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PETITION FOI{ PRonATE and GI{ANT OF LETTERS
No. ~I- 94- g7()
To:
t
Estate of II" r 1>" r L
also known as
.J. Slorbuck
Regisler of Wills for the
, Deceased. County of cuml",rlan<l In the
Sodal Se"'lrlty No. 091l-01-00l <1 Commonwealth of Pennsylvania
The pelltlon of Ihe undersigned respectfully represenls that:
Your petltioner(s), who is/are 18 years of age or older an the executrix
In the last will of the abovedecedelll, datcd F..IJrll,lrV 77.
and codlcll(s) dOled
namcd
.19~
("ale relevanl ciu:llmilanccl. e.l. renunciation, lJeoalh or neculor, ClC.)
Decendent was domiciled at death In Cumberland County, Pennsylvania. with
~ is last family or principal residence at 540 Ilr"ntwater Iload
Camp lIi11
(IIn IUeel. number and muncip.lily)
Decendent,lhen 70 years of age, died Sopteml>or 9 ,19 9<1
ot Blue RidC1e lIavon WOHl. gaRt Pfmnshoro. PA 1
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 estlmaled values as follows:
(If domiciled In Pa.) All personal property
(If not domiciled In Pa.) Personal properlY In Pennsylvania
(If not domiciled In Po.) Personal properlY In CoulllY
Value of real estate In Pennsylvania
situated as follows:
$ 100.000.00
$
$
$
WHEREFORE, pelltloner(s) respectfully requesl(s) the probate of the last will and codlcil(s)
presented herewith and the grant of letters Tpst amontarv
(Icltamenlllry. adminluratlon c.I.a.; admlnil1rallon d.b.n.c.I.D.)
Iheron.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA }'S
COUNTY OF ~
No 21-94-B70
.
Estate of
Herbert J. Storbeck
I Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW OCTOBER 14. 19..!i...., In eonslderalion of the petition on
the reverse side hereof. satisfactory proof having been presented before me,
IT IS DECREED that the Instrument(s) dated February 22, 1994
described therein be admlned to probate and n1ed of record as Ihe last will of
. Herbert J. Storbeck
and Letters Testamentary
arc hereby granted to Dorothy E. Storbeck
'i7;fl~(I (~"'!.~ /'),'~. (Ut. .'JG/..tiAL( lbptd;;
RCII"', of Will. I
FEES
Richard R. Lefever #7208
ATTORNEY ISup. CI. 1.0. No.)
McNees, Wallace & Nurick
1nn P;no ~rr~~r. P n Rnv 1166
.
ADDRESS
Harrisburg, PA 17108
PHONE
200.00
IB.OO
18.00
5.00
241. 00
Probate, Leners, Etc. ......... $
Short Certlficates( 6) ...... . . .. $
RWIHllilIKlIKXlC. .fi .le. .PAGllS. " $
JCP $
TOTAL _ S
Filed 9.C.WIW\.I~/..m~.... ........ ....
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MAILED LETTERS AND ORDERS TO ATTORNEY OCTOBER 14. 1994
21-94-0870
Thb i~ (0 n:rtil)' 111011 ,lil' inforlll,lIitlll tWit: ~iH'1I i.. (utlt'lclr wpic.d hOll1 .1I111riJ.:IIl.i1 (l'lIifjf.llt' III dl'.uh dill)' filed wilh 1Ill' ItS
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11111....,.101\ -'"
WARNING: Ills 1II0gal to dupllcato this copy by pholostat or photograph.
Fl'c (ur chb ll'l"tirk.IIl', $2.00
2513407
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SEP \ 2. \994
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CO....ONWEALTH OF PENNSYLVANIA. DEPART"ENT OF HEALTH' VITAL RECORDS
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1-18-94
Qf
liIl.W
HERBERT J. STORBECK
I, HERBERT J. STORBECK, presently of Cumberland County,
Pennsylvania, declare this to be my will and hereby revoke all
prior wills and codicils made by me,
1. Tanqible Personal ProDertv. I bequeath such items of
my tangible personal property as are specifically itemized on a
list, if any, in my handwriting, signed and dated by me at the
end thereof, and attached to this, my Will, to the person(s)
named thereupon to receive such items, and all of my remaining
tangible personal property not used in business or for the
production of income, including, without limitation, furniture,
furnishings, clothing, jewelry, objects of art and decoration,
and the like, and any motor vehicles which I own, together with
the insurance thereon, I bequeath to my wife, Dorothy E.
Storbeck, if she survives me, and if my wife does not survive me,
I bequeath such property equally among my children. If anyone
of my children does not survive me, his or her share shall be
distributed per stirpes among those of his or her issue who
survive me. If there are no such issue, said property shall go
to my other children, or if anyone of my other children is not
then living, shall be distributed per stirpes among those of his
or her issue who survive me. with regard to the property passing
hereunder, distribution shall be made among my children on the
basis of choices made in order determined by lot and by rotation,
and the values as finally determined for federal estate tax
purposes shall be determinative with regard to the values of the
property chosen, and any ultimate disparity among my children
shall be equalled by such payments among them as may be
necessary. If anyone of my children is not then living, the
choices to which he or she would have been entitled shall be made
by his or her issue in order determined by lot and by rotation.
2. Residue. I bequeath, devise, and appoint all the rest
of my property, of whatever nature and wherever situated,
including property over which I hold a power of appointment
(except that I do not exercise any power of appointment given to
me by my wife), to the then Trustee(s) under an Estate Plan
Agreement of Trust executed by me as Settlor thereof on
February 22 , 1994, to be held by said Trustee(s) and added
to and administered as part of the trust established by said
Agreement. Said trust is in existence as of the date of
execution of this will, and it is my intention, if necessary to
validate the foregoing gift to the Trustee(s), to incorporate
herein by reference its terms and any amendments thereto.
3. Survival. If my wife and I should die under such
circumstances that it cannot be determined which of us survived,
my wife shall be deemed to have survived me for all purposes
hereunder. If any other beneficiary should die within sixty (60)
days after me, he or she shall be deemed to have predeceased me
for all purposes of this will.
4. Scendthrift Clause. No interest (whether in income or
principal, whether or not a remainder interest, and whether
vested or contingent) of any beneficiary hereunder shall be
subject to anticipation, pledge, assignment, sale or transfer in
any manner, nor shall any beneficiary have power in any manner to
charge or encumber his or her said interest, nor shall the said
interest of any beneficiary be liable or subject in any manner
while in the possession of my fiduciaries for any liability of
such beneficiary, whether such liability arises from his or her
debts, contracts, torts, or other engagements of any type.
5. Facilitv of Pavment for Minors or Incomcetents. Any
amounts or assets which are payable or distributable to a minor
or incompetent hereunder may, at the discretion of my
fiduciaries, be paid or distributed to the parent or guardian of
such minor or incompetent, to the person with whom such minor or
incompetent resides, or directly to such minor or incompetent, or
may be applied for the use or benefit of such minor or
incompetent.
6. Powers. In addition to such other powers and duties as
may be granted elsewhere herein or which may be granted by law,
my fiduciaries hereunder shall have the follo\~ing powers and
duties, without the necessity of notice to or ~onsent of any
court:
(a) To retain all or any part of my property, real or
personal, in the form in which it may be held at the time of its
receipt, including any closely held business in which I have an
interest and the stock of any corporate fiduciary hereunder, as
long as in the exercise of their discretion it may be advisable
so to do, notwithstanding that said property may not be of a
character authorized by law,
(b) To invest and reinvest any funds held hereunder in
any property, real or personal, inclUding, but not by way of
limitation, bonds, preferred stocks, common stocks and other
securities of domestic or foreign corporations or investment
trusts, mortgages or mortgage participations, mutual funds with
or without sales or redemption charges, and common trust funds,
- 2 -
,
even though such property would not be considered appropriate or
legal for a fiduciary apart from this provision,
(c) To sell, convey, exchange, partition, give options
to buy or lease upon, or otherwise dispose of any property, real
or personal, at the time held by them, at public or private sale
or otherwise, for cash or other consideration or on credit, and
upon such terms and for such price as they may determine, and to
convey such property free of all trusts.
(d) To borrow money from any person, including any
fiduciary hereunder, for any purpose in connection with the
administration hereof, to execute promissory notes or other
obligations for amounts so borrowed, to secure the payments of
such amounts by mortgages or pledges of any property, real or
personal, which may be held hereunder.
(e) To make loans, secured or unsecured, in such
amounts, upon such terms, at such rates of interest, anu to such
persons, firms, or corporations as they may deem advisable.
(f) To renew or extend the time for payment of any
Obligation, secured or unsecured, payable to or by them as
fiduciaries, for as long a period or periods of time and on such
terms, as they may determine, and to adjust, settle, and
arbitrate claims or demands in favor of or against them.
(g) In dividing or distributing any property, real or
personal, included herein, to divide or distribute in cash, in
kind, or partly in cash and partly in kind.
(h) without limitation of powers elsewhere granted
therein, to hold, manage and develop any real estate which may be
held by them at any time, to mortgage any such property in such
amounts and on such terms as they may deem advisable, to lease
any such property for such term or terms and upon such conditions
and rentals as they may deem advisable, whether or not the term
of any such lease shall exceed the period permitted by law or the
probable period of retention under this instrument; to make
repairs, replacements and improvements, structural or otherwise,
in connection with any such property, to abandon any such
property which they may deem to be worthless or not of sufficient
value to warrant keeping or protecting, and to permit any such
property to be lost by tax sale or any other proceedings.
(i) To employ such brokers, banks, custodians,
investment counsel, attorneys, and other agents, and to delegate
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7. Taxes. 1 direct that all estate, inheritance, and
succession taxes that may be assessed in consequence of my death,
to them such duties, rights and powers as they may determine, and
for such periods as they think fit,
(j) To register any securities at any time in their
own names, in their names as fiduciary, or in the names of
nominees, with or without indicating the trust character of the
securities so registered.
(k) with respect to any securities forming a part of
the trust, to vote upon any proposition or election at any
meeting of the corporation issuing such securities, and to grant
proxies, discretionary or otherwise, to vote at any such meeting;
to join or become a party to any reorganization, readjustment,
merger, voting trust, consolidation or exchange, and to deposit
any such securities with any committee, depository, trustee or
otherwise, and to payout of the assets held hereunder, any fees,
expenses and assessments incurred in connection therewith, to
exercise conversion, subscription or other rights, and to receive
or hold any new securities issued as a result of any such
reorganization, readjustment, merger, voting trust,
consolidation, exchange or exercise of conversion, subscription
or other rights and generally to take all action with respect to
any such securities as could be taken by the absolute owner
thereof.
(1) To engage in sales, leases, loans, and other
transactions with the estate of my wife or any trust established
by either of us, even if they are fiduciaries or beneficiaries
thereof.
(m) To exercise all elections which they may have with
respect to income, gift, estate, inheritance and other taxes,
inclUding without limitation execution of joint income tax
returns, election to deduct expenses in computing one tax or
another, election to split gifts, and election to payor to defer
payment of any tax, in all events without their being bound to
require contribution from any other person.
(n) To operate, own, or develop any business or
property held hereunder in any form, including without limitation
sole proprietorship, limited or general partnership, corporation,
association, tenancy in common, condominium, or any other,
whether or not they have restricted or no management rights, as
they in their discretion think best.
