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DECREE OF PROBATE AND GRANT OF LETTERS AND mol, January 28 19 9~, in consideration of the foregoing petition hereof, satisfactory proof having been presented before 112, IT IS IECREED that the instrunent(s), dated April 14, 1989 . described therein be aUnitted to probate and filed of record as the last will of Ma be 1 D. Flue k a/k/a Mabel Ann Fluck and liltters Testamentary are hereby granted to Carole Ann Fatzinger, of 423 E. Lisburn Road, Mechanicsburg, PennsylvanJa 17055 ~~ g%~ ' ~~~ D. 'J . . ~ ster orlUs Probate, liltters, Etc....... $ 305.00 Short Certificates (6)...... $ 18.00 ~. Porsun PI. (sup.Ct.I.D.No.> Rer1\l'\ciations ,......, I . . . " $._ -1.58 E. Main Streot Ac:Jd:rilss Somerset, PA 15501 ~:)445-402l x~pageB JCP """'1"'1" $ 12.00 'IDrAL """t. $ 5.00 340.00 Filed January 28. 1994 Page 3 of 4 pagcs-Pet.Ltrs) , ';-":"'\''''f\'',''I''''''''''''1r'' 21-94-66 tlecedent at death OI>tled property with estiIMted values as follows: $383.000.00 $ 0 $ 0 $ 0 (If danl.ciled in Pa.) All personal property (If not cbrd.ciled in Pa.) Personal property in Permsylvania (If not cbrd.ciled in Pa.) Personal property in CoInty Value of real estate in Pennsylvania situate as follaws: NONE ~'ORE, petitioner(s) respectfully request(s) the probate of the last will and coc!ici1(s) presented herewith and the grant of letters Testamentary (testamentary: administration, c.t.a.: ,...- j- ~ administration or.o:n.,c.t.a. 1- r2n"" C/," I L'11.of.iyPl) dn E. l.ishurn Road Mechanic~g, PA 17055 thereon. - t [ 0A.nl OF PERSONAL REPRESENrATIVE cx:Jotom1Et\L'llt OF PENNSYLVANIA ) ) SS aJt.N1Y OF SCH:RSEr ) '!he petitioner(s) abave-narred swear(s) or a~tirm(8) that the statements in the foregoing petition are true and correct to the best of the 1<na\o.7ledge and belief of petitioner(s) and that as personal representative(s) of the above decedent petitioner(s) will well and truly actninister. the estate ac~ cording to law. Sworn to or affitl1lld and subscribed X before me this 0111:/ clay of X c-~i""!J/ 19 2L. X '11{nfl~cir~clv3~ifstlk' Pt - ~ '1..\'fll '\ Page 2 of 4 pagea-Pet.Ltrs) 'If'? ~.' 'f'" I .tJ-/~.tJi O-'JtttJ riY"~ll J -1 'Ui' ..., ., \ -~, I iJ ' ~~, I {.;,. I, ,I ',. " ,,'. ,t "I," 'I'"~ ( ..~, /,1 )' ~ ':'., - , , ; 'I" ,/ . \" :~,; " ',. " )., " . ,. . ". . ~, ':, ~ r.-' t __ " " II 'j' I' " , '1'1.' "',; 'J.' ""1 I, ;;,_1 ,. " 'i' ", I ' '. ~ I ~ '~_d~/,\I;-'-:i '.11(,. \'ji,; j . ':';\/ , , 'I ,,' , 'flU!.)!,' i!,1 '. " .' ,,'. ,. ':1 ';" I, . i:I'-;)1 :pl;~ ~(L \'IJ It; ,":--'" " 'I ;'i/ I I; l "I ~ I" I ,) I, II. " I' .-,j"l;\"II"; """'-" ,"" , ' " , 1/ -I.' t") is}, '-/"'1~: II:' i ~ " I, . " ''', ,f' " " i, ,,\J ,. I;;~"q'(" 1~I_l ill:, " '\',' I' i, 1,,/',1. 1'1, , " ''i'iq , .. ,deU:(1,_.'1 I", , . ,':j lei ; I"-,i' :'\l(~, ';, " , ~,; 1-' \-:.;.,~, 1\ '1,!{,nli.1 hUlj .11"'1 II{\, ... 'lit.,qSi '1'(11 " " :'(~t! , \t:u" Ji ,~I.' i;.'i'd'/';f' ~I, '1"':'\: ~ ',' " , i. 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Fel' for Ihb ('(:nilie,lIe, S.',IIII .._. ...__22.81:257 Nu, /~ - .J?. ~~7lb1l~ ~1(,HIHI-.l',i"tHlI ?~-. .-- , (J"t1:tl((((JI(f )11, if/N. d /' Oint Ilt06.I.'llf'j,tJI' COMMONWEALTH 0' PBNNSYLVANIA. DEPARTMENr OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH .. .- ....". Cumberland ~, ,u'f] =:'::::~tI olOlt"A"'iI\I.II'll/,~,~""_l Lya: a I. tlartz ... E. . to 1)"1''''''' ~omor..t Co Hemorlal Park 'lUll AOOI\I , IT'( laug.r~i:J.g;:.~, Funoral HO~;;:.t , "OI.lIOCAl.II(,IJ.!~I\~_l ...0 ..0 "'...."" ~ ""WAHl'" IUtlCIHll '" ,. CI fl/,wnIt. ~ Habol Ann Fluck lr..hlllrhll,l , l'ol",.~"'1 ort 16 ::'I~"~~v::, J;). . n. H,uri.burg ." ()ICIOll(tlI.IAA,HQAOORlI'I'....,t~.IIfIl,'>PC<<ttl 824 E. LIsburn Rd Art # 314 ,p'.rhlll PA 17011 "'...',.....,,'...... "" lUMrlC9 li. uunlnp '''.bt. Pnnn~ylvnniA ''', . .r "-..~.....o ; I: 1,.~10,. to ... ~ ."''''' I A:r,'!w, l<~U'''~Ol.A I \ <l>.UL.... 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H c , i ob 0, o..root PA 15501 PA 15501 AfcIfo'_' -- .......tNt...1II '-- Mil II ONI~_G""""""IO"""W ~,.....,.RN~,....""'"t\~1I11 <'/"'Ju""lJ(''''''Of\I4, ......1'1. -.j~~ IlI.lIOfHJUl\T ftNI\Y.llM)fllll '"'''' . .,.. 0 ..,0 . 1htl,IWW'f,tI!a .."- ,...... "hnun I'Y 14 I 1994 I;. " " , 'I' ',", ,. d. ': I" " " ,Iii ,1' < '" :1 p '11... '1, ,9 :Ill ' tl> ~')' ' ,\' \' : ,\ :.~. 'i". I',' 0, 'I'} ,. ,] HI', Ij'ld .lrfu" 1Ila: 0:. " '" t ,. " " .. 1,::1, " " '1'1 ", " " I,:! " "" " I' " .. I, ',\' ,. 'I' ':, ,. ,. <..., \, N 0... ~ , , ,~ ~ , " " " j,,,, " j"", i'_ ~,I, ! li'i' " " ,.. ., " '" " " I, ili I, '1, " ,I ,. ... , , 'II ~" I' 'Ii, "1' " '. 1'\, \,1, ." " ,\; "(\'.,1 I"', , " :\I'i ,,' ''', ". ," II,' ,/ 'i,j , 1'1, ""'/',' 1"'i ,I"~ , I!, '1 " I' " , " ,I "I' ,I,' 'I'd ',I " ", 'I!_ .\, I,' " ,I, " I' "'1'['\ , ' i I ~ 'I\! , .lj " I" II" , i';, " " ")1 '\ " ",' I, 1\,:' " '" ,. " " " , L', .- .' ,,', "1 ii" "ll',',li .' 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" , " " 'j, " :,' ,. I' I' " " " It "", " " " ,. ,. " ,. , , , " 1'" ";, " , ." " " ",' ,'i'i ,'1" '" [' ,. ,., I' .! '.I, , ";1' , ' " " "I' " , ,. , " " , , I ,p " l~ ti<" :/) I " \',' 1\: " I: " ." " , f' It-l' ~\ == ~ ' '\'-';"'1\' , - ~ '-'l - = ...... - --9 (~ ))) -. -- I ~))) -::t' :-t-t o ~\ 1!1 'iii"--'=l' ~ 0"- !1 '- '-' I c ( - [~ ~ -- .... .... .... t'a I I ~ " \ ~{ t~) ,fi , "I'" ;1 ~' ,. .'\1'-"1 i\'" ~ld',' \ ~,' ,. , ~l,... {,,!-" " 'illY' ~. ;1 " '~~'}_ J , I~f V.L,'.' /-,'\1 '." ' }i~~':';' ' ,! ,I 1- " ., " '" .. , I. I; " " [, 'I; . . " " " ,X'.. ". d......~.'~-'" 1 "..,...~,.....~~i..'..-.~._;......'.,._,j., ' , , .,".,~-,,- _~.i."-~_ L"~ '/1':;-",; ',. 'i' .' Ii ,. ., " I I'.' .,'" ,): " " ,. " ,[ '." ,I, Ioc: U I:) >-1 ,... . A >-1 ill ~ 1,i .. " ," .. ," " [. ',. " '< ,,' ,,'.' " " \ ,~ " '1- \, ' " ': ~~ ~ :oW " r.r- '(~ 0' '1' :\ b :iii ,,' Er' . ~ ~G, (lJ 10 ,~ i'c " N ',~ ,; ,J::. ~':, "'., 'n ( , ' ~-j~j " i-I Q '0 ;t: (:/ J (\ '0 r" ~J\'\j $!ti " lilO - -~ .r:. ..... . . !I ~.~ i ffi~z.. 0. :< i c " ,d. ~ 1131 !~ " ,,' ,. ,,' " " 1'1" ... 'i, I." ~' 1 " " , ,. " ,'I' "-I "," j\' " 'I I' ,. , , ," " , " . . ~' ,_;-~~_-.L :1 .'.:;, ~ ,. $:" JUctS't ltJill truO @t$htuttnt OF MABEL D. FLUCK I, MABEL D. FLUCK, of the Borough of Somerset, Somerset County, Pennsylvania, declare this to be my Last Will and revoke any Will previously made by me. 1. I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as .a part of the expense of the administration of my estate. 2. I devise and bequeath all of my estate of every nature to my husband, HENRY K. FLUCK, provided he shall survive 'me by thirty (30) days. 3. Should my husband, HENRY K. FLUCK, predecease me or die on or before the thirtieth (30th) day following my death, I .devise and bequeath all of my estate of every nature and wherever situate in equal shares to such of my children, CAROLE ANN FATZINGER .and HENRY K. FLUCK, as survive me by thirty (30) days. 4. Should my daughter, CAROLE ANN FATZINGER, or my son, HENRY K. FLUCK, predecease me or die on or before the thirtieth (30th) day following my death, I devise and bequeath the Ihare of . such child to his or her iSlue, per stirpes, living on the thirty- first (31st) day following my death; and should either my said Page 1 of 5 daughter, CAROLE ANN FATZINGER, or my son, HENRY K. FLUCK, leave no such issue living on the thirty-first (31st) day following my death, I devise and bequeath the share of such child to my other child or to his or her issue, per stirpes, living on the thirty-first (31st) day following my death. i I S. The beneficiaries under this Will may take their share in kind or partly in cash and partly in kind or in such manner as they may mutually determine, The executor shall have a professional appraiser fix the valuations of the in kind assets us needed. In case of disagreement among the beneficiaries of thIs Will, the exec- utor is authorized to make the division having due regard for each beneficiary's preference and making the in kind personal property distributions as equal as possible. 