Witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly (or willingly directed another to sign for her) and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix signed the Will as a witness and that to the best of his or her knowledge, the Testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence, and I, the said Testatrix do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament, that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. /,, , Subscribed, sworn to and acknowledged before me by Thelma E. Wilson, the Testatrix and subscribed and sworn to before me by and /<,yv L • ]7w ve..r r , witnesses, this ~~ ~'~• day of r~ ,, < <, , A.D., 1991. of ry Public TARIALSEAL Pur bf C'dar4~1~. Fosler,Notary pappHitl,PA CumberlarACounry ~v Commissan Expires Aun!;st 6.1°y'. '!"estatrlx r- Witness ~~ G Wi ess ~ ~ ~MEI~DED .'~ rvN COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE HARRISBURG,P~A60126.0601 REV -15 0 0 INHERITANCE TAX RETURN RESIDENT DECEDENT ~ 7- ~ ~ 'z FILE NUMBER ~ 1 ~ ~ ~ ~ .~ 3 ~,tm~ v~,,a aUxBIR - - ~ Z DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) '~. IAA/LS a of Tl~IELM ~ E SOCIAL SECURITY NUMBER Zo f - ! 6 - ~6 3 2- W 0 _.. - DATE OF DEATH M D0. (M) ) ~ Z ~ ---- --.__ _._ DATE OF BIRTH (M//MM,~ DD-YE/p_R) d -__- - - __-- THIS RETURN MU5T BE FILED IN aUPLICATE WRH THE U / -~ ° f 0 9~/ 9/ U d ~ REGISTER OF WILLS G (IFAPPLICABLE) SURV ING SPOUSE'S NAME (LA ST FIRST, AND MIDD E INITIA) SOCIAL SECURITY Nl1MBER F ^1.Ofigmal Retan 2. SupplenrerMl Realm ~3. Remainder Rehm laxeaa~mo~rrorz-rsazl C ~ ~ 4. Limited Estate ~ 4a. Fulum Interest Compromise 1me a aeon xner rs-uazl ~ 5. Federal Estate Taz Realm Required u i m ~ 6. Decedent Drell iestete Ineam mPy aural ~ 7. Decedent MaiMamed a Living Trust I~rn myr o<Tnatl 8. Total Number of Sate Depos° Bozes 9. LitigaAOn Proceeds Received ^ 1D. Spousal P°Vedy Gmdit lam d AaiN eermi 12-31$1 mE 1-1-95) ~ 11. Election to taz under Sec. 9113(A) Inxam sm of r+~ x tL tea..: ep ra g NAME /1a A+Rzo M• (~LSo.J COMPLETE MAILING ADDRESB p m w -- __-__. FIRM NAME IrcMOlr~xxl __ -_._..___. -__. ~b S ~,~ ztPQi<7J //21 x/t rc ~ TELEPHONE NUMBER- -__-- -- - ~~~ - 73 - ---- ~ ~p /~~ti P~ y7~~~ , Z g a V W d' 2 Q F a O T,> 1. Real Es1are (Schedue A) (1) 2. Stocks arM Bonds (Schedule B) (2) 3. Cbsey HeM Cwpomtiar, Partrrership w Sole-Proprietorship (3) 4. Mortgages 8 Notes Rerzivable (Schedule D) (4) 5. Cash. Bamc Deposits 8 Miscelaneous Personal Properly (6) (Schedule E) 6. Jdntly Owned Property (Srhtduk F) SeDarale Btlting Requested (6) 7. Imo-Yiw~s Transfers 8 Miscellaneous Non-Pmhate Properly p (7) / ~~ 00-a (Sdredule G a L) 6. Total Gross Asaels (btal Lines 1-7) (6) 9. Funeral Expenses 8 Administrative Costs (Schedule H) (9) qa, boa 11. Total Deductlom (trial Lines 9810) (11) 12. Net Value of Estate (Line 6 minus Llee 11) (12) 13. CharilaNe antl Govemmenfal BequeslslSec 9113 Tmsis fw which an election to rez has na been (13) made (Schedule J) G 1a. t4et vahre s~m)ea to rax (Line 1z minus I ine 131 (14) 7 ~j ~O ~ 10. Debts of Decedent, Mor~age Liabilroes, 8 Liens (Schedule q (10) 5EE INSTRUCTIONS Oft REVERSE SIDE FOR APPLICABLE RATES 15. Amoral a Line 14 tarmble at the spousal tax rate. a transfers undw sec. 9116 (aM12) - _. --.. -. - _-_ 16. Amowt m Line 14 tazade at fineal mle 7..0~ 0 Ua _ x .0 _.. (15) x .0 Tom. Its) `/y 0.~ 17. Anxxxu of Line 14 taxably m sibling rate - __.... __ x .12 (17) 16. Amam[of One l4 taxable al cetlateral role -. _.. __.-_. _- -..-- __._- x.15 19. Tax Due ~. ^ e i w .2:s7^.LS:ca.W -~--^-~ (18) (19) / ~ ~0 Address: arr _ _ __ _ __ ___ STATE -__..__ - --. _ __._-. ZIP Tax Payments and Credits: I. Tax Due (Page 1 Line 19) 1 ( ) 2. CreditslPayments A. Spousal Povedy Credq _ _ _ _.__ _.__ ____ _. -_ B. Prior Payments _ _ _ C. Disceunt Total Credits (A+g+C) (2) t. InterestlPenalty if applicable D. Interest E. Penalty -__ -_-._ _._. ___ __. Total InteresYPenalty (D + E) (3) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 W request a rePond (q) If Lira' i + Line 3 5 greater than Line 2, enter the dference. This is tire TA% DUE. (51 A. Entw the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE 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: Yes No a. retain the use w inmme of the propedy trans(erred :.............................. .......................................................... .. ^ b. retain the dgM to designate wlro shall use the property transferred or i4 income : .......................................... .. ^ c. retain a reversbnary interest; w ........................................................................................................................ .. ^ ^ d. receive the pranise fw Irfe of either payments, beneftts w care? .................................................................... .. ^ ^ 2. If death oaurred after December 12,1982, did decedent transfer property within one year of death widwut receivkrg adequate consideration? ............................................................................................................ .. ^ ^ 3. Did decedent own an'in trust for' or payable upon death bank account w security at his or her death? ............ .. ^ ^ 4. Did decedent own an Individual Retirement Account, annuity, w other non-probate property which contains a beneficiary designation? ...................................................................................................................... .. ^ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN. GNATURE QF PERSON RESPONS~~IBLrrE F R FILING RETURN D Th )DRESS '._,-. ~ Lfl __ _.. _ _ _-~~~~ ~O~ ~ GNATURE OF PREPARER OTHER TF1AtJ REPRESENTATNE - - -_-- DATE _ _. _ - -- __.. __ _. )DRESS _._ __. _.- - - --. -. _-. - ___.. _. -_ __ __.. .r dates of death on w after July 1, 1994 and before January i, 1995, the tax rate imposed on the net value of transfers to w for the use of the surviving spouse is 3°h ? P.S. §9116 (a) (1.1) (i11. ~r dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers b or for the use of the surviving spouse k 0% p2 P.S. §9116 (a) (1.1) (ii)]. -, a~ 5 spouse rs tl~e a~lyber~~ ry a surviving spouse from tax, and the statutory requirements for disdosure of assets ant filing a taz return are still applicable even 'rf r dales of death on w after July 1,2000: e tax rate imposed on the net value of transfers from a deceased chid twenty-one years of age w younger at death th or for the use of a natural parem, an adoptive parent, a sbpparent of the chill b 0% [72 P.S. §9116(a)(1.2)]. e tax rata imposed on the net value of transfers ro or for the use of the decadents lineal benefidaries b 4.5%, except as rxHed'm 72 P.S. §9116(1.2) [l2 P.S. §9116(a)(1)]. e fax rak imposed on the net value of transfers th or fw the use of gre decedents sidings is 12% [/2 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an lividual who has at least one parent in canrrwn with the decedent whether by Nood w adoption. Form: REV-1500 Name Thelma B. Wilson ID 201-16-4632 An amended return is being filed to include transferred property reporte o the attached Schedule G. The property was transferred to Ronald M. Wilson on 2 O/ .The decedent retained the use of the property following the transfer until her death. RE141510'EX+ (6-98) • COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEpULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF - FILE NUMBER This schedule must be wmpleted and filed i! me answer to any of quesfions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION Of PROPERTY wcwos rns wu~oF rHE rwwsvsaff,n~FJa asurp85aiaro oECSnsurauo rns onrE OVrruusrsa anncancoPr aF raE Oro ros asuesrare GATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST EXCLUSION Ic naaucns~s TAXABLE VALUE 1. Qo>,lAto M. WiLSvN Sono , gGYOOa ~~oo~ t~/2/ Za • j TOTAL (Also enter on line 7 Recapitulation) E I 7 ©~ 00 D (If more space is needed, insert additional sheets of the same size) ~~aal~- THIS DEED, made the ~ n~ day of April a Oo/ Between THELMA E. WILSON, Widow herein designated as the Grantors, And RONALD WILSON herein designated as the Grantees; Witnesseth. [hat Lhe Grantors, for and to consideration of ONE (1.00) Dollar and natural love and affection lawful money of the United States of America, to the Grantors in hand well and truly paid by the Grantees, at or before the sealing and delivery of these presents, the receipt whereof is hereby acknowledged and the Grantors being therewith fully satisfied, do by these presents grant, bargain, sell and convey unto the Grantees forever. All that certain tract or parcel of land and premises, situate, lying and being in the Township of East Pennsboro in the County of Cumberland and Commonwealth of Pennsylvania, more particularly described as follows: BEGINNING at a point on the southern line of Circle Drive, which point is two hundred seventy-three and sixty-two hundredths (273.62) feet west of the southwest corner of the intersection of Circle Drive and 34th Street and which point is also at the dividing line bewteen Lois