- 4 -
.._.~ .- _ -,..,- .-.~ ...<
of whatever nature and by whatever jurisdiction imposed, shall be
paid out of the principal of my probate estate to the same effect
as if said taxes were expenses of administration, except that any
such taxes (and interest and penalties thereon) imposed on
account of my interest in or power over any trust established by
my wife, shall be paid out of the property held in such trust,
and all other property includable in my taxable estate for
federal or state tax purposes, whether or not passing under this
will, shall be free and clear thereof; provided, however, that my
executor(s) may in the discretion of my executor(s) request that
any portion or all of said taxes (to be paid out of the principal
of my general estate) shall instead be paid out of the principal
of any trust established by me, to the extent expressly
authorized under the terms of said trust.
B. Gender and Pluralitv. Unless the context indicates
otherwise, any use of either gender herein shall also include the
other gender, and the singular shall include the plural, and vice
versa.
9. Fiduciaries. I appoint my spouse as fiduciary
hereunder. If ever my spouse is unable or unwilling so to serve
or to continue so serving, I appoint my children to serve as the
fiduciary(s) hereunder, and if any of my children is unable or
unwilling so to serve, or to continue so serving, no successor
shall be appointed to serve in his or her place.
My fiduciary(s) hereunder shall serve as guardian(s) of the
property of any minor beneficiaries hereunder, under any
instrument of trust executed by me, under any pOlicies of
insurance on my life, and in any other situation in which the
power to make such appointment exists under the laws of
Pennsylvania.
No individual fiduciary shall be liable for the acts,
omissions or defaults of any agent appointed and retained with
due care or of any co-fiduciary.
No fiduciary named herein shall be required to furnish bond
or other security for the proper performance of his duties
hereunder.
IN WITNESS WHEREOF, I, HERBERT J. STORBECK, herewith set my
hand to this, my last Will, typewritten on seven (7) sheets of
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paper including the self-proving attestation clause and
signatures of witnesses, this 22nd day of February , 1994,
A .f.t ~.i'~_t'u .LSEAL)
HERBER ORBECK;If:
Witnessed:
~~
residing at j~II"'I,J,n, ~ A-
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residing at t~, Po.
residing at {t tlA1tf/ /rltiJ, jJ /J
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF .li)u..PH I tl
ss:
(the testator), ~;d~CtrC'l (( ),.e~ve'f ,
o '....Abt , and ("'(Ht'\1 4. k~/)'\.lf"'"'''''''''' (the
tnesses), whose na es are signed to the fore ng nstrument,
being first duly sworn, each hereby declares to the undersigned
authority that the testator signed and executed the instrument as
his last will in the presence of the witnesses and that he had
signed willingly, and that he executed it as his free and
voluntary act for the purposes therein expressed, and that each
of the witnesses, in the presence and hearing of the testator,
signed the will as witness and that to the best of his or her
knowledge the testator was at that time eighteen years of age or
older, of sound mind and under no constraint or undue influence.
WITNESS
TESTATOR:
~,Q} ~.o ~O'I'
1~u-~c0vc. .;
HERBERT J. ORBECK "-, <;:
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WITNESS I WITNESS I
~>.. ~tl C.,B'It. t!W'".1'''M-
Subscribed, sworn to'-and Ilcknowledqed before me by HERBERT J.
S ORBECK, the tee Iltor, and e~beoribad nd sworn before me by
. 1"- (' '. ,J., -, , anpl
a w naasas, s aof day
, 1 94.
(SEAL)
No~'II1lII Seal
Knhyl).l, ""tor, II\""~
fjJ',"Woll\),l>"'JJin
MyCon"'''''''Jlli~)n)bJ"n. ,1000
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Herbert J. storbeck
Date of Death: September 9, 1994
Will No.:
1994-0870
Admin. No.:
To the Register:
r certify that notice of beneficial interest required by
RUle 5.6(a) of the Orphans' Court Rules was served on or mailed
to the following beneficiaries of the above-captioned estate on
November 1, 1994:
1:isInf!
Mrs. Dorothy E, Storbeck
Mr. Richard J. Storbeck
Address
540 Brentwater Road
Camp Hill, PA 17011
2830 Sunset Drive
Camp Hill, PA 17011
92 Sampson Road
Bolton, MA 01740
997 Wayfield Drive
Jeffersonville, PA 19403
Ms. Susan L. Storbeck
Mr. Ronald Storbeck
Notice has now been given to all persons entitled thereto under
RUle 5.6(a) except
Date: November 1, 1994
Si9n~QJ ~'M
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Name: Richard R. Lefever,Esquire
Address: MCNees, Wallace & Nurick
100 pine Street
Harrisburg, PA 17101
Telephone: (717) 237-5222
Capacity: Personal Representative
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Counsel for personal
representative
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
~~ '7 tl~iZ M/ //0 .jy'"
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Dorothy E. Storbeck
being duly
sworn
.ecardln9 la I.w, dopa"l ...d UY' Ih.t file is the Executrix
al Ihe Ellote al Herbert J. Storbeck
lale al ~1!.~!:~~!l!1sbo..!_9..:r(),wnBhip' , Cumberland Caunly, Po., decealed and that thl
within il on Invenlary mode by Dorothy E. Storbeck , Ihe sold Executrix
01 Ih. entire IIt.le al uld dleed.nt, eanlllllnq al .11 Iho p.llanal prap.rty .nd real estale, except r.al .stal. outside
th. Cammanwullh al Pennlylv.nl., and th.I Ihe flgurOl appasltl eaeh Item 01 the Inventary represent it', fair valul
.s al the d.I. al d.cedont's death,
/),>"t\th~ C SIlIl'l)l( It. end-Iublcrlb.d bo/are mo,
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ucutor . ~J4HU"K
McNees, Wa ace & Nurick
P.O. Box 11 66
H~rri~hl1rQ. PA
1710R-1166
Addr...
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September
Month
1994
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INSTRUCTIONS 's
I. An Invlntary must bl IIIld within thru manlh. .Iter appalnlment of perianal rlprOlenhll~.
2, A suppllm.nt Invenlary musl bo lIIed within thirty daYI af dlleavory af addltlan~L.a...h. [)l
3, Addltlon.1 sh..h m.y b. ellach.d as la porsanally ar really ~1
li
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\.
Inventory of the real amI p,.rsonal eslate of
Herbert J. Storbeck
deceased
912.400 shs MFS Municipal Bond Fund A 9,680 56
Dividend accrued to date of death on above item 4 56
Note Receivable from Richard J. Storbeck 33,500 00
PA Department of Revenue - 1994 income tax refund 38 00
43,223 12
I~. (}.,/O '1
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
~;/ b.t-PI ~3P'
. REV-liDO EX. 17-114) 0
. CCMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT.210eOI
HARRISBURG, PA "'2Iaoeo,
14, Nol Valuo Sub oct to T.. (Uno 12 minus Uno 13)
15. Spou..ITrln.t.'lllof da'.. at dulh .U" 8a:lO-1I4). S..
Inl'ruetlcn. taf Appllcablt perunlag. an PAg, 2. (I"clud.
vllu.. tram Schldul. KG' Schedul. M.I
10, Amount of Uno 14t..oblo DIll"" roto
(Includo valuos from Schodulo K or Schodulo M,)
17, Amount 01 Uno 141..oblo ot 1~'" rote
(Includo valuos from Schodulo K or Schodulo M,)
TAX 10, Prlnclpal t.. duo (Add t.. from Unoo 1~, 10 ond 17,)
COMPUTA.. 10. Crodlts Spau..IPo.....'lyCr.dlt Prior Paymonlo Olocou"t
TIOH + 5,130.00+ 270,00-
20. If Uno 19 Is roator than Uno 18, onlor Iho dllloronco on Uno 20. This 191ho OVERPAYMENT.
!Aj' ct'il\clfl1ii1fi'lt: OQ~_." ueiU,r '"lfretund"of'" ulbYe' ." entlll:iil!lii~llil:!IlI'1l111 ,!.ill
21, If Uno 181s groator than Uno 19. ontor tho dllforonco on Uno 21. This 191ho TAX DUE.
A. Enlor lho IntorDSI on tho balanco duo on Uno 21A,
B, Enlor tho total of Uno 21 ond 21A on Uno 21B, Thlslolho BALANCE DUE,
Make Check Pa able to: Re later 0' Willa, A ent
Iii i 111111 11I1 I i II II i'illliillilli IliI!I....:'II""IBE'SURE::rOANSWERIAU:'QUEBnOHSON PAGE'2'AND,roRECHEClCMA"11II~::IIiI:""'11 i!: Ii illilblllili'IIII'lilliiii,III!I,I,:1111
Hi,!;
n or pon 0 per ury, are t at avo Ole no I s roturn, nc u ng Dccompnny ng DC 10 U 09 Dn 8talomenll, an 10 tOIl 0 ff1Y no 0 go
and belle" h II true. conOic1and comploto. I doclaro that all rool 09talo has boon roportod al truo malkot valuo. Doclaratlon of proparer othor lhan tho pOfoonal
reprosontaUVo Is basad on a1llnfofmatlon of which preparer has anv knowfodgo.
ISI TUREOFPER~NRE8 N IBLEFORFI INORnURN ADDRESS OAT!. / / ___
, <:!o'. 'h--Lt-lr See Schedule attached ~ t.l. J' 'i J
TURE PREPARE? THE THAN REPREGENTATlVE ADDRESS
~- \ l Q...p
NTF 111111
DECEDENT
CHECK
APPRO-
PRIATE
BLOCKS
CORRES-
PONDENT
RECAPIT -
ULATION
-} Ii'
FOR DATES OF DEATIl AFTER \2131/9\
CHECK HERE fF A SPOUSAL
POVERTY CREDIT 15 CLAIMED
FILE NUMBER
21 1994
COUNTY CODE YEAR
DECEDENrS COMPLETE ADDRESS
540 Brentwater Road
Camp Hill, PA 17011
09 09 94 08 02 1916 Counl CUmberland
SOCfAL SECURITY NUMBER AMOUNT RECEIVED (SEE INSTRUCTIONS)
100-18-2942 160 425.62
2. Supplomonlal Ruturn 3. RomaIndor Return
(fordaleulde.thprlortoU.1J.U)
o 6. Fedoral Estalo Tit)( Return Required
0870
NUMBER
DECEDENrs NAME (LAST, FIRST, AND MIDDLE INITIAL)
storbeck Herbert J.
SOCIAL SECURITY NUMBER
098-01-0014
I VI I
lAST AND MID LE INIfIALI
storbeck Doroth E.