6. I appoint CAROLE ANN FATZINGER, my daughter, guardian of any property which passes either under this Will or othorwise to a minor and with respect to which I am authorized to appoint a guar- dian and have not otherwise specificallr done so, provided that this appointment of a guardian shall not supersede the right of any fidu- ciary in its discretion to distribute a share where possible to a minor or to another for the minor's benefit. Such guardian shall have the power to use principal as well as income from time to time for the minor's support and education (inCluding trade school and college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education or to make payment for these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking care of the minor. I . . , Page 2 of 5 " "'.01.. I 7. No fiduciary under this Will shall be requirod to give bond or other security for the faithful performance of the fidu- ciary'~ duties. 8. Any such fiduciary shall have the following powers, in addition to those given by law: To invest in, accept and retain any real or personal property, including stock of a corporate fiduciary or its hOlding company, without restriction to legal investments; To sell, exchange, partition or leaso for any period of time any rual or pursonal property and to give options therufor for cash or crudit, with or without security; To borrow money from any person including any fiduciary acting hereunder, and to mortgage or pledge any real or personal property; To hold shares of stock or other securities in nominee registration form, including that of a clearing corporation or depository, or in book entry form or unregistered or in such other form as will pass by delivery; To engage in litigation and compromise, arbitrate or abandon claims; To make distributions in cash, or in kind at current values, or partly in each, allocating specific assets to particular distributees on a non-pro rata basis, and for such purposes to make reasonable determinations of current values; and To make elections, decisions, conces&ions and settlements in connection with all income, estate, inheritance, gift or other tax returns and the payment of such taxes, without obligation to adjust the distributive share of income or principal of any person affected thereby. 9. I direct that all taxes that may be assessed in con- sequence of my death, of whatever nature and by whatever jurisdic- tion imposed, shall be paid from my residuary estate as a part of the expense of tho administration of my estate. Page 3 of 5 . ,I I I I I. I r-' I 10. I appoint my husband, HENRY K. FLUCK, Executor of this, my Last Will. Should my husband, HENRY K. FLUCK, fail to qualify or cease to act as Executor, I appoint CAROLE ANN FATZINGER Executrix of this, my Last Will. 11. Any term used in the singular or plural, or in the masculine, feminine or neuter form, shall be singular or plural, or masculine, feminine or neuter as a proper reading of this Will may require. IN WITNESS WHEREOF, I have affixed my seal, the ~ day of hereunto subscribed my name and A (1rJ / , 1989. /Ji . ?lai~-t ~, deucL a el D. F uck (SEAL) Signed, sealed, published and declared by the Testatrix above named, as and for her Last Will and Testament, in the presence of us, who have hereunto, at her request, subscribed our names in her presence, and in the presence of each other, as witnesses hereto. 171/dr/Jifj;t/li ~1/MLJ ~ Jldt00 158 East Main Street, Somerset, PA 15501 15541 P. O. Box 89, Friedens, PA Page 4 of 5 ~:- , I' i ,I I I I f ~ I' . COMMONWEALTH OF PENNSYLVANIA) ) ss: COUNTY OF SOMERSET ) We, MABEL D. FLUCK, Mark D. Persun, Esq. nnd Suzanne B. Gibson , the Testatrix and the witnesses, respec- I . tively, whose names are signed to the attached or foregoing instru- ~ent, being first duly sworn, do hereby declare to the undersigned authority, that the Testatrix signed and executed the instrument as her Last Will and that she signed willingly, and that she executed it as her free and voluntary act for the purpose therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witnesses and that to tho best of their knowledge, the Testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint er undue influence. ~~tt,?,t ~ ;;a:<A-c./c. a el D. F uck Si~~~~i~~'J SUBSCRIBED, SWORN TO and ACKNOWLEDGED before me by MABEL D. FLUCK, the Testatrix, and subscribed and sworn to before me by Mark D. Persun, Esq. and Suzanne B. Gibson , witnesses this \1.\.,,, day of ~~__, 1989. ~ ~~ C\v\'-^'- ~\)()vvv ota ry 'ubI ic . L"'--'NVli'lill"'"'N. P' 5 f 5 CAnOl. ^NII OARR, NOTMY PUBLIC age . 0 . W,!CHO'iT IlOno SOMERSeT COUNTY ~!:!..';:1~~S.S1(1N r:'XJllflt.~ JUfIE 18, 1m M~nl""1 ~OI\llI~ll"II~ ^......~.,,'"., ",1"'0'1 . ;' . t' , (1.,.\'. WILL APPENDIX TO PETITION FOR PROBATE and GRANT OF LETTERS Mabel D. Fluck NO. ESTATE LIST OF BENEFICIARIES UNDER THE WILL -.. (IF MINORS GIVE AGE): NAl-E Am RElATIONSHIP RESIIENCE 23 E. Lisburn Road Carole Ann Fatzinl!er dlluohter echanicshur" PA 170 Henry K. Fluc k son ,1 Paso. Texas -- - ss Page 4 of 4 pagea-Pat.Ltra) " ;, .. ,. ". '. , .,..,':'. \.,. ())~ r ll~'~ , ! , ~ 'C.~ " , , l.I ,:; ilj I." i;j ~.~) ceCC ,I ,.., 'i' ,," " . '1' 'I., II. .., .1' .I, " , ",""1'\;' I ~ '.. ,I ,. i!" '" " ~ ,~ " " ",l' ",(', ';,,) J '1 .1', .,II!!!!I ., I,. '. .. ,,' " I, {, 'i !']I' " " .. , '" 'I'''' ! "j'., , ' ,", " -'i" J _ '~ I' ,I, ,', , I, ~. I" ,. ',I" ,. 'I: " " ',1 ," I , ":, ., , , ,( h, " ,. I i" ~ , ~ .,.., I .1 ,'t .:y " ,"l ",I, ~. .... ,. 'I:':~" ~i 0:; ',"J ,. ,I 'ri ;) ,f" I.! r ,~\ :6 'I" ,I,~ ; .~J ~a' \, N CI.. ,I; ~ i,J ." , /,," , " " 'i \;,r( , h)' " , I" Ij" '.1' " ....". 'I.., jllJ'.','\,,]I, , " ,II II,! 1'4 ,1.\.,: " ,I\i-',' ,. I, I"" 'I," ( ., I, " I I' " III ,. , ',. " " "'." ,I'l I, ,'/. ",I, " " " I It~r~ 1'\:'11:\1 ",', ;,;; ':,.>, II' , , , 0' " " I, " ., " .. ,<'1, ., ,i, ,,1; , 1" , ., ' ,\'/! ", .', ~ f ' ',. }' " d.. i " :'1 , , .:,' "~ I, I' " , I' 'i ;1 ~ " I " "'\', ,'I, I', " ,,<, 'I '} ",II' " I .1,' ,,', , "1' j" it I., ,- ~ II :;, " Ili,I' ".:1' I;' it .." " " I' ',. " I. ,I' " , I " ,. " . . , ,to' , ", 11, ", II I ,:,','\ ,.. :1. " i , , ,.,/- ill 0; . " '.. /, 1'1 ',II, I:' " " " r. " -';"'i I,ll ,. I, ,.' " , . .,,, q'l; I' <I, I,' I "~I 'I ,;1' ,I,. .,: li:w ; , I" , r' !' " " ," (, " ,. I' I 'I " " ",' .,,1' ,. I.., I' . .. .,,,' 1 , '" , ..IL I 'I '\ ,H' ,. ',',d" " . '\,'" ;1. " , '. ~ ! , " ;'j', \ It, ,I '~'." .. , l f / I'j~' , 'i 1",,;:.1 .' ,. ii' I ' , 'j .1 " "i ..., ,. , " 1")', '11,1"((.1:, " '" .. '" .. , "/,1,, ;,L ,." ", ",' IJ. \.'.. ~ \:..... ~ . , .." 'I ,Ii. ,,;,,1 ,I, II',,! " ,H " " ,. " ,II I. 1 ~' , " ,,' ." ,. ,. , , " " , , It.. \, " I;' ,< I. ", I. ". , ,I~ifl " " (, t. ", 'I: \'., " li,l' I I, " II ,I I' ,I' \101" " ", ':,.1, . \ ~ \ ' ,I', , " I, ,.. .',", 'I', ..l', II f" '\'" , "I,' ';i " ,. .. " I, 1;1 I, " ... I ,II " , I i 1,'1" ,.. I I I , I ~ ' , I;" , .. 'II ""."'\ , ',.' I' 'iL,f;'.'( I, , , I:",: , '1' 0,1' \'1',')',"/ I'.; ',.11 ""Ii/, " , 1,1' " ,.}i t "." , , \ I I I I >" " " 'I" ':' ", " ,. JEV-II10? EX AFP (1-911,* eOHHOHWEAlTH OF peNNSYLVANIA OEPARTNENT OF REVENUE BUREAU OF INDIVIDUAL lANES Of P 1. 