Nos. 20 and 21 on Plan of Lots hereinafter mentioned; TH'?NCEie a southeasterly direction along the southern line of Circle. Drive and on a curve whose radius is one hundred fifty (150) feet, a distance of fifty-five (55) feet, more or less, to a point; THENCE South eighteen degrees sixteen minutes thirty seconds West (S i8o 16' 30" W), a distance of one hundred sixty-five and ninety--three hundredths (165.93) feet, more or less, to a point at the northern line of the Hollywood Development; THENCE South seventy-four degrees fifteen minutes West(S 74° 15'W) and along the northern line of aforesaid Hollywood Development, a distance of one hundred nine and twenty-three hundredths (109.23) feet more or less, to a point at the extreme southwest corner of the Country Club Park Development; ,,r_., t, ~ - ~~G7p THENCE North twelve degrees twenty-two minutes West (N 120 22~ W) and along land now or late of Joseph Wagner, a distance of seventy- nine and thirty-one hundredths (79.31.) feet, more or less .to a point; . THENCE North forty-three degrees one minute East (N 43o O1~ E ,~~ ~'~,4. a distance of one hundred eighty-three and fifty-five hundredths (183.55) feet, more or less to a point on the southern line o£ 'circle Drive ., the point and place of BEGINNING. HAVING THEREON ERECTED a one story brick dwelling known as and numbered 39 Circle Drive, Camp Hill, Pennsylvania. BEING all of Lot No. 20, the western five (5) feet of Lot No.19 and a smali triangular part of the southern part of Lot No. 21 on Plan of Lots of Country Club Park, which Plan is recorded in the Office of the Recorder of Deeds in and for Cumberland County in Plan Book 8, Page 40. Aforesaid triangular section of Lot No.21 begins at the dividing line between Lots Mos. 20 and 21 on Plan of Lots aforesaid and extends to the rear lot line of Lot No. 21 at a point twenty-five five (25) feet north of the original point designating the original rear lot line between Lots Nos. 21 and 22 on Pian of Lots aforesaid, continues along the rear lot line of Lot No. 21 for twenty-five (25) feet and returns by way of original dividing line between Lots Nos. 20 and 21 on plan aforesaid. BEING the same premises which Country Club Park, Inc. by its deed dated January 28th, 1958 granted and conveyed to Ray B: Wilson and Thelma E. Wilson, his wife, which deed is recorded in the Office of the Recorder of Deeds in and for Cumberland County in Deed Hook "K"-18, Page 299. Ray B. Wilson died February 24, 1969 whereby the fee vested in Thelma E. Wilson, his wife, the surviving tenant of the.tenancy- by-the-entireties. This is a transfer from mother to son and is exempt from Petinslt~' vania transfer tax. ~ i-, ~, ~ c~ r - a y r r ~ s -1 :..; 'y ~ '~I w f w ~, ~ ~ --1 nl !" O -~ p m eooK `' ~ ,~ 887 Together with all and singular the buildings, improvements, ways, woods, waters, watercourses, rights, liberties, privileges, hereditaments and appurtenances to the same belonging or in anywise appertaining; and the reversion and reversions, remainder and remainders, rents, issues and profits thereof, and of every part and parcel thereof; And also all the estate, rights, title, interest, use, possession, property, claim and demand whatsoever of the Grantors both in law and in equity, of, in and to the premises herein described and every part and parcel thereof with the appurtenances. To have and to hold all and singular the premises herein described together with the hereditaments and appurtenances unto the,,,,. Grantees and to Grantees' property use and benefit forever. And the Grantors covenant that, except as may be herein set forth, they do and will forever warrant and defend the lands and premises, hereditaments and appurtenances hereby conveyed, against the Grantors and all other persons lawfully claiming the same or to claim the same, In all references herein to any parties, persons, entities or corporations, the use of any particular gender or the plural or singular number is intended to include the appropriate gender or number as the text of the within instrument may require: Wherever in this instrument any party shall be designated or referred to by name or general reference, such designation is intended to and shall have the same effect as if the words "heirs, executors, administrators, personal or legal representatives, successors and assigns" had been inserted after each and every such designation. IN WITNESS WHEREOF, the Grantors have hereunto set their hands and seals, or if a corporation, it