\, Orlglnal Roturn
.
o 4, Umllod Eslolo
HI 40, Futuro Inlorosl Compromlso
(for dalos 01 dOOlh o"or 12-12-02)
~ 6. Docedent Dlod Toslato 0 7, Docedonl Malntalnod a Uvlng Trust
(AUach copy nf Will) (AUoch copy 01 Truot)
B~DE~E!ANDCDNFIDENTlAL!TAXIHFDRMATlOH BHOUUlBE DIRECTECl,TOli''!'ilI,'i!iliIIHill' 1IHlli,iiUlli I 111!Ii lilli'
COMPLETE MAILING ADDRESS
100 pine street
Harrisburg, PA 17101
O. Tolal Number of Solo Dopooll Boxoa
r "II
i1lliiillili!ili,!llililiIHI!!!i
NAME
Richard R. Iefever
TELEPHONE NUMBER
717-237-5222
1, Roal Estoto (Schodulo A)
2, Stocks ond Bond. (Schodulo B)
3, Cloooly Hold SlockJPorInorshlp Inlorosl (Sch, C)
4, Mortgogos ond Notos Recolvoblo (Schodulo D)
e. Cash, Bank Doposlts & Mlscellanoous Porsonal
Proporty (SChodulo E)
0, Jointly Ownod Proporty (Schodulo F)
7, Tronsfo,. (Schodufo G) (Schodulo L)
0, Tolal Gross Assol. (lotal Unos1-7)
9, Funoral Expenses. Adrrinlstrallve Costs,
MI.colloneous Expon.o. (Schodulo H)
10, DobIS, Mortgogo Uoblllllos, Uons (Schodulo I)
11, Total Doductlons (totol Uno. 0 & 10)
12, Not Valuo of Estato (Uno 0 minus Uno 11)
13, Chorl1oblo and Govornmontal Boquo.l. (Schod"lo J)
.J'"
,I
"
..,
,
,
. I IJ
...
203,648.74
10,133.66
193,515.08
(15)
(14)
193, S-lS-;08 x.Q!. .
193,515.08
5,805_~~S.,
(\6)
,06 .
(17)
0.00 x ,16 .
0.00
(10)
6,798.14
Inloronl
(19)
(20)
5,805.45
(21)
(2M)
(21B)
405.45
0.00
-'105.45
Copyright Fo"n, Software Only, 111I4 Nelco,lnc. NII4PAOOt
McN~ES, WALLACE & NURIGi<
ox
H"o'l ,- P^." 'r"
~ld5 JL.ID. Ill..
DAft
S,.l.3 /9."5
,
EBtate of: Herbert J. storbeck
21-1994-0870
'lhe followirg persons are signirg the return as representatives of the estatel
Dorothy E. storbeck
540 Brentwater Road
Canp Hill, PA 17011
PA REV-lIl00 EX (7-94) Plge 2
Act 1148 of 1994 provldee for Ihe reduction of Ihe lax rales Impoaed on Ihe nal value of Iranafera 10 or for Ihe uae of
, the apou... The ralaa .. prascrlbed by the alalule will be:
. 3% (.03) will be appllcabla for eslal.. of decedenla dying on or after 711/94 and bafore 1/1/96
. 2% (.02) will be applicable for ealalaa of decedenla dying on or after 1/1/96 and before 111107
. 1% (.01) will be eppllcable for ..Ial.. of decedenls dying on or after 1/1/07 and before 1/1/08
· Spouaallransfara occurring on or after 1/1/98 will be exempl from Inherllance lax.
PLEASE ANSWER THE FOllOWING QUESTIONS
BY PLACING A CHECK MARK (oJ) IN THE APPROPRIATE BLOCKS.
YES NO
1, Old decedent malee I trlnsler Ind:
L relalntheu80orlncorneoltheproportytranaferred,......., t........ 0".. ..,........, '.................. .".....,.. X
b. relaln the r1ght to d981gnatowho ehall use tho propertytransfoood or Its IncomD.. . t..... 0..'.1.'.............. ............ X
o. retain a reveraJonary Interest: or. , . . . . . . . . . . . . . . . . . . . , . . , . . . . , . . . . . . . . . . . . . . . . . . , . . , . , . . . . . . . . . . . , . . , . . . .
. . , . . , . X
d. receive the promse for Ufe of ellhot payments, benoflts or care?..... . . ,.. .. , .... ,. 1".""". . ...,...... .... ........ . X
2, "death occurred on or belor. December 12, 1992, did docedent within two years procodlng death transfer propeny without rocelvlng
adequate consideration? If deeth occurred aher Docember 12, 1982, did docedentlransfer propeny within one year 01 deeth without
receiving adequate con8lderatlon?................,...,.",..............,.........,........,., ,.,..,............ X
3, Old decedent own en 'Intrus1fo( blnkaccounlat his or hor de.th?, ",."""""",.,.".."",.,.""."",.""""" 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.
PAl5002 NT'....
Cop)'l"llIhl Fa,,", Saflwa,. Onl~1 tll1l4 N.lca,lnc. NlI4PA002
~.ff-q;o.f""'i.\.",.~,,,....,,..~..,,,.,;,
RIV..taDI EX. C.-II.
COMMONWEALTH OF PENNaVLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS AND BONDS
ESTATE OF
FILE NUMBER
Herbert J. storbeck
(AU ....-tv !olnUy-owned with Righi 01 Survlvorahlp muat be cIIacloaad on Schadula F,)
ITEM
NO,
21-1994-0870
DESCRIPTION
VALUE AT DATE
OF DEATH
1 912.400 shs MF'S Municipal Booo F\1nd - A
Dividen:l accrued to elate of death
9,680.56
4.56
TOTAL Also .ntor on IIno 2, Roca lIulaUon
(II mora apaeol. noedod, Insert addlUonalahoeta olssma slzo,)
s
9 685.12
PA1&031 NTF ,m
Copyright Form. SOIlWIII Onl)', 1111. N.lco, lnc. NII.PA031
.....I"'io~i"--'.".>L"h',;.,"'..'2L<'~'__, _.,.,<:.";_'.
REV..1IOI U. (1,,17)
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
J
'COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Herbert J. storbeck
AU oln -ownod wI1h tho RI t 01 Survlvorohl must bo dloclosod on Schoduls
ITEM
NO.
PIGue PrInt or Typo
FILE NUMBER
21-1994-0870
VALUE AT
DATE OF DEATH
DESCRIPTIDN
1 Loan J\dvanceIreIlt to Ridlard J. storbeck
2 Pa. Dept. of RevenUe - 1994 incane tax refurxl
3 9,50G.352 shs Franklin Olstodian F\Inds, Inc.; Inoane Series; IRA
ale #90211960302
Beneficiary: Dorothy E. storbeck, survivirg spouse
4 Meridian Bank IRA Certificate of Deposit #3213647401
Beneficiary: Dorothy E. storbeck, survivirg spouse
Interest aocrued to date of death
5 Meridian Bank IRA Certificate of Deposit #3213562311
Beneficiary: Dorothy E. storbeck, survivirg spouse
Interest acx:rued to date of death
33,500.00
38.00
21,009,04
20,308.96
11. 13
27,411.02
160.70
TOTAL Also onlor cn Ilno e, Roco Itulolton $
(Ansch oddltJonal81/2:' x 11" shoot. II moro spaco I. needod,)
102 438.85
PA15011 NTF ",_
Copyright Form. Softwar. Onl)', 1114 N,leo,lnc. NI4PAO.t
REV-lDlO EX . (2-87)
.cOMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE G
TRANSFERS
PLEASE PRINT OR lYPE
FILE NUMBER
Herbert J. storbeck 21-1994-0870
TlIIS SCH. MUST BE COMPL.ETED & FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OF COVER SHEET IS YES,
DESCRIPTION OF PROPERlY DECO, DOtLAR VALUE
ITEM Include nemo 01 tho .onslor.., thol, EXCLUSION TOTAL VALUE % OF DECEDENrs
NO, rolatlonatil~-to docodont, date 01 .analor, OF ASSET INT. INTEREST
1 alio state Life Insurance Co. 62,471.67
policy 10903602. ~.."lt was the
owner, Dorothy E. storbeck,
surviving spwse is the narned
beneficiary. Policy was a single
premium annuity to begin at age 80
2 AIG Life Insurance O:rlpany policy 29,053.10
1Sl'8345056. Decedent was the
owner, Dorothy E. storbeck,
surviving spwse is the narned
beneficiary . Policy was a single
premium deferred annuity.
TOTAL 'Also onto, on Ilno 7, Rocanltulation\ $ 91 524.77
(II moro spaco Is noodod,lnsort oddltlonalshoot. of .arno alla,)
PA15l01
NTF U17A
Copyrlght Fo,"" SDttwAr. Only, 11114 N,tcD,lnc. NI4PA101
"_"'''''-'''''"d'J~_
REV"lIn Elhl7.1I1
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RUIDENT DECEDENT
Pl.... Prlnl or Typ.
FILE NUMBER
21-1994-0870
ESTAT1! OF
Herbert J. storbeck
ITEM
NO.
A. Fun<<all!lcpen"':
DESCRtPTION
AMOUNT
1 Myers-Harner F\lneral Hare
2 Gigante - funeral luncheon
5,416.00
369.02
B, AdmtnlalnUv. eoata:
1,
P....,nal RopraaontaUvo COmmissions
Social Socurlty Numbe, 01 P....,nal Rop,oeentoUvo:
Vo., COmmlsslono paid
0.00
2, Attorney F....
3,500.00
3, Farrily Exo~tIon
Claimant
Add,... 01 Claimant 01 docedonra dooth
SUoot Add,...
0.00
RolaUonshlp
City
State
ZIp Codo
4, Probato F..s
241.00
C. M_lIanaoua Expen...:
1 C\lmberlard law Journal - Legal advertising 40.00
2 'lhe Sentinel - legal advertising 64.64
3 ~ees, Wallace & Nurick - reiml:ursernent for miscellaneous 75.00
expenses
4 Register of Wills of CUmberlard county - fee to file PA 15.00
Inheritance Tax Return
5 Register of Wills of CUmberlard county - fee to file Inventory 10.00
TOTAL Also onto, on IIno 9, Rocs Itulsllon $
(II mora apace la naadad, Insart addlUonol ahaata 01 uma olre,)
9 730.66
PAI&ll1 NTF..II
Cop)':I"ht Form. SOIlWA'. Only, '''4 Naleo, Inc, N84PAtt I
,
.~,~.~~.~\ .)~'J'?;.r~':t~~~.
RIV-tI1Z U.CIIUJ
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RITURN
RISIDENT DECIDINT
SCHEDULE I
DEBTS OF DECEDENT.
MORTGAGE LIABILITIES AND LIENS
Pi.... Pltnl 0'
FILE NUMBER
21-1994-0870
I!STAT1! OF
Herbert: J. storbeck
IT1!M
NO.
DESCRIPTION
AMOUNT
1 Internal Revenue Service - 1/2 share of 1994 incane tax
liability
403.00
TOTAL Also enter on line 10, Roca hulaUon
(II more space I. needed, Insert addltJonalsheeta of same Bize,)
s
403.00
PA15121
NTF 2110
Copyright Form, Softw.,. Onl~, tl1l4 N.lco,lnc. NII4PA1Z1
ftIV-tl1' EX .12."1
COMMONWEALTH OF PENNSYLVANIA
, INHERITAHCI! TAX RETURN
RESIDENT DECEDENT
ESTA'Il! OF
SCHEDULE J
BENEFICIARIES
Herbert J.
ITEM
NO.
storbeck
NAME AND ADDRESS OF BENEFICIARY
A. T..ablo Boquo,ta:
1 Dorothy E. storbeck
540 Brentwater Road
camp Hill, PA 17011
2 Trustees Under Fstate Plan Deed of
ITEM
NO.