280 601 11ARRISBURO. PA 11lza.0601 /I/_/IYr'i ACN 101 (/ INHERITANCE TAX STATEMENT OF ACCOUNT DATf. 01"17,,95 S FLUCK MABEL D FILE NO. 21 94-0066 DATE OF DEATH 01-11-94 COUNTY CUMBERLAND NOTEl TO INSURE PROPER CREDIT TO VOUR ACCOUNT, SUBMIT TNE UPPER PORTION OF THIS FORM WITH YOUR TAK PAYMENT TO THE ADDRESS SHOWN, MAKE CHECK PAYABLE AND REMIT PAYMENT TO, , MARK D PERSUN ESQ 158 E MAIN ST SOMERSET PA 15501 REGISTER OF WILLS CUMBERLAN~ COURT HOUSE CARLISLE, :fIA~ 170~ :o~ cr' r;o c.: AH.u R.H1lt.' ~ \: ",11 (' (', II 0'\ r'~. :' CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR FILES" , :. ...."0 ~:.': iliv: i lib";" E'iC "'A FP"" i 1":9' i 'i""""- -"ti Ii."" i NHE"rii "AN'cr"f 'A X" "ST AT EHENf" oj:-" 'AccfliOil1i!~. iiti ";':" -" -- 'In'' ~)-""" -""""" .)S~ \,AI "1. - ESTATE OF FLUCK MABEl D FILE NO. 21 94-0066 ACN 101 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 TAK DUE, APPLICATION OF ALL PAYMENTS, TIlE CURRENT ftALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST fIGURE. DATE 01-17-95 DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 10-31-94 PRINCIPAL TAX DUE, 25,106,39 PAYMENTS (TAX CREDITSIl PAYMENT DATE 04-06-94 11-16-94 RECEIPT NlIMBER XAII85922 REFUND DISCOUNT (tl INTEREST (-I 1,255,32 ,00 AMOUNT PAID 24,000.00 148.93- TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE 25,106,39 .00 .OD .OD . IF PAID AFTER THIS DATE, SEE ~.VERSE SIDE FOR CALCULATION OF ADDITION.L INTEREST, ( IF TOTAL DUE IS LESS THAN .1, NO PAYMENT IS REqUIRED, IF TOTAL DUE IS REflECTED AS A "CREDn" ICR), YOU MAY BE DUE A REFUND, SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) PAVItENTl REFUND lCRI' REPLV TO, DISCOUNT, IHTERESTI ., ',' U.tloh thl top portion of thl. Hotlc. .rA, .ub.lt with ~our Ply.ent .td. PIVlbl. to thl n... .nd Iddr... prlnt.d on thl rIVlr.. .Ide. All Ply.."t. rtc.lv.d 'hili fJr.t b, aPplied to any Int.r..twhlch "v be dul with Iny r...lndtr applied to thl tlXt A r.fund of a tlM orldlt. which WI' not r.que.tad on thl Tax Alturn, .Iy b. r.qulltld by co.plltlng an "Appllcltlon for R.fund of Plnn,yl"lnla Inherlt.no. and E.t.t. Tlx" fREY-1SI]). l~pllc.tlon. ar. IVlllabl, It thl Off.ol of thl Rlahter of Willi, any of thl 24 R.v.nu. Dlltrlct Offl".., or by c.dllng thl 'Plclal 2it'hour In.w.rlna ..rvl01 nu.b't' for forn. or~.rlnal NEW IN PENNSVLVANIA l'eOO.362.~OSO, outlld. Plnn,yl"lnl, .nd within thl 100al H.rrl.bura ar.. {7171 187-8094. Que'tlon, r.glrdlng error. contain.d on thl. notlc. .hould b. addr....d tOI PA D.part..nt of R.v.nuI, Bur.'Y , of Indlvldull Tlx", ATTHl po.t A.......nt Awvllw Unit, DEPT. 280601, Harrl.burg, PA 171Z8.0601, phone (7171 787-6303, lf Iny tlX due I. PIJd within three (3) oalendar ~onth. aft.r the dle.d.nt'. d.ath, . flvu p.ro.nt (5~) dl.oount of the tllX paid I. allow.d. Int.r.., Ii ohargld b.glnnlng with fl,.t day of d.llnquenoy, or nln. (9) lonth. Ind on. (1) day fro. thl d.t. of dllth, '0 the dltl of ply..nt, Talln which b.ea.. dlllnqu.nt b.fore J.nuary I, 1982 bier Internt It thl ntl of .IM f6%) Plre.nt p.r annul calculatld It . dltl~ rat. of .000164. All tall" which b.o... dlllnqulnt on .nd _ft,r Jlnu.ry 1, 1912 will be.r Intere.t It a rete which will vary fro. ellender ye.r to eelendlr ye.r with that rat. Innoune.d by the PA Depart.ent of R.v.nu.. Th. appllc.bl. Int.r..t rat.. for 1912 through 1995 .r'l '!!!r Interllt Aat, O,lly IM.".t raetor !!!r Int.rut R,t. P,lh Internt flotor 1"2 m .000348 1987 9% ,DOOm 1985 16% .000418 m8-199l IU: ,Doom 1984 11% .oaOSOI 1992 9% ,ooom ( 1983 l3% ,000336 199H994 7% ,000192 1986 10% ,000214 1993 9% ,ooom ~~Int.r..t I. calculltad a. follow'l I"TEREST . BALANCE OF TAX UNPAID X NU"BER OF nAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notlcl I..u.d eft.r the taM b.oo... dtlt~~nt will rtfl.ct an Int.r..t oalculttlon to flft'an (IS) daV' b.yond thl d.t, of the ........nt. If Ply..nt I. tide Ift.r thl Int.r'lt oo.put,tlon dati .hcwn on thl NOtlCI, Iddltlonll lntlr..t ~u.t b, C:Ilcullt'd, ';I , I, I,!. '15( ir' . ,.1} '~) F'5 '" t~. \), , , 'I, i;j ;-,1 ;"j" I" (,.,T(1 (J G, ~o: '" '" . 'I' " I' ," 'I, , ,,,'4,', " " , " , l ~ ' \, .J ",.., " ""~,', .... .. N, '~'I ~ :2: i9 " ,I, " ~." ';. Ii" I\{. ... , ~ ' I, I' )." " '. I,' , , " 1\ 'I '\"" ,.' "I' ,. "Ii " 'Ii I. "'I~, ,"'" 'I" ,. , ," " 'Ii' \i " " ,I' ''',,' ~ ...J ~' " l' ,. " ,,'" I,. " " " " ,y. 'I " " , 1.":,~,' '0.; ) 0; , . ~" .) I, " ~.' , 'q liil ':'l' . i1i "..;) ~a, , ' 'I' ,I '1' 'I' I '" t-. " , , " .1',,\ , , j: I' 'I" ;,.,1 ' ;-', .1 I' ,i :-I'~ j' "I'," ',';, ,',' """,'- '. t'" "" II .' ,'_ r , , ~ -, .. < , " ! ,I' jl.l ,. I' " _h_'d '-ii' I,r' Il" ,.. I' (,!, , " , ", ',I, , 'I, hi' I 1'.' ~ '. ,',' !; . ;, .',1'_',,1:,1 ':'{II' ,. ," " " " I, ,I ,', " " " I. ~' p., 'j' (r ",r;; '1 Ij I" , .. h, '1':' ',\'" :'1' '.1 , , I, I :,1' ,I " " " , ,\.,. , ..I I ,,',j, I. i " !' I i' ilL . ~~. ! 'II i,;'~ 'I"~ " , I', .' 'tJ:j",{li,': .,. i," I. .' '" d' 'I ,J' " , . 'I'" i ,'._d' 11; " " n I' I '/'.1., ',', i,l,' " , '! 1', ! ;\, '!';\ , ,\,;.' " , :11,<": I I" ,Il' 1', ,. J,"; , " 'j,-l,-"'-'(\"'.;Fl'; """p:",.,:l,";'"","'\ " I .1'1,' ..,I I , /,' " '.,1/' I' ," " , , /1.. !t;:,',tl" ,,' '/ " '\' I I , I' I 'I"" ,\ . "-"i-.t I ~ \ ' I I ,\ I. . I' , ;!" - ~ r: \.'1' I"~ I I .,,1 ii' I "I' '1, I I ,I + ";' "1- , ,.; I,. . ,,', '! ,I, .',./ "I' ,,' " "i , : "I';' , I " I , , ","j'" ," 'r'. ,;, .1 'j'l\ "I' t,,' , ~\\ '._;\,. I" " " ,. II) ;1,,- '\'/ f'l;'},;, " ,,' I. I' , ,. " - "I ~, - .", , I , ~ , " .1",,, I ,-",." I '1"-"", " , '''1-',' ", ,/ ! " l., , ,Ii " I' _" tl '1;, ,'." '-,':/' ,. " '''',''''', ,l,_, " \. , , ',I' , " /, i: " I' " , '., I" I '!V "I " I;' '.!/'!<;' , ,.". \. " jh " " !', ",; '"I," ,,' ,\ '\, " ,\: " , , " , ~ '''' .t'j ".' I to"""'" "I' 1 I ". I'," --1',,1: ,\i'i' 'ii, ", " , 4,-, ,(/I, Jr, ';'j\'I'ij' ,\ /1:,-'.'1, , ,I i' "'" r.',.. j'J, ! ~ " \;::,'(;,:1':','" II,!,. ,~!; h(,j;~ \(U!,), 1'10 ";';-1 ii, '~i," ,i, ,':,;'\' " " , I'.'!, " I ,: , '1" " " I I' ._.._l. JJld-t,,\;: " "I, " ,', 't ~,~ ,. " " " " ,,' "to I. " I' 'II I':' ,t" , '" I /.' ',..\' If"~. ,';' , , '. , " , " ,,, " " I' " '"I ;" I, '. I' " ,. . " ReV. I DOQ Ix.. IU31 .*. COMMONWIAl~~NIVlVANIA DIPARTMINT or RIVINUI IUUAU 0' IUMINATION '.0. lOX 1117 HARRIIIURO. PA 17103 NI'5 AM IlAli: Ii' r,'; D MIDDlllNI IAli ILl - I 8' ~:;. - '7 INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) I ~~~i L oC I m """2"09-~.Lc.l2') Fluck Mabel fociArf!ciJITTYN'UMiu .- FILl NUMBER 21-94-66 D. ----mT~:6:~';_~94 n-~.:~ [J 2, Suppllmenlal Rllurn o Aa. Fuluro Inl..11I Campromlll 824 Lisburn ReI. #314 Camp lIil1, I'A 17011 ~."L_ J~\!l11h.l,'.l'J.illl d o 3. Rlmalnd.. Rtfu,n o 5, Fld..al Eltall Tax Rllurn R.qulred .Jl. 8. Talal Numb.. of laf. d.palll ba... rn6. O.ced.nl dl.d 111101. 0\17. Docld.nl malnlaln.d n living Irull . (Allach ~~u..of Willi _____J~'!!'ch .~n_"! l,ulll ALL COIlIlUPONDINCI AND CONPlDINTIAL TAX INPOIlMATION SHOULD II DIIlICTID TO. N,AM1T-k -'l'--!l ---.----.-1' -- ....--..-----IDDill5 158 East Main Street "ar . crsun, :sq. . , tlfffilofiffiUMllr----n---.-- __nO Un' -- -. .---- Some rset, Pcnnsy1 vanIa L(LHl1..4Ji~.~ 0 ~~~=.=~==, CITY STATE 0\11. Original Rllurn OA. llf. E1lal. ~I z o i 1. R.al Ellal.(Sch.dul. AI ( 11 2. Slo<k, and BondI (Schedul. B) ( 21 3, Cloltly Hlld Slock/Partn...hlp Inl..." (Sch.dul. q (31 A, MartgaOtl and NollI Roc.;vobl. (Schldull PI ( A) 5, Calh, Bonk Dlpalltl & MII"llonlOul PllIonal Proplrty( 51 (Scn.dul. E) 6, Jolnlly Ownld P,ap"rty (Schldul. F) ( 6) 7, T,anlfl.. (Schldull GI (Schldull l) ( 7) 8, Tolal Grnll AIIIII(Iolalllntl 1.7) 9. Fun..al EXplnltl, Admlnlllrallvl COllI, Ml'ClllanlOul ( 9) Exp.nltl (Scho<lull H) 10, D.bll, Mortgagl lIabllltltl, lIlnl (Schldull I) (10) 11. Talal Olductlonl (Iolalllnll 9 & 101 12, Nil Valu. of Elloll (IInl 8 mlnulllnl 111 13, Charltabl. and Gov.,nmlnlal BoqUtl11 (Schldul. J) lA, NI' Valullub oct 10 lox IInl 12 mlnulllnl 13) 15, Amounl of IInl lA loxablo 016% 'all (151 (Includl valutl from Schldull K 0' Schldull M) 16, Amounl of IIno 1A laxabll 0115% roll (16) /lncludl valutl from Schedull K or Schodull M) 17. P,lnclpallax dUI(add lox f,om IInl 15 plullax from IInl 16) 18. Tolal Prior paymlnhl Amounl Paid DllCounl 24.000.00 _ +-J.... 263.16 _ 0.00 283.969.25 0.00 0.00 ] S 9, 94.l...1J__ 0.00 0.00 ( 8) 23,467.11 2.005.66 418,439.85 (11) (121 (13) _ (IA) ~ ,06 a 15501 lIP 443,912.62 " C.... 25.472.77 418.439.85 0.00 418.439.85 25 .106. 