has caused these presents to be signed by its proper corporate officers and its corporate seal to be affixed hereto, the day and year first above written. SIGNED SEALED AND DELIVERED IN THE PRESENCE OF OR ATTESTED BY elma E. ikon) -~ -_ ~ ~ /~°-"£ '--.. nr-.n ~,~;-r,i~i7G COh(MONWEALTH OF PENNSYLVANIA, COUNTY OF CUMBERLAND Be it Remembered, that on ^~'RI~ 27`~ ~ooi me the_subscriber, a Notary Public, personally appeared THELMA E. WILSON known to me (or satisfactorily proven) to be the person subscribed to the within deed and acknowledged Chat sh sac:e for the purposes thFrein contained. WI1'NCSS my hand and seal the day and year aforesaid.' otary fC~blic ss.: before My Commission Expires: IMARGAREiTFOSTER,NotaryPublic Camp Hill, Cumberland County MV Commission Expires Dec. 27, 2004 COMhIONWEALTH OF PENNSYLVANIA, COUNTY 0'F CUMBERLAND SS.: Be it Remembered, that on before me the subscriber, a Notary Public, personally appeared who acknowledged self to be the of a Corporation, and that being authorized to do so as such corporate officer executed the foregoing instrument for the purposes ehereln contalnud on behalf of the corporation. WITNESS my hand and seal the day and year aforesaid. The Undersigned certifies that the precise residence and complete post office address of the Grantee is: 105 Linden Drive, Ca s. otary u ~ e I Certify this to he recorded My Commission Blx~~ru~z~crland County PA ,,~,,:"- +`, Recorder of Deeds Hill, PA /J 17011-7220 p' O -_ p ~ E ~J l y `~ . ~ ~ ) ' ~ !~ L_ q~±Y ~ ~ ,~ J `~' ~~' 0 ~ ~ ~ w \` ~ ~~ ~ 'v CS ~ Q ~t :~ ~ R:: ~ ~ ,..~ R~~ E `.~ i`', ~i vJ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: WILSON RONALD M 105 LINDEN DRIVE CAMP HILL, PA 17011 REV-1162 EX(11-96) PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ACN ASSESSMENT CONTROL NUMBER -------- fold ESTATE INFORMATION: ssN: 2oi-is-4632 FILE NUMBER: 2101 -1 173 DECEDENT NAME: WILSON THELMA E DATE OF PAYMENT: 02/07/2003 POSTMARK DATE: 02/OC/2003 couNTY: CUMBERLAND DATE OF DEATH: 1 2/21 /2001 NO. CD 002141 AMOUNT 101 ~ 559.78 TOTAL AMOUNT PAID: REMARKS: RONALD M WILSON SEAL CHECK# 272'7 INITIALS: AC RECEIVED BY: 559.78 DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS ~,~ ~ a~-~~ COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TNXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 NOTICE OF INHERITANCE TAX HARRISBURG, PA 17128-0681 APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REY-1547 EX ~FP (01-037 DATE 02-03-2003 ESTATE OF WILSON THELMA E DATE OF DEATH 12-21-2001 FILE NUMBER 21 01-1173 COUNTY CUMBERLAND RONALD M WILSON ACN 101 105 LINDEN 1)R Anount Remitted CAMP HILL PA 17011 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1547 EX AFP (01-03] NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WILSON THELMA E FILE N0. 21 01-1173 ACN 101 DATE 02-03-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN N0. O1 1. Real Estate (Schedule A) (1) .00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) .00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this fora with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) .00 tax payment. 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule Gl (7) 90,000.00 8. Total Asse•ks (g) 90, 000.00 APPROVED DEDUCTIONS AND EXEMPTIONS: .00 9. Funeral Expenses/Adn. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (101 .00 11. Total Deductions (11) .DD 12 . Net Value of Tax Return (12 ) 9 0 , 0 0 0 . 0 0 13. Charitable,/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) (13) .00 ct to Tax bj t t S f E t V l (14) 161,923.66 14. e a e u ue o s a Ne NOTE: If an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 00 00 .00 15. Amount of Lina 14 at Spousal rate (15) • = X 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 161,923.66 X 045. 7,286.57 17. Amount of Line 14 at Sibling rate (17) .00 X 12 .00 18. Anount of Line 14 taxable at Collateral/Class B rate (18) •00 X 15 .00 al Tax Due Princi 19 (19)= 7,286.57 p . ~wv wwrn*TC~. •, DATE NUMBER + INTEREST/PEN PAID (-l AMOUNT PAID 08-20-2002 CD001543 .00 3,236.57 12-20-2002 CD001980 .00 4,050.00 BALANCE OF UNPAID INTEREST/PENALTY A5 OF * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 12-21-2002 TOTAL TAX CREDIT 7,286.57 BALANCE OF TAX DUE .00 INTEREST AND PEN. 59.78 TOTAL DUE 59.78 ( IF TOTAL DUE IS LESS THAN S1, 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.) RESERVATIDN: 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 Mills printed an the reverse side. --Make check or money order payable to: REGISTER OF HILLS, AGENT REFUND (CR): A refund of a tax credit, which was mat 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 far taxpayers with special hearing and / 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 an 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, Harrishurg, 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, Harrishurg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent^ (REV-1501) far an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three C3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9l months and one C1) day from the date of death, to the date of payment. Taxes which hecame 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 2003 are: Interest Daily Interest Daily Interest Daily Year Rata Factor Year Rate Factor Year Rate Factor 1982 20% .000548 1987 9% .000247 1999 7% .000192 1983 16% .000438 1988-1991 11% .000301 2000 8% .000219 1984 11% .000301 1992 9% .000247 2001 9% .000247 1985 13% .000356 1993-1994 7% .000192 2002 6% .000164 1986 10% .000274 1995-1998 9% .000247 2003 5% .OOD137 --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 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 an the Notice, additional interest must be calculated. ~ ?-a ~ / ~ COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280661 INHERITANCE TAX HARRISBURG, PA 17128-0661 STATEMENT OF ACCOUNT REV-1f 07 E% AFP (01-03) DATE 02-24-2003 ESTATE OF WILSON THELMA E DATE OF DEATH 12-21-2001 FILE NUMBER 21 01-1173 COUNTY CUMBERLAND RONALD M WILSON ACN 101 105 LINDEN DR Amount Remitted CAMP HILL PA 17011 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this fore with your tax payment. CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1607 EX AFP (01-03) *** INHERITANCE TAX STATEMENT OF ACCOUNT *** ESTATE OF WILSON THELMA E FILE N0. 21 01-1173 ACN 101 DATE 02-24-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-03-2003 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 7,286.57 PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID C-) AMOUNT PAID OS-20-2002 CD001543 .00 3,236.57 12-20-2002 CD001980 .00 4,050.00 02-06-2003 CD002141 59.78- 59.78 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. * IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN S1, 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. ) 7,286.57 .00 .00 .00 PAYMENT: Detach the top portion of this Notice and submit with your payment made payable tc the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check ar money order payable to: REGISTER OF WILLS, AGENT. -- If NON-RESIDENT DECEDENT make check or Honey 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-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices or from the Department's Z4-hour answering service for forms ordering: 1-800-362-2050; services far taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). REPLY T0: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Oept. 280601, Harrisburg, PA 17128-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3l calendar months after the decedent's death, a five percent (5%1 discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed an the total of the tax and interest assessed, and Hat 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, ar 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 rata of six (6%7 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 far 1982 through 2003 era: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rata Factor Year Rate Factor 1982 20% .000548 1987 9% .000247 1999 7% .000192 1983 16% .000438 1988-1991 11% .000301 2000 8% .000219 1984 11% .000301 1992 9% .000247 2001 9% .000247 1985 13% .000356 1993-1994 7% .000192 2002 6% .000164 1986 10% .000274 1995-1998 9% .000247 2003 5% .OOD137 --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 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. STATUS REPORT UNDER RULE 6.12 Name of Decedent: _ ,( 'fi ,~~,ry~,ig ,~, ,~~,~~~4 ate'' Date of Death: /?l~ll~! Will No.: ,~/- ljf ~ ,// 73 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: State whether administration of the estate is complete: Yes [~ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes _ No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes ~ No n c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the. Orphans' Court and maybe attached to this report. ~ /~ Date: / ~ ~b,~ ~~~1 h~~J ~' ~ ~ L.G!t Signature Name /~ Address - ~./,Z,Z-~~ ~-/~/ 7 Telephone No. l 1 V/ Capacity: ~ Personal Representative Counsel for personal representative