NAME AND ADDRESS OF BENEFICIARY
B, Charltablo and Govolllmontal Boquosta:
None
FII.E NUMBER
RELATIONSHIP
21-1994-0870
AMOUNT OR
BHARE OF EBTATE
surviv!n;J spouse
160,425.62
Trustees
33,089.46
AMOUNT OR
SHARE OF ESTATE
TOTAL CHARITABI.E AND GOVERNMENTAL BEQUESTS Also ontor on IIno 13, Roco Ilulollon
(II more aplC' I. n..ded, Ina.rt addIUonll.h..llI 01 slme sl..)
s
0.00
PA15t31 NT' 12'"
Copyright Form. Soflw." Only, 11114 Neleo, Inc. Ng4PA 1:S 1
ioA''',1<:C...'-'
-',-
REV-1114 Ut13.1121
SCHEDULE K
LIFE ESTATE/ANNUITYI
TERM CERTAIN
COMMONWEALTH OF PENNSVLVANIA
INHERITANCE TAX RETURN
RESIOENTDECEOENT
ESTATE OF IFILE NUMBER
Herbert J. storbeck 21-1994-0870
ThIs BChodulo 19 to bo usod for all slnglo U'o, )oInt or Buccosslvo Iifa oslat09 and tarm cot1a1n caJculaUons. For datos 0' daath ahar 12-31-81 and
bo'or. 8-1"09. actuarIal 'actora 'or slnglo 11'0 calculaUons can bo 'ound In Rovonuo Booklot (REV-1501B). For datos 0' doath on or ahar 8-1-80
octullllllactoll can bo lound In IRS PubllcaUon '14~7 Actuarial Valuoo, Alpha Volumo,
The InalrUmont croaUng tho 1110 Intorool Is a: (Pl.... .ltIch a eopy 01 Inlllumanl)
WItI Inlarvlvos Dood of Trust Olhor
lIilll II I 11111111 1Ii11l1 i 1I1111I1iilillllllllllillllill:IIHlllillliilllliiliiiillillllilillilliilliiii,iUFE. ESTATE 'INTEREST,. CALCULATION ,i',ii'll'
Pr..ent Age
(N.ar.lt BIr1hdoy)
!1i!!,I;iilh:lI@:ii!'I'I1I!!li:,,'i:III,ii:i;(i:,i::i!il!il;i:!illii:!:II<:,I:;,~,i.i.:! :;::i::
Namola) 01 LII. T.nlnl{a)
Da'a 01 BIr1h
Tarm 01 V.... UI. Eatat. Is Payabl.
Doroth E. storbeck
10 29 23
71
TOIm 0' Yaara
Torm 0' Yoaro
Torm 01 Vaars
Term 0' Yoaro
1, Vlluo 01 Fund Irom which Ulo Estato(s) Is payablo:, , , ...., .... .. .... , .. , .. ....., .. .. .., , .... .... $
33,089.46
.57618
2, Actulllal Factor por approp~oto Toblo . , , , , , . , , , , , . , .. , , , , , , , , . , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
Intor..1Tabloroto-- 031t2'''' 06"'" 010% ~arlsbloRalo 8.4 %
3, Valuool Ulo Eatato (Un. 1 x Un. 2) ............'.... ...... .........,.........., ,..,..",... $
19,065.49
1I11111111111111111111111111111illlilllllllilllllllmlllllllllllllllliiillhllilllilililliiillllIliliil;!ilillll'ANNUn:Y,IINTEREST;, CALCULATION ,:'iiiiii'i'i'i:"i'i'::I,liliill'illli:III1III'IIi!i",ll
i'illil1IIIIiIrilll:llIillllllilillill'lillilllil:i.I'li'iii,,,
Pra.ant Aga
(N..,a.t BIr1hdoy)
Namoll) 01 Annultanl{s)
DII. 01 BIr1h
Tarm 01 V..r. Annully la Payablo
Torm o. Yoars
Torm 0' YOAtS
Term of VanTa
Torm 01 VonTS
1, Valuo of Fund Irom which annuity Is payablo, , , , , , , , " , , , '" , , , , .. , , .. , , , , " , , , .. , , " , , , " , , , " $
2, Froquoncy 01 paYOUI-- OWookly . OBI-woakly . OMonlhly
OOUar1arIY OSoml-AnnuoJly []Annuolly []Olhor
3, Amount 01 payout per po~od , , .. , .. .. , , .. , , .. , , , , " , , , " , .. . , , , , , .. , , , , , , , .. , , , " , .. " , , , , ,
4, Annual poymonl......, .., .. .., .., ...., , , .., , '" .. ...... .." .. , , .., .... , .., , .... , .... .. , ,
~, Annutty Factor (soo InalrUcUons)
Intor..t Toblo rato -- 031/2'''' 06% 010% OVarlablo Rato %
6, Adju.lmonl Factor (100 InstrucUons), , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
7, Valuo 01 Annuity --11 using 31/2'''',6''''', 10',{, or II vorloblo rate and po~od payoulls ot ond
01 porlod, calculation Is: Un. h Una 5 x Un. 8 , .. , ,.. , , .. , , .. , , .. , .., , .. " .... , , '" , ...., , ..,
If using varloblo ralo and porlod payout 'a at boglnnlng 01 period, eolculotlon '0:
(Un. 4 x Un. 5 x Una 6)+ Una3,
NOTE: Tho valuos oltha runds whIch croate tho abovo futuro Intorests must bo roportod 8S part 0' tho Estate Assots, Uno 1 through
Uno 7, Tho R..uhlng Ulo/Annulty Inlerost(s) should bo roportod at tho approprlato lOll rote on Un.. 13, 15 ond 18 00 roqulrod,
PA18141 ,n. ""
CopyrighIFo,m. Soflw.,.Only, 111114 NelcO,lnc. NUPA141
, REV.Ill>l7 EX. <.110..)
.
COlo'MONWEAI. TH OF PENNSYLVANIA
INHERITANCE TAl( RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Herbert J. Storbock 21-1994-0870
This schedule Is appropriate only for Estates of decedents dying after December 12,1982.
This schedule Is to be used for ell future Interests where the rete of lax which will be applicable when the future
Interest vests In ossesslon and en 0 ment cannol be established wllh certalnt .
The Instrument creallng the future Interest Is: (Please attach copy of Instrument)
o Will ([J Trust 0 other
SCHEDULE M
FUTURE INTEREST COMPROMISE
I. Beneficiaries
NAME OF DATE OF AGE TO
BENEFICIARY RELATIONSHIP BIRTH NEAREST BIRTHDAY
1. Doroth E. Storbeck Survlvin S use 10/29/23 70
2. Richard J. Storbeck Son 6 03 54
3. Susan L. Storbeck Oau hter 5/23/52
4, Ronald M. Storbeck Son <1/22/58
5.
II. For decedents dying on or efter July 1, 1994, If a surviving spouse exercised or Intends to exercise one of the
following wllhln 9 months of the decedent's death, check the appropriate block :lIId supply a copy of the
document In which the surviving spouse exercises such withdrawal right.
o Unlimited right of withdrawal 0 Limited right of withdrawal
III. Explanatlon of Compromise Offer: (If more space Is needed, attach additional 8,S X 11" sheets)
Under ~rtic1e 4(b) of the trust, principal may be used for the Sottlor's wife
for support, maintenance and health care, and to maintain the standard of living
maintained during Settlor's lifetime. Under ~rticle 4(d) Mrs. Storbeck has the
right to withdraw up to $5,000 annually from principal and to request a withdrawal
equal to 5% of the trust's market value less any prior distributions in that year.
Due to Mrs. Storbeck's health, it is anticipated that she will exercise her withdrawal
rights and therefore the entire trust will be depleted prior to her death.
Therefore, the entire trust should be taxed at 3%.
IV. Summary of Compromise Offer:
1. Amount of Future Interest....."...,.,...""..,..,.., $ 14,023.97
2, Value of Line 1 exempt from tax as amount passing to charllles, etc, . , , . . . , . . , . .
(also Include as part of total shown on Line 13 of Cover Sheet)
3. Value of Line 1 passing to spouse at appropriate tax rale , . , . , . . . . . , . , , , . , . , , .
Check 1 Block 06% , ~ 3%,02%,01%,0 Exempt
(also Include as part of total shown on Line 15 of Cover Sheet)
4, Value of Line 1 Taxable at Lineal Rate ",........,.,..,..".,....,... , , .
(also Include as pert of total shown on Line 16 of Cover Sheel)
5, Value of Line 1 Taxable at Collateral Rate, . . . . . . . . , . . . . . . . . . . . . , . , , , . . , ,
(also Include as part of total shown on Line 17 of Cover Sheel)
6. Total Value of Future Interest (sum of Lines 2 thru 5 must equal Line 1) , . . , . . . , ,
$ , -0-
$ 14,023,97
$ -0_
$ -0-
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$ 14.02l.97
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Register' of Wills of CUMBERLAND county, Pennsylvania
Certificate of Grant of Letters Testamentary
No. 1994-00870 PA No. 2194-0870
ESTATE OF STORBECK HERBERT J
\uA~., ~~K~., M~uuu~1
Late of
EAST PENNSBORO TOWNSHIP
~UM~~"uA~U ~UUN~X,
,
Deceased
WHEREAS, on the 14th
dated September 9th 1994
was admitted to probate as the last will of STORBECK HERBERT J
(uA~., r~K~., M~uuu~1
Social security No.
day of October
098-01-0014
1994 an instrument
late of EAST PENNSBORO TOWNSHIP
9th day of September 1994 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, MARY C, LEWIS , Register of Wills in and for
the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify
that I have this day granted Letters TESTAMENTARY
to DOROTHY E STORBECK
who has duly qualified as Executor(rix)
and has agreed to administer the estate according to law, all of which fully
appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYLVANIA
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my Office the 14th day of October 1994.
,
CUMBERLAND County, who died on the
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21~94~870
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HERBERT J. STORBECK
I, HERBERT J. STORBECK, presently of Cumberland County,
Pennsylvania, declare this to be my will and hereby revoke all
prior wills and codicils made by me.
1. Tanqible Personal Prooertv. I bequeath such items of
my tangible personal property as are specifically itemized on a
list, if any, in my handwriting, signed and dated by me at the
end thereof, and attached to this, my Will, to the person(s)
named thereupon to receive such items, and all of my remaining
tangible personal property not used in business or for the
production of income, including, without limitation, furniture,
furnishings, clothing, jewelry, objects of art and decoration,
and the like, and any motor vehicles which I own, together with
the insurance thereon, I bequeath to my wife, Dorothy E.
storbeck, if she survives me, and if my wife does not survive me,
I bequeath such property equally among my children. If anyone
of my children does not survive me, his or her share shall be
distributed per stirpes among those of his or her issue who
survive me. If there are no such issue, said property shall go
to my other children, or if anyone of my other children is not
then living, shall be distributed per stirpes among those of his
or her issue who survive me. With regard to the property passing
hereunder, distribution shall be made among my children on the
basis of choices made in order determined by lot and by rotation,
and the values as finally determined for federal estate tax
purposes shall be determinative with regard to the values of the
property chosen, and any ultimate disparity among my children
shall be equalled by such payments among them as may be
necessary. If anyone of my children is not then living, the
choices to which he or she would have been entitled shall be made
by his or her issue in order determin~d by lot and by rotation.
2. Residue. I bequeath, devise, and appoint all the rest
of my property, of whatever nature and wherever situated,
including property over which I hold a power of appointment
(except that I do not exercise any power of appointment given to
me by my wife), to the then Trustee(s) under an Estate Plan
Agreement of Trust executed by me as Settlor thereof on
February 22 , 1994, to be held by said Trustee(s) and added
to and administered as part of the trust established by said
Agreement. Said trust is in existence as of the date of
execution of this will, and it is my intention, if necessary to
validate the foregoing gift to the Trustee(s), to incorporate
herein by reference its terms and any amendments thereto.