39 ___ Il nil 25.106.39 25.263.16 156.77 19, If IInl 18...11 grooler than IIno 17, Int.. Ihl dlH...nco on IInl 19. Thlllllho OVERPAYMENT. A, ~Chock herl If you aro roqulltlng 0 rolund of you, overpaym.nt, 20, If IIno 17 II groo'erlhan IInl 19, Inlerlho dllloronco on IIno 20, Thll II IhllALANCE DUI, A, Enler Ihl Inltroll on Ihl balanco dUI on IInl 20A, B. Enler Iho 10101 01 IIno 20 and 20A on linl 20B. Make Chtc~ Pa1!'.~Io..!.~'-~!lllt., al VlIIII, Ai!,nt . - ---------- - ..11 SURE TO ANSWIR ALL QUIITIONS ON RIVIRII SIDI AND TO RICHECK MATH.... UnderPin."11I 01 perjurY.T dO(lar"fll'-iiijf,;;;i..amln'lciih~'r'lur';;-Tn-;ludlng"ccomponylng "hodul.. and 'Iall;;;,n'" and 10 Ihl b.II of my knawltdgo and bOilof, h II lru., corr.ct and compl.te, I d~lar.lhal all ',01 11101. has bHn "port.d at 'rut mar..t valu.. O.c1aratlon of prepar., alMr than 1M perianal "pr.Mnlatlv. II baltd on alllnforma"an of which proparor hal any knowlodgo, . /7 ,(/j '-\1' ". , ,II' P ,", I ''''.'', /"// /'" _ ~ / /"t/",/ iT6NAfn'i(~/te~10t1!;;1ci~5I1ll ,~: ;l1f~olri'u1-N--.--l~~rii~~,u.l' -,(:..~ N/.<.cA", ",'i~'r---iV'~lTl J.ifU/-L'1-- , ,) 7J:tlfori;J,,[l~iijj"~5!NjATIVil. 58 ..ILa~ L ~l~D~fi!~iL.~_~~I~\)~;' set ;-P'A---1 i5-1;J.~:~__ _~;- j(;, - Y L-.-- ~ I s 0.00 ~ ,15. (17) Inllroll (181 - (19) (20) (20-'1 (20B) 0.00 0.00 0.00 " ' '., , I . .' I " VII NO 1. Old decedent make a transfer and: a. retain the use or Income of the property transferred, b. retain the right to designate who shall use the property transferred or It. Income, c. retain a reversionary Interest or d. receive the promise for IIfo of either payments, benefits or cal'e' x X X X .... .... .......................................................................................................................... 2. If death occurred on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequate consideration' If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration' .......................................................................................................................... .... .... 3. Old decedent own an 'In trust for' bank account at his or her death' .................................................................................~........................................ X .... .... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. \, c' ,('\ " . , . ) \':- ('l' ". ;1 j) !:';'i -, ., UU ',' , VI IIV,IIOIIM+ ~"Il , COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE "B" STOCKS AND BONDS Mabel D. Fluck (All 'OPttW IOlntlt-owntd wUh RIght of IUNlvotlhlp muU b, dllOloltd on S,htdul. uP"1 FILE NUMBER 21-94-66 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH K Assets held in Grantor Trust dated 3/20/90, Somerset Trust Company, Somerset Pennsylvania 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Federated Money Market Trust $16,812.67 15,000.00 26,500.00 567.36 1,513.623 shs Fedoratrd ARMS Fund $25,000. par Eastman Kodak, 9.5', 4-15-00 Accrued Interest $25,000. par FNMA, 7.00% 12-25-20 Accrued Interest 25,250.00 77.78 20,000.00 53.33 $20,000. par FNMA, 6.00', 4-24-23 Accrued Interest $20,000. par Household Financial, 8.875%, 7-5-99 Accrued Interest 21,825.00 54.24 $20,000. par Salomon, Inc. 8.125%, 6-15-95 Accrued Intorest 20,950.00 117.36 20,587.40 372.67 15,190.05 . 50.00 16,031.25 568.33 28,625.00 1,130.56 52,906.25 1,300.00 $20,000. par FIlLB, 6.45%, 3-27-95 Accrued Interest $15,000. par FNMA, 7.5%, 7-25-22 Accrued Interest $15,000. par GMAC, 7.75%, 1-15-99 Accrued Interost $25,000. par ITT Financial, 9.25%, 7-15-01 Accrued Interest - 176 Days $50,000. par FHLB" 9%, 3-27-95 Accrued Interest - 104 days TI.lTAL IAllo enter on line 2, Roolpllullllon) *283.969.25 (If mort ,P'CI II nttded Inllrt IddlUon.1 thH1t of Mm. .111) 1IV,IIOlIH I'~ll COMMONWI!ALTH OF PENNSVLVANIA INHl!RITANCE TAX "'ETURN RESIDENT DECEDENT SCHEDULE "E" CASH AND MISCELLANEOUS PERSONAL PROPERTY ESTATE OF FILE NUMBER Mabol D. Fluck 21-94-66 tAli ro rt oint! -owned with thl RIght of Survlvof1hlp mUll b, dltclDltd on 9ch~ul. /IF") ITEM DESCRIPTION NUMBER I. Checking Account #2026501 at Somersot Trust C0mpany 2. Checking Account #33515565 at Dauphin Doposit Bank 3. Premium Refunds: Sta to Fa rill Blue Cross & Blue Shield Mutual of Omaha AARP Penn Treaty Union Fidelity 4. Medical Insurance Claims: AARP Legionnaire Insurance Trust Blue Cross & Blue Shield, Proscriptions Penn Treaty A11ianz Life Insurance Company Union Fidelity Life Insurance Company 5. Life Insurance Claim - Lincoln National Life Insuranc Company 6. Refund - The Woods at Cedar Run: Rent Reimbursement Meal Credit Security Deposit plus interest 7. Refund - Bell of PA 8. Cumberland County Veteran's death benefit 9. IRS - 1993 Tax Refund - Form 1040 10. Union Fidelity Insurance Company - Medical Insurance Claim TOTAL (AlIa enter on line 6, RecapltuleUon) flf mar. 'P'OI I' nHdId In,," .ddltlonll'hH1' of Mm. 111.1 VALUE AT DATE OF DEATH $ 99,100.48 49,439.67 18.17 143.45 27.70 39.75 360.13 11. 95 1,258.16 52.24 308.33 466.62 2,250.00 2,308.00 1,012,34 187.00 75.00 1,892.50 4.88 100.00 21. 00 866.00 . 159,943.37 REV.llli EX. 17:111 ' . . :l SCHEDULE "H" , COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES, . INHERITANCE TAX RETURN ADMINISTRATIVE COSTS AND RESIDENT DECEDENT MISCELLANEOUS EXPENSES ~~n~ . - Mabel I). Flucl< ITEM NUMBER A. B. .1. c. FILE NUMBER 2l-9~ DESCRIPTION AMOUNT 1. Funeral ExpenlBl: Hauger-Zeigler Funeral lIome The First Christian Church, lunch after funeral meal and travel expenses for family to attend funeral: 68.00 148.40 648.00 169.52 $ 6,615.99 300.00 Richard Fatzinger Timothy Fatzinger Henry K. Fluck Carole A. Fatzinger Admlnlltretlve Costs: Personel Reprosontatlve Commllllons Social Security Number of Parsonal Roprosontatlve: Yeer Commllllons Plld 2. Mark D. Persun, Esq. 13,350.00 At10rnay Feos 3. Family Exemption Claimant _ Reletlonshlp Addrell of Claimant at doceclent's death - 4. ProbetoFoos Register of Wills, cost to pr0bate will 340.00 1. Mlscellanoous Exponsos: Joseph M. Metro, appraisal fee PA Department of Health, Bureau of Vital Statistics, death certificates 45.00 72.20 350.00 60.00 2. 3. The Sentinel, Advertising Lotters Bulow Hottle & Co., incume tax preparation Somerset Trust Co., fee for services as Agent for Executrix 800.00 500.00 4. 5. 6. Reserve for filing etc. TOTAL (Also entor on IIno 9, Reoa Ituletlonl 1._ 23,467.11 llf morlep.c. I, ""did lnu" .ddltlon.1 Ih"1I of 11m. 11,.1 ',' '.' '. . RIlV.UIa EX' (1.B3) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT OECEDENT - ESrATE OF Mabel D. Fluck SCHEDULE "1" DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS FILE UMBER 21.g4-66 ITEM NUMBER DESCRIPTION AMOUNT 1. Mechanicsburg Rehab System, balallce due for services December 1993 2. Bell of Pennsylvania, final bill 3. Somerset Trust Company, Master Card balance 4. Harrisburg Hospital, charge for private room, 11-18-93 to 12-21-93 and 12-28-93 to 1-11-94 6. The First Christian Church, Mabel Fluck Flowers ordered by $ 13.96 17.56 23.64 1,882.00 31.00 , 37.50 5. Pennsylvania Department of Revenue, tax due on 1993 form PA 40 I. , , , , .. " TOTAL (Also enler on line 10, Recapllulalloril $ 2 0 6 (If mOrl'plol I. nltdld In'ln Iddltlonlllh..lI of Mml.11I1 UY.UlJl'lt 111"1 ~.~' ~. '....... COMMONWfA\TI' O' "WlSn\lANIA INHlllfANCI 'AX IUUIN ___IIIOIN' CII~~DIN' SCHEDULE J BENEFICIARIES l_ UTAU Of Mahe 1 D. Fluck FILE NUMBER 2-194-66 _....