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3. Survival. If my wife and I should die under such
circumstances that it cannot be determined which of us survived,
my wife shall be deemed to have survived me for all purposes
hereunder. If any other beneficiary should die within sixty (60)
days after me, he or she shall be deemed to have predeceased me
for all purposes of this will.
4. SDendthrift Clause. No interest (whether in income or
principal, whether or not a remainder interest, and whether
vested or contingent) of any beneficiary hereunder shall be
subject to anticipation, pledge, assignment, sale or transfer in
any manner, nor shall any beneficiary have power in any manner to
charge or encumber his or her said interest, nor shall the said
interest of any beneficiary be liable or subject in any manner
while in the possession of my fiduciaries for any liability of
such beneficiary, whether such liability arises from his or her
debts, contracts, torts, or other engagements of any type.
5. Facilitv of Pavment for Minors or IncomDetents. Any
amounts or assets which are payable or distributable to a minor
or incompetent hereunder may, at the discretion of my
fiduciaries, be paid or distributed to the parent or guardian of
such minor or incompetent, to the person with whom such minor or
incompetent resides, or directly to such minor or incompetent, or
may be applied for the use or benefit of such minor or
incompetent.
6. Powers. In addition to such other powers and duties as
may be granted elsewhere herein or which may be granted by law,
my fiduciaries hereunder shall have the following powers and
duties, without the necessity of notice to or consent of any
court:
(a) To retain all or any part of my property, real or
personal, in the form in which it may be held at the time of its
receipt, including any closely held business in which I have an
interest and the stock of any corporate fiduciary hereunder, as
long as in the exercise of their discretion it may be advisable
so to do, notwithstanding that said property may not be of a
character authorized by law.
(b) To invest and reinvest any funds held hereunder in
any property, real or personal, including, but not by way of
limitation, bonds, preferred stocks, common stocks and other
securities of domestic or foreign corporations or investment
trusts, mortgages or mortgage participations, mutual funds with
or without sales or redemption charges, and common trust funds,
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even though such property would not be considered appropriate or
legal for a fiduciary apart from this provision.
(c) To sell, convey, exchange, partition, give options
to buy or lease upon, or otherwise dispose of any property, real
or personal, at the time held by them, at public or private sale
or otherwise, for cash or other consideration or on credit, and
upon such terms and for such price as they may determine, and to
convey such property free of all trusts.
(d) TO borrow money from any person, including any
fiduciary hereunder, for any purpose in connection with the
adminiatration hereof, to execute promissory notes or other
obligations for amounts so borrowed, to secure the payments of
such amounts by mortgages or pledges of any property, real or
personal, which may be held hereunder.
(e) To make loans, secured or unsecured, in such
amounts, upon such terms, at such rates of interest, and to such
persons, firms, or corporations as they may deem advisable.
(f) To renew or extend the time for payment of any
obligation, secured or unsecured, payable to or by them as
fiduciaries, for as long a period or periods of time and on such
terms, as they may determine, and to adjust, settle, and
arbitrate claims or demands in favor of or against them.
(g) In dividing or distributing any property, real or
personal, included herein, to divide or distribute in cash, in
kind, or partly in cash and partly in kind.
(h) Without limitation of powers elsewhere granted
therein, to hold, manage and develop any real estate which may be
held by them at any time, to mortgage any such property in such
amounts and on such terms as they may deem advisable, to lease
any such property for such term or terms and upon such conditions
and rentals as they may deem advisable, whether or not the term
of any such lease shall exceed the period permitted by law or the
probable period of retention under this instrument; to make
repairs, replacements and improvements, structural or otherwise,
in connection with any,such property, to abandon any such
property which they may deem to be worthless or not of sufficient
value to warrant keeping or protecting, and to permit any such
property to be lost by tax sale or any other proceedings.
(i) To employ such brokers, banks, custodians,
investment counsel, attorneys, and other agents, and to delegate
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to them such duties, rights and powers as they may determine, and
for such periods as they think fit.
(j) To register any securities at any time in their
own names, in their names as fiduciary, or in the names of
nominees, with or without indicating the trust character of the
securities so registered.
(k) with respect to any securities forming a part of
the trust, to vote upon any proposition or election at any
meeting of the corporation issuing such securities, and to grant
proxies, discretionary or otherwise, to vote at any such meeting;
to join or become a party to any reorganization, readjustment,
merger, voting trust, consolidation or exchange, and to deposit
any such securities with any committee, depository, trustee or
otherwise, and to payout of the assets held hereunder, any fees,
expenses and assessments incurred in connection therewith, to
exercise conversion, subscription or other rights, and to receive
or hold any new securities issued as a result of any such
reorganization, readjustment, merger, voting trust,
consolidation, exchange or exercise of conversion, subscription
or other rights and generally to take all action with respect to
any such securities as could be taken by the absolute owner
thereof.
(1) To engage in sales, leases, loans, and other
transactions with the estate of my wife or any trust established
by either of us, even if they are fiduciaries or beneficiaries
thereof.
(m) To exercise all elections which they may have with
respect to income, gift, estate, inheritance and other taxes,
including without limitation execution of joint income tax
returns, election to deduct expenses. in computing one tax or
another, election to split gifts, and election to payor to defer
payment of any tax, in all events without their being bound to
require contribution from any other person.
(n) To operate, own, or develop any business or
property held hereunder in any form, including without limitation
sole proprietorship, limited or general partnership, corporation,
association, tenancy in common, condominium, or any other,
whether or not they have restricted or no management rights, as
they in their discretion think best.
7. Taxes. I direct that all estate, inheritance, and
succession taxes that may be assessed in consequence of my death,
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of whatever nature and by whatever jurisdiction imposed, shall be
paid out of the principal of my probate estate to the same effect
as if said taxes were expenses of administration, except that any
such taxes (and interest and penalties thereon) imposed on
account of my interest in or power over any trust established by
my wife, shall be paid out of the property held in such trust,
and all othar property includable in my taxable estate for
federal or state tax purposes, whether or not passing under this
will, shall be free and clear thereof; provided, however, that my
executor(s) may in the discretion of my executor(s) request that
any portion or all of said taxes (to be paid out of the principal
of my general estate) shall instead be paid out of the principal
of any trust established by me, to the extent expressly
authorized under the terms of said trust.
8. Gender and P1ura1itv. Unless the context indicates
otherwise, any use of either gender herein shall also include the
other gender, and the singular shall include the plural, and ~
versa.
9. Fiduciaries. I appoint my spouse as fiduciary
hereunder. If ever my spouse is unable or unwilling so to serve
or to continue so serving, I appoint my children to serve as the
fiduciary(s) hereunder, and if any of my children is unable or
unwilling so to serve, or to continue so serving, no successor
shall be appointed to serve in his or her place.
My fiduciary(s) hereunder shall serve as gUardian(s) of the
property of any minor beneficiaries hereunder, under any
instrument of trust executed by me, under any policies of
insurance on my life, and in any other situation in which the
power to make such appointment exists under the laws of
Pennsylvania.
No individual fiduciary shall be liable for the acts,
omissions or defaults of any agent appointed and retained with
dUe care or of any CO-fiduciary.
No fiduciary named herein shall be required to furnish bond
or other security for the proper performance of his duties
hereunder.
IN WITNESS WHEREOF, I, HERBERT J. STORBECK, herewith set my
hand to this, my last Will, typewritten on seven (7) sheets of
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paper including the self-proving attestation olause and
signatures of witnesses, this 22nd day of February , 1994.
witnessed:
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~u..PH If{
t<'4 ~ ~.f~J..~AL)
HERBER ORBECK
residing at ~JIIII'jJ, ~ A-
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residing at t~,Pa
residing at eruy; JJjJ, /J /I
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S8:
ERT J. STORBECK (the testator), ,
G , and , ~ (the
tnesses), whose a es are signed to the fore nstrument,
being first duly sworn, each hereby declares to undersigned
authority that the testator signed and executed the instrument as
his last will in the presenoe of the witnesses and that he ~d
signed willingly, and that he executed it as his free and
voluntary act for the purposes therein expressed, and that eaoh
of the witnesses, in the presenoe and hearing of the testator,
signed the will as witness and that to the best of his or her
knowledge the testator was at that time eighteen years of age or
older, of sound mind and under no constraint or undue influenoe.
WITNESS
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TESTATOR:
/~~,,0:vL
HERBERT J. ORBECK ~~r'C
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WITNESS:
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WITNESS:
subscribed, sworn to nd acknowledged before me by HERBERT J.
S ORBECK, the testator,
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and ~~bscribed ~nd sworn before me by
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, the witnesses, .9lis 6J8~ day
(SEAL)
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ESTATE PLAN
AGREEMENT OF TRUST
BY THIS AGREEMENT, executed on February 22 , 1994,
HERBERT J. STORBECK, presently of Cumberland county,
Pennsylvania, as Settlor, hereby establishes a trust of the
assets itemized on Schedule A hereto, and the same HERBERT J.
STORBECK, hereby agrees to perform as the Initial Trustee of said
Trust, and of such additional property as may be placed in trust
hereunder, by the Settlor, the Settlor's wife, or with the
consent of the Trustee(s) any other person, all in trust subject
to the terms and conditions set forth herein. If HERBERT J.
STORBECK ever is unable or unwilling to serve, or to continue so
serving, as the Trustee hereunder, he shall be succeeded as
Trustee by his wife, Dorothy E. Storbeck, and by his children.
If ever anyone of such four persons is unable or unwilling so to
serve, or to continue so serving, no successor shall be appointed
to serve in his or her place. No fiduciary hereunder shall be
required to furnish bond or other security for the proper
performance of his or her duties hereunder, The Trustee(s)
hereunder shall serve as guardian(s) of the property of any minor
beneficiary hereunder. No individual fiduciary shall be liable
for the acts, omissions or defaults of any agent appointed and
retained with due care, or of any cO-fiduciary.
1. Durina Settlor's Lifetime. During the lifetime of the
Settlor--
(a) The Trust may be revoked by the Settlor by written
notice to the Trustee(s), and in case of such revocation, all
property then held in the Trust shall be given over to him. The
Trust may be altered or amended by agreement between the Settlor
and the Trustee(s).
(b) The net income of the Trust, if any shall be paid
to or for the benefit of the Settlor no less often than quarter-
annually, and the principal of the Trust, or any portion thereof,
shall be paid as the Settlor, or someone acting legally on his
behalf, may demand and without qualification. Even though the
Settlor is not adjudicated incompetent, if he is under a legal
disability, or because of mental or physical disability he is, in
the opinion of the Trustee(s) unable to make reasonable demand
for amounts from the principal, the Trustee(s) shall pay for his
benefit, or for the benefit of his wife, such amounts from the
principal of the Trust as may be necessary to maintain for either
of them a standard of living approximately equal to that
maintained by either of them during the lifetime of the Settlor,
and to meet their expenses arising from ill health or invalidism.
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2. Allocation of Assets. The primary purpose for the
establishment of this Trust is to provide for the Settlor's wife
and family after his death. The Settlor anticipates that a major
portion of his estate may be administered hereunder as a result
of bequests to the Trustee(s) contained in his will. Upon the
Settlor's death:
(a) If the Settlor's wife survives him, then the
Trustee(s) shall establish a Marital Trust hereunder, governed by
Section 3 below, by allocation thereto, from the property held
hereunder, including property received from the Settlor's estate,
an amount, if any, equal to (i) the minimum amount, after taking
into account all deductions other than the marital deduction and
applying all credits available, which is necessary as the marital
deduction to reduce to the lowest possible amount the federal
estate tax payable by reason of the Settlor's death, less (ii)
the value of all other assets in the Settlor's gross estate which
qualify for the marital deduction and which pass or have passed
to his said wife under other provisions of this instrument or
otherwise. In determining such amount, all assets involved in
the calculation shall be valued at final federal estate tax
values, but in funding the Marital Trust, date of distribution
values shall be used and only assets that qualify for the marital
deduction shall be used. The interest of the Settlor's wife in
the Marital Trust shall qualify for the marital deduction, and
any provisions herein which may appear to conflict with or in any
way defeat the Settlor's intention to obtain the marital
deduction for the Marital Trust shall be construed or applied to
accomplish that intention. The aforegoing provisions of this
Subsection to the contrary notwithstanding, the Marital Trust
shall not be funded with a value in excess of Four Hundred
Thousand Dollars ($400,000.00).
(b) The remainder of the property passing hereunder
(or, if the Settlor's wife does not survive him, all the property
passing hereunder) shall be held as a Non-Marital Trust governed
by Section 4 below.
3. Marital Trust. The income and principal of the Marital
Trust (if established hereunder) shall be distributed as follows:
(a) Income. The Trusteels) shall pay the net income
from the Marital Trust to or for the benefit of the Settlor's
wife, for her lifetime, in such installments, but not less
frequently than quarterly, as the Trustee(s) may determine.
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(b) Principal, The Trustee(s) shall pay from time to
time from the principal of the Marital Trust to or for the benefit
of the Settlor's wife:
(i) such sums as shall in the discretion of the
Trustee(s) seem proper for her support, maintenance, and health
care or necessary to permit her to maintain a standard of living
approximately equal to that maintained by her during the Settlor's
lifetime, taking into account such other sources of income,
support and estate that may be available to her, and
(ii)
principal, that the
behalf, may request
such sums, including any or all of the
Settlor1s wife, or someone acting duly
in writing.
on her
If any unproductive property is held in the Marital Trust at any
time, the Settlor's wife shall have the power to require the
fiduciary(s) hereunder either to make the property prOductive or
to dispose of it and reinvest the proceeds in productive property
within a reasonable time.
(c) After Wife's Lifetime. Upon the death of the
Settlor's wife, all the principal then held in the Marital Trust
shall be distributed as she may by her will appoint, making
specific reference to this Marital Trust under this Agreement of
Trust. Except as expressly stated in the preceding sentence,
there shall be no restriction, condition or qualification on, or
to the power to make such appointment and the permissible
beneficiaries. The power of appointment shall be exercisable by
the Settlor's wife alone and in all events, and there shall be no
power in any person other than said wife to appoint to any person
any part of the property passing under the Marital Trust. To the
extent that said wife shall fail to exercise effectively her power
of appointment over any part of the property in the Marital Trust,
the Trustee(s) shall (except to the extent that the Settlor's wife
expressly directs to the contrary in her last will or in a writing
delivered to the Trustee(s) during her lifetime) pay from the
unapportioned portion of the principal of the Marital Trust:
(i) the amount of any additional estate,
inheritance or other death taxes imposed on account of the death
of the Settlor's wife by reason of her power of appointment over
and other rights in the unappointed portion of the principal of
the Marital Trust (the amount of each such additional tax to be
equal to the excess if any of the tax, including any interest
thereon, payable by reason of her death over the amount of such
tax which would have been payable if no such tax was payable by
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reason of her death with respect to the unappointed principal of
the Marital Trust), and
(ii) any expenses incurred in the administration of
her estate attributed to the determination of such taxes (and the
Trustee(s) may accept the written statement of her personal
representatives as to the amount of taxes and expenses payable
hereunder) ,
and the remaining balance of the principal held in the Marital
Trust at her death shall be added to and considered part of the
Non-Marital Trust and shall be administered and distributed under
the provisions herein governing the Non-Marital Trust.
4. Non-Marital Trust. The income and principal of the
Non-Marital Trust shall be distributed as follows:
(a) Income. The net income from the Non-Marital Trust
shall be paid at least annually to or for the benefit of any or
all of the Settlor's wife and issue in such proportions or amounts
as in the discretion of the Trustee(s) seems proper to provide for
their support, maintenance, and health care, for the education of
the Settlor's issue, and for the maintenance by the Settlor's wife
of the standard of living maintained by her during the Settlor's
lifetime, taking into account such other sources of income,
support and estate that may be available to the beneficiaries.
Without intending to create any legal rights, the Settlor states
that he would approve distribution of income to those
beneficiaries in lower tax brackets, even if that would require
invasion of principal for other beneficiaries. No beneficiary of
the Non-Marital Trust shall participate as a Co-Trustee in any
decision under this Subsection for his or her own benefit.
(b) Principal. The Trustee(s) shall from time to time
pay such sums from the principal of the Non-Marital Trust to or
for the benefit of the Settlor's wife and issue as may in the
discretion of the Trustee(s) seem necessary for their support,
maintenance and health care, for the maintenance by the Settlor's
wife of the standard of living maintained by her during the
Settlor's lifetime, and for the education of the Settlor's issue,
taking into account such other sources of income, support and
estate that may be available to the beneficiary and the needs and
resources of all the beneficiaries. Any of the foregoing
distributions to or for the benefit of the Settlor's issue shall
be based on their needs, rather than on a desire to maintain '
absolute equality of payments among them. The Settlor's first
priority for the income and principal of the Non-Marital Trust
taken together is the support, maintenance and health care of the
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Settlor's wife for life, and the support, maintenance, health care
and undergraduate education of each of the settlor's issue until
completion of his or her undergraduate education. In determining
whether an invasion shall be made for the benefit of the Settlor's
wife from the principal of the Marital Trust, or from the
principal of the Non-Marital Trust, such invasion shall be made
from the Marital Trust as far as practical. No beneficiary of the
Non-Marital Trust shall participate as a Co-Trustee in any
decision under this Subsection for his or her own benefit.
(c) Leaal Sunnort Obliaation.
under subsections (a) and (b) above which
extent the legal obligation of any person
recipient of such payment.
(d) Wife's Riahts of withdrawal. In addition to the
foregoing, during any calendar year the Settlor's wife shall have
the unqualified right in her sole discretion to demand in one or
more writings delivered by her to the Trustee(s) that she be paid
up to Five Thousand Dollars ($5,000.00) from the principal of the
Non-Marital Trust, and in addition, on December 31 of any such
calendar year she shall have the unqualified right in her sole
discretion to demand in a writing delivered by her to the
Trustee(s) that she be paid from the principal of the Non-Marital
Trust, an amount equal to five percent (5%) of the aggregate
market value of the assets held in the Non-Marital Trust as of
such date, minus all amounts distributed to her under this
Subsection during such calendar year. The right permitted the
Settlor's wife under this subsection may be exercised by her only
as herein provided before the end of any given calendar year to
which applicable and any amount as to which such right is not
exercised for any such calendar year shall lapse and shall not
accumulate or carryover to any future calendar year.
No payment shall be made
would discharge to any
for the support of the
(e) After wife's Lifetime. upon the death of the
survivor of the Settlor and his wife, the Trustee(s) shall
distribute the principal remaining in the Trust as follows:
(i) To the Settlor's son, Richard -- Twenty-six
Thousand Eight Hundred fifty Dollars ($26,850.00) (to equal Thirty
One Thousand Fifty Dollars ($31,050.00) heretofore received by the
Settlor's son, Ronald), and if Richard is not then living, per
stirpes to his issue.
(ii) To the Settlor's daughter, Susan Three
Thousand Four Hundred Dollars ($3,400.00) (to equal Thirty One
Thousand Fifty Dollars ($31,050.00) heretofore received by the
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Settlor's son, Ronald), and if Susan is not then living, per
stirpes to her issue.
(iii) Ten Thousand Dollars ($10,000.00) to each of
the Settlor's grandchildren who ia then living.
(iv) Two Thousand Dollars ($2,000.00) to Teena
Fishburn, if she is then living.
(v) The balance -- per stirpes to the Settlor's
issue, provided, however, that if any such issue is then under the
age of twenty-five (25) years, his or her share shall be held for
him or her in a separate trust under the terms of Section 5 below.
5. Secarate Trusts. The income and principal of a separate
trust in which a share in the Trust is held for a beneficiary
pursuant to the terms of Subsection 4(e) above shall be
distributed as follows:
(a) Income. The income shall be distributed at least
quarterly to or for the benefit of the beneficiary. No payment
shall be made under this SUbsection which would discharge to any
extent the legal obligation of any person for the support of the
beneficiary.
(b) Princical. The Trustee(s) shall pay from the
principal such sums to or for the benefit of any or all of the
beneficiary and his or her issue as in the discretion of the
Trustee(s) seems proper for their support, maintenance, health
care, and education, and such sums to or for the benefit of the
beneficiary as in the discretion of the Trustee(s) seems proper to
help establish him or her in a business or profession or acquire
or furnish a home for him or her, taking into account the other
sources of income, support and estate that are available to the
distributee, the reasonably anticipated needs and resources of the
beneficiary and his or her issue, their income and estate tax
brackets, and the desirability of the transaction (if any). No
payment shall be made under this Subsection which would discharge
to any extent the legal obligation of any person for the support
of the distributee.
(c) Distribution of Seoarate Trust.
(i) When such beneficiary shall have attained the
age of twentY-five (25) years, the Trustee(s) shall distribute to
him or her at his or her written request the entire balance then
held in his or her separate trust.
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(ii) If such beneficiary should die before making
proper request for the entire balance in his or her separate
trust, then the entire balance in his or her separate trust shall
at his or her death be distributed, outright or in trust, in such
sums or proportions as such beneficiary may direct in his or her
last will, expressly referring to his or her separate trust
hereunder, but only among the Settlor's issue; and to the extent
that such beneficiary shall fail to exercise effectively his or
her limited power of appointment hereunder, the aforementioned
balance in his or her separate trust shall then be distributed per
stirpes to his or her issue, or, if no such issue survive him or
her, per stirpes to the issue of his or her parent who was a child
or more remote descendant of the Settlor, or, if no such issue
survive him or her, per stirpes to the issue of his or her
grandparent who was a child or more remote descendant of the
Settlor or, if no such issue survive him or her, per stirpes to
the Settlor's issue, with the share of any of such issue for whom
property is then held in or payable to a separate trust under this
section being added to such separate trust.
(d) Disposition Upon Application of Rule Aqainst
Perpetuities. Notwithstanding SUbsection (c) above, if during the
lifetime of a person for whom a separate trust under this section
was established the interest of such person therein becomes void
under the applicable rule against perpetuities, then the balance
in such separate trust shall then be distributed outright to such
person.
6. Failure of Issue. If ever there is no beneficiary in
existence for any amount held hereunder, as hereinbefore provided,
one half of such amount shall be distributed per stirpes to the
siblings of the Settlor, and the other one half per stirpes to the
siblings of the Settlor's wife.