__._-----~_._.._---- .~----------,.._-_._.._._....._- ~- ITEM NUMBER NAME AND ADDRESS Of BENEFICIARY RUATIONSHIP AMOUNT OR SHARE Of lSTATI ------ -A:T;;;;~b1I-;~u..;~'Pro b ate------_u.---- 1. Carole Ann Fatzinger 423 B. Lisburn Road Mechanicsburg, Pennsylvania 17055 Henry K. Fluck 604 Las Olas Court El Paso Texas 79932 Daughter 50% of Residue 2. Son 50% of Residue " ' ITIM NUMBIR NAME AND ADDRnS OF BENEfiCIARY AMOUNT OR SHARE Of ISTATI ,8, Charltabll and Oauornmlntal Blqul.llI 1. TOTAL CHARITABL~ AND OOVERNMENTAL BEQUESTS (AI.a Inler an IInl 13, Recapitulation) $ (II moro .paco I. noodod, In,o,' additional .h.... ol.amo lito) UVoIS,UUt P'UI .~Jb COMMOHwrAI111 ell 'Itltl~YI"'A.lIA IHHIIUAHCI '^J: IIIUIH anIOI~' DIC.IDINt SCHEDULE J BENEFICIARIES 1 = - FILB NUMBBR BSTAtE UF Mabel D. Fluck ITEM NUMBER 21-94-66 -.- -----..,.- ~ ._-,~-------,..._.,. ,-------,~-- _.-- .____. .__.~__..,.._ ._._n___,........__. ..._,___._.~..n_~_. NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE OF ESTATE ITEM NUMBBR 1. A" Taxable 8oque.", LIVING TRUST Richard Fatzinger 532 LaGuardia Place #378 New York, NY 10012 Timothy Fatzinger 11 San Juan Drive Mechanicsburg, PA 17055 Sandra Bauriedl 423 East Lisburn Road Mechanicsburg, PA 17055 Bianca King Fluck 5684 Costa Blanca E1 Paso, Texas 79932 Jared Bauried1 423 East Lisburn Road Mechanicsburg, PA 17055 reat-Grandso $5,000;00 Grandson $10,000.00 2 . Gtandson. $10,000.00 3. Granddaughter $10,000.00 randdaughter $10,000.00 4. 5 . -~ NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARB OF ESTATE --' 8, Charllable and Governmental 8eque.'" 1. TOTAL CHARITABLE AND GOVERNMENTAl8EQUESTS (AI.o enle' on line 13, Recapllulallan) S . (II mOil .pacI ,. ntldld, '.IIr! additional .htlt. of .aml "") , I, , I I I " I, .1 ,I 'I II \ .:\\!.!'1~~1 1\:,,',,\'1,: :1 ,C\,III1\" I ",. i','.' I '/ ,'. ~" j /1\ ,'~. " ' 1 I, ~I '\: " .') , t-j\',.'., ._.:............, ,,,,,',..!...~...u.:"'_....,...,. . I' r, :' I .1 ,. 'I; I' " i.1 ~ " , , iii_ "', I'''. , I, " " ii' ,. '5 '" N ~~" h '. I"~ . '1 :'I " ,'} ,I 1\ " ., , ;~ .- r,~ "1 I' d' " 1'1' ,I ./ .' '\" t, ""I", ,j1L1t " ~.~ ~. NY ~, ~. i' '" I " , j ~ " \',' -:/ TaJ \~ "O~ " '" , ~ I' ,.I , " I,', f"\ ", " 'i I' I I, , ,. t' 1(' '1-, " ,. , ;, " '!' I, "I , , ""11 , I",' ""! ii' " ,,, ;;/, '1,;,1 " " ", '1,\ i'; " ,I' 'I, ,. (. j1: " ,(\ "'f " 'iii' 1'-'1 : 1,,11' " " ,I,i" III <I, " '/ 'j I,' I, 'Ii' 'j", , 'I', -',. ii' .. j', I " " I' I' " " "~,I: I " "'} j, I' ;. " , '; " ii" , I, , , I ,,, " " /, 'I " '" ,. " (', if I. '., '-I' '\'1 ": , I, 1 , , I' I ,I 1", " ". \ I ,i I" " ';1 ", ,;', i, ~ 'I i, .\' Ii \' " I,!, , \', "',\' 'I' ','" L .,: t' 1-,', " , 11-' ", " , " ,I' i; Ii!' " , " I, ~ " /. ,. I, i' ,I" " " I' 'i', " I, '" ,Ii ';,1 'I " "., !, d ,j' " " , II I' " I,! " ,I; Ii ',I:',li"') , I ",I '1-' L "~I, " ,. , (" !! 1,1 'I': , 1"1 , \" '; 'i if " '-" ji "It_I, " i' i"'i d' " ":' ,-, I. h ,d':j " " , ,',' ",I " B_~ You, Sink In 'hi Hlghllnds P.O. BOX 777. . SOMERSET, PA, 15501-0777 . PHONE: 814-44.'1-3881 April 6, 1994 Register of wills . cumberland County Court House 1 Court House Syuare Carlisle, PA 17013-3387 REI Mabel D. Fluok, Estate File No. 1994 - 00066 Dear Register: Enclosed is a oheck in the amount of $24,000 which is to be applied as an estimated payment on the Pennsylvania Inheritanoe Tax for the Estate of Mabel D. Fluck, File No. 1~94-00066. If you have any questions about this matter, you may oall me at (814) 443-9207, or you may call the Attorney for the Est.ate, Mark D. Persun, at (814) 445-4021. Pl.ease send the reoeipt for this payment to me ln the enolosed envelope. Very truly yours, SOMERSET TRUST COMPANY, Agent for Carole Ann Fatzinger, Exeoutrix ASP: tjb . ~tf;,~",- . \I, I Ann B. Pe~l!l\'ih ]1I'Vioe President Trust Offioer 9(.: i.l: /.- W;\: Ilii. . Enolosure :;11" J\1 'U .' ').)U " I' ""'" j- ~~-11 -~ (l ~p, ~d :o:tl IN THE COURT OF COMMci PLEAS'OF lill 8 CUMBERLAND COUNTY, pfNSYlf'\NI,\;~'~' ORPHANS COURT DlVISIO .: .:1. ... , .. N ~,~ ,--, ~/' ~..' ~;.:j ~ ( ~ i~ (~ (.. -.I _. ~~ t:!J (fI~ o FINAL RECEIPT, EELEASE. REfUNDING AND INDEMNIFICATION AGIlBlll)1mIT INRE: ) EST A TB OF Mabel D. Fluck ) also known as Mabel Ann Fluck ) late of Cumberland County, ) PennsylVllnia, ) Deceased ) No, 66 Estate of 1994 The undersigned legatee and devisee under the Last Will and Testament of Mabel D. Fluek also known as Mabel Ann Fluck, deceased, does hereby: I, Waive the filing of a fonnal accounting and distribution only as to the fil1lll distribution hereafter set forth; 2, Acknowledge receipt previously of $96,000,00 and on this date a final distributilln of $76,568.29 from said estate; 3, Release Carole Ann Fatzinger, Executrix of the Estatc of Mabel D, Fluck, also known as M~"el Ann Fluck and its successors and assigns, from allliahility resulting from its handling of said Estate relative to the aforesaid distribution; 4, Agree, if necessary, to refund to the said Estate any portion of the final distribution to whieh he or she may be eventually determined to not be entitled and, to the extent of said distribution, to indemnifY said Estate for claims made against the undersigned as legatee and devisee and to reimburse the estate for all expenses and costs incurred thereby; 5, Agree, to the extent of the foregoing final distribution, to reimburse the Estate for the undersigned's prorata share of inheritance tax and other legitimate estate debts or obligations tha( may hereofter accrue and for which sufficient Estate assets are not available to satisfY same; and 6. Declare that this instrument shall be legally binding upon him or her and upon his or her personal representatives, successors or assigns, i:L ~.e~'"""" f,.ell IN WITNESS OF, [ have hereunto set my hand and seal th~ day of NO'leftlllw 1994. I/-; /( MN< Henry K. Fluck ArJ15/1 /~~ .og<:y" . ~ /"~..~~~~.,'" - ~ ;,:",j;i...:;/) ~~:;/,:~, ::,\,:,"~,) 1 , .' . ~ ~ , ' , " , ' \ ", .o) 'I' ':, I', '. r I.' ::' ~ " ' , , I" 'Ii ' > '1'1' ,.- \ " "I" \ ,., --- ,. '_-i, g~:~~W~~1 :.~~l~~ ?l_~ " ) ) ss . On this, thedffi\.ctay of Jtb<!.e:~:L<. ~994,. ~efoe~~el . the undersigned officer, personally appeared _1:I.~I"l.I K...J-L.tJ~ known to mel or sat.isfactodly proven, to be the pel:lOi1Whose name is subscribed to the within instrument, and acknowledged that he executed the same for the p~(poses therein contained,' 1 have signed my name and affixed my seal. " , ',c .'"., ....., ',' "K \' ,', r.":'. ,,(r.i'."ll' - 'i, ':1 (/"'\',:\;:j $~"'''", OJ \\ '.'.;, I' : I ,,~ .\" , , ~ ';~\ I '// 1,1 ~,~~ iJ; UJ '." '_~ .i'i."U1 ) Ii ,,',.'\'!,~J\.. " com,""I,HI"',,, r ,; ;.:~) ~ :"l'''''l~\,:',,; ~'Qo'I';H;o-,;,:"l.,;J";",':. .,~ "'';'~ ,\ ", , , "I ~~ , , ts\ :Ilffil " g" J1l8 " (' " ~ -'-i ~. .: ((1 \'~. ,:,.. (1;" (\'1 "1 c.l.. ~, ... , ,: .: N (\ '~~I " .". 'f ,~}(fl "I i!a C:fl " . r' 3(U Jg ~ iiio , ;:l. I:!> - " O' " ,. " ",' , " , '/I' , " .. " " " " " " . I' 'I , " " " ,I , , " ," , ~ INRE: ) ESTATE OF Mabel D. Fluck ) also known as Mabel Ann Fluck ) late of Cumberland County, ) Pennsylvania, ) Deceased ) IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPIIANS COURT DIVISION No. 66 Estate of 1994 EINAL RECEIPT, REI,EASE, REFUNDING AND INDEMNIFICATION AGREEMENT The undersigned legatee and devisee under the Last Will and Testament of Mabel D, Fluck also known as Mabel Ann Fluck, deceased, does hereby: 1. Waive the filing of a fbnnal accounting and distribution only as to the final distribution hereafler set forth; 2. Acknowledge receipt previously of $96,000,00 and on this date a final distribution of $76,568.29 from said estate; 3. kelease Carole Ann Fatzinger, Executrix of the Estate of Mabel D. Fluck, also known as Mabel Ann Fluck and il~ successors and assigns, from all liability resulting from its handling of said Estate relative to the aforesaid distribution; 4, Agree, ifnccessary,to refund to the said Estate any portion of the final distribution to which he or she may be eventually detennined to not be entitled and, to the extent of said distribution, to indemnifY said Estate for claims made against the undersigned as legatee and devisee and to reimburse the estate for all expenses and costs incurred thereby; S, Agree, to the extent of the foregoing final distribution, to reimburse the Estate for the undersigned's proralll share of inheritance tax and other legitimate estate debts or obligations that may hereafter accrue and for which sufficient Estate assets are not available to satisfy same; and 6, Declare that this instrument shall be legally binding upon him or her and upon his or her personal representatives, successors or assigns, IN WITNESS OF, I have hereunto set my hand and selll this J!L day of November 1994. a~.p,) a. ~~ Carole A. Fa I ger c: . ." .' '.' ,\, :.\ ;: .,r\ .IN THE MATTER OF THE ESTATE OF , MABEL D, FLUCK ti/k/a MABEL AN~ FLUC~: ) IN THE COURT OF COMMON PLEAS OP ) CUMBERLAND COUNTY, PENNSYLVANIA ) )No. 66 E~tate of 1994 I' FIRST AND FINAL ACCOUNT OF CAROLE ANN FATZINGER EXECUTRIX ~--~_.....~-_...-- Date of Death: Letters Administrative Granted: . First Complete Advertisement of Grant of L~tters: Account Stated to: January 11, 1994 Jan\\ary '20, 1994 February Ie, 1?~4 Novembe~ 10, 1994 R.______..,..._.__.__.."__._..,__..__._.__..____.. , ' , ~UMMARUlliLU11)ID( , ' PRINCIPAL RECEIPTS IncomE! Recei pb Capital Gain/(Loss) P.lSBU.RSEMKtLTS RESERVE $401,583.79 '14,452,6'\ (3,206,53), P..illl.Q. 2 5 12 ($ 2 4 5 , 488 . 17 ) (1,000.00) , 9' 11 Balance Remaining for Distribution , (B 0 0 II Val u e) . . . . , . ,'. . . . . . . . . , , , . , , . . '. . $16 (; , 3 41 ,7 3 , (Market Value). .November B, 1994. ..$153,136.5B Proposed D10 t d bu t i el/l ~ 13 I I, 1,1' ., ',' I ',""."".','."".\ -'; "'-,~h' 'i, \ '., ,. , " .;i" " j., , i, ( 2/11/9'1 , . 3/4/94. " 1'\ 3/4/94 3/4/94 3/24/94 3/2 ,1/ 9'1 3/24/9,1 '3/24/9'\ ::Sf 31/ 94 4/21/94 . . 4/25/94 4/25/94 5/2/94 5/4/94 5/11/94 5/11/91\ Rocoived from State Furm - Premium Refund,Policy #3B-J3-4048-2 18.17 Received from Dlue Cross & Blue Shield Refund of Premium P<lid 143.45 4,88 Received from Bell af PA - Refund Received from Tho l'loodz at Cedar :;un Rent Reimburz"lnent for January 187.00 Meal Credit for Jan~ary , 75.00 Security Deposit 1;829,11 2,091.11 Received from Mutual of Omaha Premi\lm Refund 5;23 Recei vad f rOHl the Prude,,) ti "I In;::\1rancCl Co, of lImedcCl (lIi\RP) - RIilfund on Medical Expenses Received from Legionnaire Insuranoe ~rust Refund on Medioal Expensds Received f~om County of Cumberland, Pennsy1vania Veteran's Death Benef it 1,258.16 52,24 100.00 Refund on Cancelled 1I11R!? Policy #031.35322 39.75 Deposit ~ Blue Cross ~ 65 Plus Prezcripti ons .308.33 Refund from Penn Treaty LIfe Insurance CompClny Premium Refund Received from Penn Treaty Life Insurance Company - Refund Relating to stay in Rehub Hospital 122193-122893 ~ Received from IRS - Refund Form 1040 for Year End 12/31/93 360,13 466.62 21.00 Reoeived from Mutual of Omaha - Premium Refund 22.47 Received from Alliunz Life InzurancB Compuny Cancer Policy Claim 1,875,00 Received from Union Fidelity - Unoarned Portion of PromiuM 11.95 3 I' I. . .. ^ " "~tot:, l\1Q.QlllLR~Q.Qj, l?ll. . .2/2/94 ' 2/16/94 2/28/94 2/20/94 2/28/94 3/2/94 3/2/94 3/16/94 3/20/94 3/28/94 3/20/94 3/29/94 3/29/94 4/4/94 4/4/94 '1/18/94 Interest Received TR US TREAS DB - PRN 28.81 Interest on ~OOOO PAR Val ue SALOI.ION INC OEN TERM IITS BE J.lTNli' 8 ,1~5% 6/15/95 135,42 Interest on 25000 PAR Value FNJ.lA 91 B2PL CMO 7~ 12/25/20 Interest on 8712.2 PAR Value FNMA 92-182J 7.5% 07/25/22 Interest on 20000 PAR Value' li'NMAO ONNA eMO 6\ 04/~5/23 145 . 8 3 . 54.45 100,00 Interer.t Received TR US TREAS DB - PRN '239,65 Interest.Received TR' US TREi.S OB - tNC 0.1'4 Interest on 20000 PAR Value SALOMON tNC OEN TERM NTS BE HTNF 8.125% 6/15/95 135,42 Intermst on 25000 PAR Value FNJ.lA 91 82PL CNO 7\ 12/25/20 Interest on 2489.26 PAR Value FNMA 92-182J 7.5% 07/25/22 Interest on 20000 PAR Value FNMAO ONMA CJ.lO 6% 04/25/23 Interest on 20000 PAR Value FHLB 6.45% 3/27/95 ~ Interest on 50000 PAR Value FEDERAL HOME LN BKS DEB 9,000% 3/27/95 145.83 15..56 , 100,00 ,645,00 2,250.00 Interest Received TR US TREAS OB - PRII 110.7,) Interest Received TR US TREAS OB - !lIe 1. 48 Interest on 25000 PFIR Val,ue E1\STMAN KODAK CO, HOTE 9,5~, DUCJ'4/1S/00 1,187.50 5 Interest Received TR US TREAS 08 - INC 6/16/94 Interest on 20000 PAR Value SALONON INC GEN TERN NTS BE MTNF 8.125% 6/15/95 4/18/94 4/26/94 4/26/94 5/3/9;1 5/3/94 5/17/94 5/26/94 5/26/9,1 6/2/94 6/2/94 'I' Interest on 20000 PAR Value SALOMON INC GEN TERN NTS BE HTNF 8.125% 6/15/95 " 135.42 Interest on 25000 PAR Value FNHA 91 82PL CNO 7% 12/25/20 145.e~ Interost on 20000 PAR Value FNNAG GHH!\ CHO 6"; 4/25/23 100.00 Interest Received TR US TREAS OB - PRN 68.94 Inte~est Received TR US TREAS 08 - INC 6,.34 Inte~est on 20000 PAR Value SALOMON I liC GEN TERH NTS BE HTNF 8,125% 6/15/95 135.42 Interest on 25000 PAR Value T!'NMA 91 82PL CNO 7% 12/25/20 145,'83 Interest on 20000 PAR Value FNMAG GNMA CNO 6% 04/25/23 100.00 Interest Received TR US TREAS OB - PRN . 66.73. , I 10.28 135.42 6/28/94 Interest on 25000 PAR Value FNNA 91 82PL CMO 7% 12/25/20 . 145.83 6/28/94 Interest on 20000 PAR Value~ FNNAG GNMA CNO 6% 4/25/23 100.00 6/28/94 Interest on 25000 PAR Value EASTMAN KODAK CO. NOTE 9.5% Due 4/15/00 7/5/94 I ' 7/5/94 '481.60 Interest Recelved TR US TREAS on . 1'1<11 02.24 Interest Received TR US TREAS OB - INC 11.62 , I ! 6 7/5/94 7/6/94 7/18/94 7/18/94 7/26/94 7/26/94 8/2/94 8/2/94 9./26/94 8/26/94 9/1/94 . 9/2/94 9/2/94 Interest on 20000 PAR Value SALOMON IUC OEN TERM NTS BE MTNF 8.,125% 6/15/'35 90,28 Interest on 20000 PAR Value HOUSEHOLD PINL,NOTE 8,875% 7/5/99 I Interest on 15000 PAR Value GENERAL HTRS ACCLP CORP NOTE 7.750% 1/15/99 807;51 581. 25 Inter~st on 25000 PAR Value ITT FIU'L CORP.NOTE 9.25% 7/15/01 1,156,25 Interest on 25000 PAR Value F'mlA 91 82PL CHO 7% 12/25/20 145.83. Interest on 20000 PAR Valuo F'NMhG ONHA CMO 6% ~/25/23 100,00 Interest Received TR US TREAS DB - PRN . 218.15 I~terest Received TR US TREAS OB - INC 19,63 Interest on 25000 PAR Value FUMA 91 02PL CMO 7% 12/25/20 145,83 Interest on 20000 PAR Value FNHAG GNMA CHO 6% 4/25/23 100.,00 Interest on 20000 PAR Value FHLB 6.45% 3/27/95 .551. 83 .Interest Received TR US TREAS DB - PRN 161.42 Interest Received TR US TREAD DB - INC i 25.60 9/23/94 Interest on 15000 PAR Value GENERAL MOTORS ACCEP CORP 7,750\ 1/15/99 219.58 9/27/94 Interest on 25000 PAR Value FNMA 91 82PL CHO n 12/25/20 9/27/91 Interest on 20000 PhR Value FNHAG GNMA CNO 6% ~/2S/23 14 5' i 8 3 100.00 7 ,,' 9/20/94 I~~oreston 50000 PAR Value rEDERALHOHE LN BKS 9,0!\ 3/27/95. 10/4/94 Intorest Received " TR US TREAS OB - PRN ,'I . '10/4/94 Interest Received TR US TREAS OB - INC 10/26/94 InteL"est on 25000 PAR Value FNNA 91 B2PL CHO 7% 12/25/20 10/26/94 Interest on 20000 PAR Value FNHAO GNHA C/10 6% 04/25/23 11/02/94 Interest Received TR US TREAS 08 - PRN , , 11/2/91.1 Interest Received , , TR US TREAS DB' - INC 2,250.00 ' , , . " ,,~7; O~ " n . 23.33 145. S3. '100, bel )' ,I '56.44 ' ", 33.62 -, , I TOT.AL. INCO~jE RECEIP~S , 14,452,64, .1' " " , , I , " "; i_.,1 ',t, " , , q " 'i, , ' ,,_' I', I, .' " " ,,'i'i, ',I " , 11;- " /' ,'1 ,- 'I \. H : "i." " ,. " ';; '. , " :, ," ", , 1;' ~,,' ,I" 'I ,., ;" , ",I t, " I.. " " "'i" .. , ,,., ' , , ", '--I " I. ; 1 ,,;1 "jc ,- , , I j' ,. " .,. " ;' " " , " " ' \.' I i'" " . I' , ' ;1, ;' 'B , ' , PJ.