7. Survival Clauses. If the Settlor and his wife should
die under such circumstances that it cannot be determined which of
them survived, the Settlor's wife shall be deemed t~ have survived
him for all purposes hereunder, If any other beneficiary
hereunder should die within sixty (60) days after the settlor, or
within sixty (60) days after any other person the survival of whom
determines his or her rights hereunder, then such beneficiary
shall be deemed to have predeceased the Settlor or such other
person for all purposes hereunder.
8. Powers. In addition to such other powers and duties as
may be granted elsewhere herein or which may be grantee by law,
the fiduciaries hereunder shall have the following powers and
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duties, without the necessity of notice to or consent by any
Court:
(a) To retain all or any part of the property of the
settlor, real or personal, in the form in which it may be held at
the time of its receipt, including any closely held business in
which the Settlor has an interest and any stock of any corporate
fiduciary hereunder, as long as in the exercise of their
discretion it may be advisable so to do, notwithstanding that said
property may not be of a character authorized by law.
(b) To invest and reinvest any funds held hereunder in
any property, real or personal, including, but not by way of
limitation, bonds, preferred stocks, common stocks, and other
securities of domestic or foreign corporations or investment
trusts, mortgages or mortgage participations, and common trust
funds, even though such property would not be considered
appropriate or legal for a fiduciary apart from this provision.
(c) To sell, convey, exchange, partition, give options
to buy or lease upon, or otherwise dispose of any property, real
or personal, at any time held by them, with or without order of
court at their option, at public or private sale or otherwise, for
cash or other consideration or for such credit terms as they think
proper, and upon such terms and for such prices as they may
determine, and to convey such property free of all trusts.
(d) To borrow money from any person, including any
fiduciary hereunder, for any purpose in connection with the
administration hereof, to execute promissory notes or other
obligations for amounts so borrowed, and to secure the payments of
such amounts by mortgages or pledges of any property, real or
personal, which may be held hereunder.
(e) To make loans, secured or unsecured, in such
amounts, upon such terms, at such rates of interest, and to such
persons, firms or corporations as they may deem advisable.
(f) To renew or extend the time for payment of any
obligation, secured or unsecured, payable to or by them, for as
long a period of time and on such terms, as they may determine,
and to adjust, settle and arbitrate claims or demands in favor of
or against them.
(g) In dividing or distributing any property, real or
personal, included herein, to divide or distribute in cash, in
kind, or partly in cash and partly in kind.
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(h) To hold, manage, and develop any real estate which
may be held by them at any time, to mortgage any such property in
such amounts and on such terms as they may deem advisable, to
lease any such property for such term or terms, and upon such
conditions and rentals as they may deem advisable, whether or not
the term of any such lease shall exceed the period permitted by
law or the probable period of retention under this instrument; to
make repairs, replacements and improvements, structural and
otherwise, in connection with any such property, to abandon any
such property which they may deem to be worthless or not of
sufficient value to warrant keeping or protecting, and to permit
any such property to be lost by tax sale or any other proceedings.
(i) To employ such brokers, banks, custodians,
investment counsel, attorneys, and other agents, and to delegate
to them such duties, rights and powers as they may determine, and
for such periods as they think fit.
(j) To register any securities at any time in their
names as fiduciary, or in the names of nominees, with or without
indicating the trust character of the securities so registered.
(k) With respect to any securities held hereunder, to
vote upon any proposition or election at any meeting of the person
or entity issuing such securities, and to grant proxies,
discretionary or otherwise, to vote at any such meeting; to join
or become a party to any reorganization, readjustment, merger,
voting trust, consolidation or exchange, and to deposit any such
securities with any committee, depository, trustee or otherwise,
and to payout of the trust created herein, any fees, expenses,
and assessments incurred in connection therewith; to exercise
conversion, sUbscription or other rights, and to receive or hold
any new securities issued as a result of any such reorganization,
readjustment, merger, voting trust, consolidation, exchange or
exercise of conversion, subscription or other rights and generally
to take all action with respect to any such securities as could be
taken by the absolute owner thereof.
(1) To engage in sales, leases, loans, and other
transactions with the estate of the Settlor, the estate of his
wife, or any trust established by either of them, even if they are
also fiduciaries or beneficiaries thereof.
(m) To make all necessary proofs of death under the
insurance policies of which they are the beneficiary, to execute
any receipts for the proceeds and to institute any action to
collect said proceeds and to make adjustments of any claim
thereunder, provided, however, that they need not institute any
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action unless they shall have been indemnified against all
expenses and liabilities to which they may become subject as a
result thereof. If, however, they desire to institute such action
without indemnification, they are hereby authorized to be
reimbursed for all expenses and liabilities incurred as a result
thereof from any amounts which may be held in trust hereunder then
or thereafter.
(n) To operate, own, or develop any business or
property held hereunder in any form, including without limitation
sole proprietorship, limited or general partnership, corporation,
association, tenancy in common, condominium, or any other, whether
or not they have restricted or no management rights, as they in
their discretion think best.
9. Spendthrift Clause. No interest (whether in income or
principal, whether or not a remainder interest, and whether vested
or contingent) of any beneficiary hereunder shall be subject to
anticipation, pledge, assignment, sale or transfer in any manner,
nor shall any beneficiary have power in any manner to charge or
encumber his or her said interest, nor shall the said interest of
any beneficiary be liable or subject in any manner while in the
possession of the fiduciaries for any liability of such
beneficiary, whether such liability arises from his debts,
contracts, torts, or other engagements of any type.
10. Facilitv of Pavments for Minors or Incompetents. Any
amounts which are payable or distributable hereunder to a minor or
incompetent may, at the discretion of the fiduciaries, be paid or
distributed to the parent or guardian of such minor or
incompetent, to the person with whom such minor or incompetent
resides, or directly to such minor or incompetent, or may be
applied for the use or benefit of such minor or incompetent.
11. Taxes. Estate, inheritance and succession taxes that
may have been assessed in consequence of the Settlor's death, of
whatever nature and by whatever jurisdiction imposed, whether or
not on account of property passing hereunder, may on request of
the Settlor's personal representatives and consent of the
Trustee(s) be paid out of the principal of the Non-Marital Trust
hereunder, as if said taxes were expenses of administration
thereof, and all property passing to the Marital Share hereunder
shall be free and clear thereof, provided, however, that no such
taxes shall be paid out of assets that are not includable in the
federal gross estate of the Settlor.
12. Gender and Plurality. Unless the context indicates
otherwise, any use of either gender herein shall also include the
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other gender, and the singular shall include the plural, and ~
verS8.
13. Law Governinq.
interpreted in accordance
Pennsylvania.
This Trust shall be administered and
with the laws of the Commonwealth of
IN WITNESS WHEREOF,
hereunto set their hands
above.
the Settlor and the Trustee(e) have
and seals on the date first mentioned
WITNESS:
SETTLOR:
~ l0iI~rD~ 6 ,,-(J
/~ qk~ (SEAL)
HERBERT J. r6'l'ORBECK .c....,v<
WITNESS:
Ca~~ ~, +(~,. I~-t
TRUSTEE:
/W~. ~&C~n A I" ~EAL)
HERBERT /ISTORBECK ~.J
Co'
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SCHEDULE A
One Dollar ($1.00) - Attached below
...-...-.-....'-" ...---... .-...-..-.,.-
I, the undersigned HERBERT J. STORBECK, this 22nd day of
February , 1994, do hereby acknowledge that in my capacity as
Settlor of the accompanying Estate Plan Agreement of Trust I have
paid to myself as Trustee thereof One Dollar ($1.00) in cash, such
payment representing the initial funding of such Trust.
,~ ~.
~<....... ()C..cCJ1~_~"'/'"
HERBERT J. ORBECK ,-
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.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ))/t....PJ-/IN
SSI
on this, the C>lanol day of Febr()..(A./'"!d., 1994, before me, a
Notary pUblio, the undersigned offioer, pe~sonally appeared
HERBERT J. STORBECK, known to me (or satisfaotorily proven) to be
the person whose name is subscribed to the within Agreement of
Trust, who aoknowledged to me that he exeouted the same for the
purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
\
Nt>'.1IlaISe31
Kall1ynJ,Pt1\llt,=
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MyConV11lEOO1~Jan. 1996
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DOROTHY E STORBECK
~40 BRENTWATER ROAD
CAMP HILL. PA 17011
101
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COMMONWEAl.T1t OF PENNSYl.VANIA
DEPARIMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT28<lSOI
UAnRISBURG, PA 17128.0601
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
'*'
NO, AA 2 4 2365 REV.II02 "111'0"
RECEIVED FROM:
r
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
rOlDIl[A(
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FClUJ HERE -1
ESTATE INFORMATION:
FIl.E NUMBER
21-1994-0870 BSN 098-01-0014
NAME OF DECEDENT (LAST! (FlnST!
STORBECK H~R8ERT J
DATE OF PAYMENT
(MI)
POSTMARK OATE
10/20/1997
COUNTY
--CUMBERLAND
DATE OF DEAnt
TOTAL AMOUNT PAID
S5.14
SEALCHECKII 430
. ,~
RECEIVED BY ,1/, ( . . ."_ "
MARY C. / " WI S ~/t';j( /t-;a-1f:2.
REGISTER OF WILLS ~
DO
REMARKS DOROTHY E STORBECK
REGISTER OF WILLS
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02 ..' AA OS. 2338 COMMONWEALTH OF PENNSYLVANIA ~~
NO. DIPARTMINT Of REVINUI · Jl:
1'"."" "1"'1 OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX ' " .
RECEIVED FROM:
i
ACN
ASSESSMENT P:I
CONTROL ...
NUMBER
AMOUNT
JOHN S KOSTUKOVICH CPA
3607 ROSEMONT AVENUE
SUITE 401
CAMP HILL, PA 17011
lv1
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ESTATE INfORMATION,
t:'I filE N MBER
"" e 1-1994-0870
E1 NAME Of DECEDENT IIAST)
STORBECK HERBERT J
II DATE Of PAYMENT
m POSTMAR E
COUNTY
SSN 098-01-0014
(fiRST) (MI)
REMARKS
m TOTAL AMOUNT PAID
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RECEIVEDBy'97~I1s1<:iJ'J,{t':~.,.:JH./ _ :
" (J 4))t~v/I/~ I
MARV C. LEWIS . ~ I
REGISTER OF WILLS
'.
CUMBERLAND
DATE Of DEATH
SEAL
DOROTHY E STORBOCK
CIO JOHN 6 KOSTUKOVJCH CPA
CHECK" 792
REGISTER OF WILLS
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RECEIVED FROM,
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ACN
ASSESSMENT P:'I
CONTROl ~
NUMBER
AMOUNT
LEFEVER, RrCHARD R.