~\l.J.!t1! Rm!ll\.t~, The First Christian Church Donation - Luncheon after Funeral .1/2B/94 ' . Ilaugcr-?eigler r'uneral Ilome Funeral Bill for Habe,l Fl uck Account # 10947 J/28/94 1f2B/9.\ . 1/28/94 Richard Fatuing~r ,Reimbursement for Train Fare TlmothY Fatzinger Roimbursement for Hotel Rooms 68.00 , ' 140.40 300,06 . 6,615,99' 1/28/94 Henry K, Flucl( Reimburse for Airfare 2/3/94 . 2/8/9'1 '2/9/94 2/9/94 2/14/94 ,648,00 ,2/3j94 Hechanicsburg Rehab System Balance due for December 1993 Billing (Television, Hairdresser and Tax) . 13. ~6 carole Ann Fatzinger Reimbursement for meals, gas, and tmnpilte tolls 1.69,52 TRF to Trust to covor overdraft caused by making distributions 4h72t,62 Bell of Pennsylvania Current Bill 17.56 Hark D, Persun Costs Advanced for Register of Wills 340.00 Joseph H, Appraisal Apa l' tmen t Hetro Fee for contents of . 60,00 2/25/9~ ,Carole Ann Fatzinger Partial Distribution 50,0'00,00 3/2/94 Ilenry K .Fluck Partial Distribution 50,000,00 3/2/94 Somerset Trust Company Balance Due on Mastel' Card 23,64 9 Hal'k D. ,Bn I tlnCO Persun of Attornoy Fees ~d50. 00 I, Total Disbursoments 245,4~8.17 EESERVEL.19-Q.1'O QIL EST A TE 1,000.00 . , " , " ,. ,. , I. '., '" '" "I, I' " .' 'I " I. I'"~ I, ;" '1: , ,. ,. " " " I,'. " 'I, II 'Ii " I, ,I " : " , I, 'I " , " " , , I' "I' I, , I' " , " " ';," ,: 1,'\, ,. '~i' ",', ; , '" 'I:"" " 11.\ ,I' ,,' I" " , , I. I' 'I , .. '.. ,. " I I' " , I,. ';11' , I, , " \, I, '.'1' II "I" I. I " ~ II , " " , 'I '" , , " II, '. ""1: " fo-' 'I, i'l ," ,I , I , " , I'll, ",' ,'"" " " .' ,tl,l" , , '" ,., " II \, II' 'j.' I 'j',' "', I, " , , ,. " I " " , Ii, " " ' , ", \1\ ",1 1\ ,,.' " "I'. " /'" (,Li" I ,.' , " "I " " " '" iiI' 'l; ., '" ,. "I' ,,' ,. ...,'" i1 jl' ,.,.' ,'I' 11 "r,', CAPITb1..0AINS JJ&s.~I"&l Prooeeds 'Dl1teof Death <:loin !i Of Sa 1 e Value ,(I,oo.!: ) i" , , 2/28/94 Prinoipal B712.20 6,301.7B ("18, e-I) I on 6,222,94 I, PAR Value FNI1A ! 92-1B2J 7,5\ 7/25/22 3/2B/94 Principal on 24$9,26 2,4B9.26 2,520,80 ,.(31. 54) PAR Value FNHA 92-182J 7,5% 7/25/22 6/28/94 Sold 25000 PAR 25,612,50 '26/500~O.o (887,50) 6/21/94 @ 102,45 EASTMAN KD~AK CD. NDTE 9,5\ 4/15/0.0 7/5/94 Sold 20000 PAR 20,260,00 20,950.0.0 ~690.,00) 6/27/94 @ 101,30 SALDMON INC GEN TERH NTS BE I1TNF 8,125\ 6/15/95 9/1/94 Sf> 1 d 20000 PAR 20,.070,00 2.0,587.4.0 (517.4.0) 8/31/94 @ 100,35 FHLB 6,45\ 3/27/95 9/23/94 Sold 15000 PAR 15,030,00 16,031,25 U.J..Q01. 25L 9/16/94 @ 100.20 GENERAL I1TRS ACCEP CDRP 7.75.0\ 1/15/99 TDTAL CAPITAL GAIN/(LOSS) (3,206.53) ,/." . ~ , " " " I' ,I" ,. , , I I I . , " 12 " ,.'1 " " , ' IN THE MATTf;n Ol~ ~\llE ~snTE OF. MABEL D. PLUCK a/k/a MABEL ANN "LUCK w~fLJ?UJJ..t~l2.\l.U.Q.n , " ) IN THE, COURT OF CO~lMON P,f,EAS or 'I ctiMBERL~ND COUNTY. PENNSYLVANIA ) '. No. 66 Estate of 1994 Balance for di~trib~tion in accordanoe with the Pi~.t and Final Aocount Carole Ann Fatzinger lIenL'Y K. Fluc1: Total of Proponed Distribution ,. " pi ,. ;." I, It. " ", I; , 'i;,1 , '., , , , " , , , " H " , I: , " ,. " " " o. "'., ", ., ',,' ,I' ' I, I' I. ,,,,' ,. " , ,. ,. " ,. , " , 'I I' 0 'I r' , , , , I' .' I, /, !' I' I, " , , " d' " I' , '" i '.'i ';I"", ',1" ", " " " , II/I' I'" 13, , '''I' " " , " I' L,'" .<;. " , ' ,. , I ,I' " " I. I" " , '.,,' " $153,136,58 76';568,29 76r568.~9 ", $153.136.58 ,,' I " ,if I' '" ," " I' ," " " " p I, " I, ,0 I, , " , ,. " " I, , ,. , '11-" ,c ." " I' I' o " .1 h '-q I I , I I ,I ,I I I I I , i I 1 I I I I i I I , ~ 'OIOH", I I I' J . , , I I I I I I I I I I I i I I I i , , ,.,_ ...t ....'.....-...".. ...., " . ~ ---'-'- - __..'--0 -__ _~~ ___ __~. "n_....._., __"H ._._ ~.__,_..... __ ~._.... ___ _,'_ ____. ______--. __. _..... __ ____ RECEIVED FROMl i ACN ASSESSMENT I!' . CONTROL ~ NUMBER AMOUNT . . CAROLE ANN FATZINGER 423 ~AST LIBSURN RD JOI , 1J/:!'t . V\I\I. ~'O MECHANICSBURO PA 1 7055 fOIDHUf . ESTATE INfORMATlONI l m MBER ~ 21-1994-0066 It 0 A I;iI FLUCK MAllEL D II E Of PAYMENT B BBN e09..,OI-126S R T I ,. TV d. ,lOt) /94 CUMBERLAND II TOTAL AMOUNT PAID t"" , !, ,r.' 1''/ , RECEIVED BY. , REMARKS CAROL ANN FATZINGER SEAL REQISTf/R Of' WII.L8 . . . -'--., - --- _. -- ~- -..,..., --,- --,- "_ _ h_ _, '_' _ __ _ _ ___ _. __ _ -.- _,_ -:-- _-'-," ! ' f . ' ',' " .." ",.,. ...........- .......'--............ ~"''''''.J.4.'~ - ...., '''TO' II I . . ~ I(rs REV-1!547 EX AFP (08-94. COMHONWEAlTH OF PENNSYLVANIA DEPART"E"l OF REVEHUE 8UREAU Of INDIVIDUAL TAMES DEPI. zoom HARRISBURG, p", 17121.0601 ESTATE OF- DAT! OF DEATH 01-11-94 -) \ NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ACN 101 FILE NO. COUNTY DATE 11-07-94 -21 94-0066 CUMBERLAND ---- NOTE I TO INSURE PROPER CREOIT TO YOUR ACCOUNT, SUBHIT TNE UPPER PORTION OF TNIS FORH WITH YOUR TAX PAYHENT TO THE REGISTER OF WILLS, HAKE CHECK PAYABLE TO "REOISTER OF WILLS, AGENT" REMIT PAYMENT TOI MARK D PER SUN ESQ 15B E MAIN ~T SOMERSET PA 15501 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 A.ount Ro.1 Hod l CUT ALONll THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS .. il iV: iilti; - ill -A Fii - i OS-; 94 Y"iioYic niF - "(NHiil-if Ai(cE - 'fAX - APPRA-i siiiiiir; -AL rciWAi(cE - CiA - - - - - - ---- - - - - - -. DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FLUCK MABEL D FILE NO. 21 94-0066 ACN 101 DATE 11-07-94 If In ......m.nt w.. i..u.d pr.viou.ly, lin.. 14/ 15 Ind/or 16, 17 .nd 18 will r.fl.ct figur.. th.t includ. the tot.l of ~ return. a......d to d.t.. ASSESSMENT OF TAX' 16. AMount of L1no 14 ot Spou.ol roto US) 16, AMount of L1no 14 to.,blo ot Llnul/Clou A roto Ub) 17, Aoount of Llno 14 to.oblo ot Collotorol/Clo.. B r.to (171 la. Prlnolpol To. Duo TAX RETURN WAS I 1 X I ACCEPTED AS FILED RESERVATION CONCERNINll FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ONI ORIGINAL I, R.ol E.toto ISchodulo A) 2, Stock. ond Bcnd. ISchodulo BI 5, Clo.oly 1I.1d Stcck/portn.r.hlp Intorut (Sohodulo CI 4, Hortgogo./Noto. Rocolv.blo (Sch.dulo D) 5. Co.h/Bonk Dopo.lt./HI.c. Por.onol Proporty ISchodulo EI 6. JointlY O.nod Prcporty (Schodulo FI 7. Tron.for. ISchodulo ~) a. Totol A.IOt. APPROVED DEDUCTIONS AND EXEMPTIONS' 9. Funorol E.pon.o./Ad., Cc.lo/HI.c. E.pon.o. (Schodulo H) 10, DOblo/Horlgogo Lloblllllo./Llon. (Schodulo I) 11, Totol Doduotlon. 12. Not Voluo of To. Roturn IS, Chorltlblo/Oovlrn.lntll Boquo.tl ISohodulo JI 14. Not VIluo of Eltoto Subjoot to TI' NOTE I TAX CREDITS I PAYHENT DATE o -06-94 RECEIPT NUHBER XA885922 DISCOUNT (') INTEREST 1-) 1,255.32 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST, ( ) CHANGED U) .00 121 203,969.22- (51 ,00 14) ,00 (5) 159,943,37 (6) ,00 11l ,00 181_ 443,912.62 191 23,467,11 (10) 2.005,66 III ) ?Ki.G7? 77 U21 418,439.85 US) .00 (4) 418,439.85 .00 418,439.85 ,00 X ' DO, X ,06. X,15. UBI ,00 25,106,39 ,00 25,106.39 AHOUNT PAID 24,000.00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE 25,255,32 ._-, 148,93CR -- .00 148.93CR IF TOTAL DUE IS LESS THAN fl, NO PAYHENT Ii REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I \ I " (', 1" ,..' ,. .' . , ' r'" I :1 ! " ~:j 1..\0 RESERVATION. E.t.t.. of decedent. dying on or bl'or. D.otlblr 12, I'" .. If .ny future 1nt.r..t In the ..t.t. I' tren.flrred In po.....lon ctr tnJqVNnt to Clan II (ool1.',rIU btntflcl.r1,. of thl dludent 'Ulr thl IMplratlon of any IIt.t. 'or l1f~ or for v..rl, thl Co..onwl.lth hlr,bV l_pr.,llv rl.trv.. th. right to Ippr,l.. .nd ...... tran'f.r Inherlt.no. T,)Ct. .t thl lew'ul ell.. . (oo11.tlr,1) r.te on .ny .uch lutur. Inhr..t. PURPOIE OI! NOTICE I To ful,III the r.qulr..."t. 0' S.otlon 2140 0' th. I~h.rlt.no. and Elt.t. 'IX Aot, Aot 22 of 1991. 7Z P.t, Soctlon 21\0. PAY~HTI Dettoh th, top portJon of thl, Hotlc. and lub,lt with your pIV.lnt to th, RIII.t,r 0' WlII. printed on the r.v.r.. .Ide. --H.k. ,hook or eon.. ordor ....bh to> REDXSTER OF MILLS, ADENT All pIV""" r'c.ly'~ Ihlll flr.t bt .ppll.d to .n~ Int.r..t which .IY b. due with an~ r...lnd.r Ippll.d to the t.x. REFUND (tR)1 A r.fund of . t.x crldlt, which w.. not r.qu.ltld on the T.x R.turn, ..~ bl r.qu..t.d by co.pl.tlng .n'"Appllo.tlon for R.fund of P.nn.ylvanl. Inherltancl .nd E.t.t. r'K" IREY-Illl), Appllo.tlon. .r. .v.il.bll It thl OfficI 0' tht Rtghtu of Willi, any of the U R.v.nut Dlttrlot Offloll, or by o.l11n/l the .p.ohl ~4'hour .nlMlrlng ..rvlc. nUlblr. for for.. ord.rl~gl In P.nn.~lv.nl. l-100-S62-Z050, out.ldl P.nn'Ylv.nl. .nd within 100.1 H.rrl.burg .r.. (717) 717-1094, TOO' (717) 712-2252 (H..rlng I,palrld Only). olJECTIoNSI Any putv 111 Il'lt.r..t not IItI.fi,d with the IIppr.I....nt, .11(1wanc. or dlt.llowlnc. of d'ductlon., or ........nt of t.x (Including dl.count or Int.r'lt) a. .hown on thl. Hotloe ,u.t ubJlot within Ilxty (60) dlY. of r.c.lpt of thh Notlol bYI --wrltt.n prot..t to the PA aIP.rt..nt of Rlv.nue, Bo.rd of Appelll, OEPT, 211021, Hlrrilburg, PA 17121-1021, OR --IllatIon to hlvl the 'Ittlr dlt.r'lnld at .udlt of thl .uoovnt of the p.r.on.l r.pr...nt.llye, OR --IPPI.1 to the Orph.nl' Court, ADHIH IITRATlI'E C_CTlDHII Factu.' .rrorl dl.eaver.d on thl. ........nt .hould b. .ddr....d In writing tal PA D.p.rt..nt of R'v,nue, lur.to of Indlyldu.l TIX", ATTHI Po.t a.......ht Rlvl.w Unit, DEPT, 210601, H.rrt.burg, PA 1112'-0601 Phont ()17) 181-6505, S.. Pit. ] of the bookl.t "In.truotlonl for Inh.rltlno. Tlx Rlturn for I R..ld.nt Dlotdtnt" (REY-ISOl) for .n .xpl.nltlon of Idllnlltrltly.IV corr.ctlbl. Irrorl. If tRy tlX due I. p.ld wIthin thr.. e]) olllnd.r 10hth. aft.r the u.e.d.ntl, d..th, . flu. plrelnt (S~) dlloount of the tlX p.ld I. .llow.d, OIICOUIlT I IHTEMIT' Int.r..t I. chlrg.d b.glnnlng 'with flrlt d,v of d.llnqu.noy, or nln. (9) tonth. .nd ant (1) dlY frol the d.t. of d'lth, to the d.t. 0' p.v,tnt. Tlx.1 which bloa.. d.llnquent b.for. Jlnulry I, 1982 b..r Intlr..t .t the rlt. of IlK r6~) Plrc.nt per Innu. c.lcullt.d .t . dl'lv rete of .000164. All tlM.. which blau. dellnqulnt c..n .nd .fter Janulry 1, 19a2 will b'lr Intlr'lt at . rlt. which will v.ry fro. e'l.nd.r Yllr to e.l.ndar ~I.r with th.t tit. .nnounc.d bv the PA D.p.,t..nt of AaYlnIJ', Th. appllalbl. Intlr..t rat.. for 1982 through 199ft "11 '!.!!r Inter..t RIt. D.llv Int.r..t Flotor !!!r Int.r.,t Rlt. D.lly Int.r..t F.etcr 1912 lOX ,000&48 1916 lOX ,000174 1981 16X ,000\58 1917 9X ,000247 198\ IIX ,000501 1918-1991 llX ,000501 1918 UX .000556 1992 IX .0002\7 1995-199\ 7X .000192 "-Interllt II olleul.t.d I. follow" IHTnIlT . BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FAa. OR ....Any Notlc. 1..Uld Ift.r thl t.~ b,cOlJI delinquent will r.fl.ot In Int.r..t c.lcul.tlon to flft..n (11) dl~' btVond thl d.t, of the ........nt. If p.y..nt t. 'Id. aftlr th, Int.r..t ao.putltlon d.t. shown on thl Notlq., IdcUtlon.1 Interllt JU.t b. c.leul.ted, . , JRD/June 30, 1992/17858 REGISTER OF WILLS Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 NOTICE PURSUANT TO RULE 6.12 PENNSYLVANIA SUPREME COURT ORPHANS' COURT RULES ,To: Penonal Representative Counsel: MARK D. PERSUN. ESQ. REI Estate of MABEL 0 . FLUCK , Deceased, Late of CAMP HILL Estate NO,I 21.1994.066 DateofDecedent'sD~th: JANUARY 11. 192,L . Pursuant to Rule 6.12, the above named personal representative or the above named attorney, If applicable, within two (2) years of the decedent's death, and annually thereafter until administration Is completed, is required to flIe witl, the Register of Wills a Status Report as required by Rule 6.12, In substantially the prescribed form, showing the date by which the personal representative, or attorney, as applicable, reasonably believes administration will be completed. The purpose of this Notice Is to advise you that unless the requisite Status Report Is flied with the Register of Wills or Clerk of the Orphans' Court, as appropriate, within ten (10) calendar days after the date of this Notice that the Reglstor ofWlIIs Is required to DOtlfy the Orphw' Court Division, Court of Common Pleas of such delinquency and to request that said Court conduct a hearing to determine whether sanctions should be Imposed upon the delinquent penonal representative and the delinquent personal representative's counsel, If any. Accordingly, If the requisite Status Report Is not flied by FEBRUARY 29 ,19..2,pyou are hereby advised that a request will be submitted to the Court In accord!llcc with Rule 6.12. Date: FF.RRlJARV 1 'i, 1996t l ~Vll ) t1tU L(/) [JLyJU.tl..j- DiJtributlon to Estate File , , STATUS REPORT UNDER RULE 6.12 Name of Decedent I Mabel D. Fluck Date of Deathl 1-11-1994 Will No. 66 JJstatu of 1994 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 estatel 1. State whether administration of the estate is complete I Yes X No -- 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete I 3. If the answer to No. 1 is Yes, state the followingl 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 iSI 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. Datel 2- 20-96 Signature Mn,..lt n PQri'1R Name (Please type or print) f.... 158 Enst Main Stroot, Snmnr~nt, PA Address 15501 ( , (~J ( 814) 445-402L Tel, No. , , I Capac ity I Personal Representative X Counsel for personal representative f.: ,I III I ,r (MAH I rmf/ AM3) , ' ..",' i)' "".f \ . 1',\ " 1','4,;",1" 'j'.' , :1"1" ii.', ',' I t ~ \" ". ,I, " Ifl;;:i .L~ . Ii! 'II'" ':~; '.tq 1/'" 1 k ~~ II,',.., ~i:.ril ,...1 ;}\;;l ~':'l ' '.r.~ (ii'" ' l' 'I ,Iil.j: .1;,.. '1"1 i I . -H~,~h\~:i'lv'~ ~,"-,'-IJ"':i'lal'l'!'~jt'/""~I..' ",'.." .<#'....,.;.....~~'....\....... "....",..' .......... \ .' ",. ' ',' " , ,: " " \' ':, '.' "l' ',.1 , , , 'I , ' / Y, I' " "I ,!' , ~h,\ )' "" ... ~ ",-' ,. , ,. I ' ,''',j'''<i,;.~':,Ml!llVji'~\,&~.",#;\1'f!'W.1 li,*^lIl !1IWtfi)(fN', "",~'jt.j;,tll,,,,;~'t1''''i'}11!.,''';<'f1 .-".t'.,\" Mark D. Persun ATI'ORNBY AT LAW 168 BAST MAIN STRBB1' SOMERSET, PBNNS~V~!~r~~6e)~r,~~f.~1 Ii ..........~ - ....-I'f~.,.."ft........ ,."....-'.'.I',,,_....,~..,f'........,, -- ,...,............",....,...t'...,.,.,. ...""'''~'" . '......",...."'... ~-.......,~,~.,'t,....~ ..--.,~~;,.,.,.."~. ~ '~'".\ \i!ll}\, I " C\li' CUlII" n\ri, , l\l\ Register of Will. Attention: Cheryl One Courthouse Square Ca~lisle. PA 17013 " . , ,I 1'?013-33Q2 02 111111I1111111111111111111111111111111111111111I11111111.111111 , .~----_.".""'-'"''''''-">!~''''~W'jI_'''~l~~~liW.'''t",,,,~'fo'''''''''~''~''''I'''..~ "....-.'..".- " .-'..-.............-r.,- , , 'I . , !.' l' ,,;\ \ , 'il \ .; 1'1' ~ I'.. " ',1" , ..I '1'1' ." , . 'I Ji;.;i , 'I' , , 1"'1 ". If, " '~ ,\ , , " " . ""'1' .'1 '"J " " " " ;'d\ ';, , 'i. " ", " I, I I'.. .~' , 'f' 't',,, .......,. , -,""" . . ! I ! ".\ \ '\ .. ! ! I Ir-' "I " ''tl'' ," 'I"" , " . ~ "I. " .' " " I l," ,t' " , " ", I, ,! ,< ",' I, " .' 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" lomt Oalo I 04/06.194 YOllIFIlOn&NumbortVI/ylmponanH III tt-f'l/~ )...f,' t' l) ) OepartmenllFloor No !l')f.jl,rlb:'ll' D!' \'/U1:1 Companv' Cllm~l~rl'lf\rl COllllt.y l'r.:<urt H(Ju~f1 ellle\ 51!ootAfldrott IWf CIMC/Ofllrfl/OPO B~ltJ 0/ PO lip CodH) RECIPIENT" COPY o (Aoclp1en1't N,ln1e) Pilla_II Print nt<1-".n!'PMM'I\jfl\t"'I".ry(lI'pot1.~1I I '/17) 240-(,345 DllpartmonVFlC'OfNo, MI\ 0, PCIl:SUl\ Compnny ~IJ~It:ll S t' 1 H~l!!, T Cl/Tii U)f (It.;' r SlfOlllAddross 1.:<.\ rip" 1 'A III ,I 1 OI\lr.t Ibll8tl :}./u~to Clly Slalo C"y 51alo 1'1\ liP Roqllited 1 ~I I r (I 1 $ i:li'H: K ~ I. T !L- ) IF HOLD lOR PICK,UP, Print FEDfA' Add,," HI" Slroo\ AtldI059 YOUR INIlRNAt Iflt I INO RfFfRfNC~ INFORMATION (OP/IM,I) (FIIJ/ 14 CNr,clllJ ,,11I 'PPJlf on InrolcI.j ZIPAequlled Fll'iJo1f,llbpfelllJ$O BHOCnMllfl\ 1..__ t)CCIMlJlIV~'UlJCIWg8 I. 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