P. O. BOX 1166
101
$5,1:30.00
HARRISBURG PA 17108
ESTATE INFORMATION,
MBER
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21-1994-0870
SSN 098-01-0014
MI
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CUMBERLAND
H
REMARKS
m TOTAL AMOUNT PAID
$5. 130~QO
REGISTER OF WILLS
MARY C. I.E
REGISTER OF
DOROTHY E. STORBECK
SEAL
CHECK# ~07
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
BUREAU Of INDIVIDUAL TAXES
INHERITANCE 'AX DIVISION
DO'" UD'Ol
HARRISBURG, Pi 17121-0'01
..'.Itllll ,,, m.tU
JOHN S KOSTUKOVICH
STE 401
3607 ROSEMONT AVE
CAMP HILL PA 17011
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
11-10-97
STORBECK
09-09-94
21 94-0870
CUMBERLAND
101
HERBERT
J
A_aunt R..itt.d
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTEI To inaure proper cradlt to your account, aub.it the upper portJon of this for. with your tax pay..nt.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiE'v=iliiij-ix-AFP-Co:i=m-------ii.ii-iiiH€iii"fA'NCE"i'ilx-ii'i,'jiiEHEIWiiF-il'ifcciuiiiuiiiii-------------m-----
ESTATE OF STORBECK HERBERT J FILE NO.21 94-0870 ACN 101 DATE 11-10-97
THIS STATEHENT IS PROVIDED TO ADVISE Of THE CURRENT STATUS Of THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
IS A SUHHARY Of '(HE PRINCIPAL TAX DUE, APPLICATION DF AtL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT. 10-06-97
PRINCIPAL TAX DUE..
4,866.83
PAYMENTS (TAX CREDITS).
PAYMENT
DATE
12-07-94
11-20-95
10-20-97
RECEIPT
NUMBER
MM913266
AA082338
AA242365
DISCOUNT (+)
INTEREST/PEN PAID (-)
240.64
2.19-
.38-
4,572.13
54.06
5.14
AMOUNT PAID
,....."'-
.J" .
,"
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
4,869.40
2.57CR
.00
2.57CR
. IF PAID AFTER THIS DATE, SEE REVERSE
SIDE fOR CALCULATION OF ADDITIONAL INTEREST.
If TDTAt DUE IS LESS THAN '1,
NO PAYHENT IS REQUIRED,
If TOTAL DUE IS RF.FLECTEO AS A "CREDIT" ICRI,
YOU HAY BE DUE A REFUND, SEE REVERSE SIDE OF THIS fORH FOR INSTRUCTIONS.
PAYJEHTI
Detach tM tDP portion Df this Motlca and .....It with your parl."t .ad. payabla tD tM nu. and Reir...
prlnbd on tM rav.r.. Ildl.
If RtllDENT DECEDENT a.. check or aonn' order pnlb" tOI REGISTER OF WILLS, AGENT.
If NON-REtiIDEHT DECEDENT a.a ch.ck 0" lon.y ord.r paYMl" tOI COHHONWEALTH OF PENNSYLVANIA.
REFUHD (CRJI A r.fund of . t.. crldlt, which w.. not ,..qu..t.d on the Ta. Raturn, .ay b. r.qu..t'd by coapl.tlng an
"Application '0" R.fund of Pann.ylvanla Inherltanc. and E.tat. Ta." (REY-1S1S)1 Application. arl Ivalllbla at
thl Off lea of the Ragl.t.r of Will., any of the 2S R.vanua DI.trlct Dfflc.. 0,. f,.ol the napartaant'l 24-hou,.
an....,.lng ..rvlc. ~.,.. fa,. for.. ord.rlngl In P.nn.ylvanl. 1-IOO-"Z-2050, out.ld. Penn.ylvanl.
and within local H.rrl.burg ar.. (717) 717-1094, TOO' r717J 772-2252 CH..rlng 1.,.lr.d onlyJ.
REPLY TDI
Qu..tlon. r.g.rdlng .,.,.ort contaln.d on thl. notlc. thould b. .ddr....d tal PA D.p.rtlant of R'v,nu., Bur.au
of Individual T...., ATTNI Po.t A.......nt R.vIIN Unit, D.pt. 210'01, H.r,.l.burg, PA 11121-0'01, phone
Cl11J 117-6505.
DISCOUNT I
If any t.. dua I. p.ld within thr.. CSl caland.r lontha .ft.,. tha d.c.d.nt'. d.ath, . flv. p.rc.nt C5X) dl.count
of thl t~. paid I. .llowed.
PENALTY I
ThI 15X ta. .-n..tv non-partlclp.tlon p.nalty I. coaput.d on th. tot.l of the ta. and Int.r..t .......d, and not
paid b.for. Janu.ry II, 1996, th. first day aftlr the and of thl ta. a.,..ty period.
INTEREST I
Intarllt II ch.rgld bag Inning with first day of d.lInquencv, or nlna C9J aanth. and one (1) day frCHI the data of
d..th, to the d.t. 0' payelntl Ta.a. which blc..a d.llnquant b,'or. January 1, 19.2 baar Intar..t at thl r.ta 0'
.IM C'X) parcant pa,. annua calculatad at . dally ,.ata of .0001'4. All ta... which b.c... d.llnquent on and .,t.r
Janua,.y 1, 19.2 will b.a,. Intara.t at . rata which will va,.y frOl cal.nd.,. va.r to c.lend.r v.ar with thlt rat.
announcad by thl PA D.p.rt.~t of R.v,nu.. Th. ,ppllcabl. Int.r..t rata. 'or 1'.2 through 1997 aral
y..,. Intlrllt Rata D.lly Inbrllt F.ctor Yaar Intara.t A.ta Dally lnt.rllt Factor
1912 ..X .DaD"1 19.7 'X .Dau",
1915 lOX .aDDO. 1911-1991 llX .000501
1914 IIX .0DDSOl 1992 'X .000247
1915 UX .00015' 1993-1994 7X .0110192
1916 lOX .0110274 1995-1997 .X .OODZU
nlnt.rllt I_ c.lcul.tad .. folloNII
INTEREST . BALANCE OF TAX UNPAID X NUNDER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Anv Notlc. I..ued .'ta,. the t.. b.co... d.llnqu.nt will ,..,lact an Int.r..t c.lcul.tlon to ,I't.an (15) d'YI
b.rond tha d.t. of the ........nt. If p.v..nt 1. a.d. aft.,. the Int.r..t co.,ut.tlan data ahown an the
Notlc., .ddltlon.l Intara.t au.t b. c.lcul.t.d.
.
III )l/(j- 7
COHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTHENT
,
BUREAU OF INDIVIDUAL TAKES
INHERITANCE rAK DIVISION
DEPr, ZIG60l
tlAARlSIlURQ, PA 171U.0601
JOHN S KOSTUKOVICH
STE 401
3607 ROSEMONT AVE
CAMP HILL PA 17011
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
ACN
(L--
10-02-97
STORBECK
09-09-94
21 94-0870
CUMBERLAND
101
Amount Renltbd
~)."t<..)
, . ll\
.,
....1191111""1.'"
HERBERT
J
HAKE CHECK PAYABLE AND REHIT PAYHENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTEI To In.u~. proper cradit to your account, subll'llt the upper portion of this form with your taM paynent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RFCORDS ~
R-Ev:isiij-Eif-AFP--ioi-:9;j------iiM-iN'HERI-fANC-€-rili-RifcORO--Auj-usrii€Nr--i.-----------------------------
ESTATE OF STORBECK
HERBERT
J FILE NO, 21 94-0870
ADJUSTHENT BASED ON. ADMINISTRATIVE CORRECTION
VALUE OF ESTATE I
1. R..I Eat.t. (Schedule A) (1)
2. stocks end Bonda (Schedule 8) (2)
3. Clos.ly Hald stock/Partnership Inter..t (SChedule C) (5)
4. Hortg.gel/Not.. Receivable (Schedule D) (4)
51 Ca.h/Oank Deposita/Hllc. Parlonal Property ISchedule E) (5J
6. Jointly Owned Property (Schedule F) (6)
7. Transfara (Schedule OJ (7)
8. Tot.1 A..at.
DEDUCTIONS AIID EXEHPTIONS I
9. funaral E~pansa./Adaini.tr.tive Co.t.1
Hiscallanaous E~p.nsa. (Schadula H) (9)
10. Dabts/Hortgag. Li.bilitias/Lian. (Schadula I) (10)
11. Total Deduction.
12, Nat Valua of Ta~ Raturn
13. Charitabla/Governaantal Baqua.t. (Schadula J)
14, Nat Value of e.t.ta Subjeot to Ta~
TAXI
151 AMount of
16. Anount of
17. Anount of
18. Principal
TAX CREDITS:
PAYHENT
DATE
12-07-94
11-20-95
Lina 14 at Spou.al r.ta
Lina 14 ta~abla .t Lin..l/Cl... A rat.
Lin. 14 t.~abl. at Coll.teral/Cl... 8 rat.
Tax Dua
liS,
lib)
117)
RECEIPT
NUHBER
MM913266
AA082338
DISCDUNT C.)
INTEREST/PEN PAID (-I
240.64
2.19-
ACN 101
.00
9,685.12
.00
,00
102,438,85
,00
91,524,77
(8)
7,928.66
403,00
llII
1121
(U)
(14)
162 ,227,62 x. 03'
,OOX.06-
,OOX.15-
(18)
AHOUNT PAID
4,572.13
54.06
INTEREST IS CHARGED THROUGH 10-17-97
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORH
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
DATE 10-02-97
203,648,74
8.331.66
195,317.08
,00
195,317,08
4,866,83
,00
.00
4.866,83
4 864,64
2.19
.38
2,57
. IF PAID AFTER DATE INDICATED. SEE REVERSE (IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
FDR CALCULATION OF ADDITIONAL INTEREST. IF TOrAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE DF TNIS FORH FOR INSTRUCTIONS,)
" ...
'~
PAVItENT I
Datach tha top portion of thla Notlca and aubalt wlth vour pay.ant ..da PlYlbla to tha n... and addraa.
prlntad on tha ravlr.a ,Ida.
-- Hlka chack or .onay ordar pavlbl. tal REGISTER OF WILLS, AGENT I
RErUND (eR) I
A ra'und of a ta. cradlt, which w., not raqua.tad on thl Ta. Raturn, .av bl raqua.t.d bv coaplatlng an
"Application 'or Rafund of pann.vlvanl. Inhlrltancl and E.tlt. TI." (REV-ISIS). Application. .r. .vall.bla .t
tha OfficIo' thl R.glat.r 0' Will., any of the 21 R.v.nua DI.trlct a"lc.a or 'rot the O.p.rt..nt'a Z4.hour
an.w.rln, ..rvlc. nuab.r. for 'or.. ord.rlngl In P.nn.vlvanl. 1-100-36Z-20SO, out, Ida p.nn.vlvanla
and within local H.rrlsburg ar.. (111) 711-10'4, TOOl (111) llZ-22S2 (H..rlng I.palr.d onlv).
REPLY
TO,
Du..tlon. r.g.rdlng .rrors contalnld on this notlc. .hould b. .ddr....d tal PA D.p.rt..nt 0' R.v.nut, Burlau
0' Indlvldu.1 T...., ATTNI Po.t A.......nt Ravlaw Unit, D.pt. 210601, H.rrl.burg, PA l1IZI-0601, Phona
(111) 111-6505.
DISCOUHTI
I' anv t.. due I. paid within thr.. (Sl c.l.nd.r .onth. .,tar thl d.c.d.nt'. d..th, . flv. p.rc.nt (SX) dl.count
0' thl t.. p.ld I. ,llow.d.
PENAL TV I
Th. ISX t.x .an..tv non-p.rtlclp.tlon p.n.ltv I. co.put.d on the tot'l 0' tha t.. and Int.r..t .......d, and not
paid b.for' J.nuary .1, 1'96, thl flr.t d.v .ft.r the .nd 0' the t.. ,,"..tv p.rlod.
IHTEREST I
1nt.r..t I, charg.d bag Inning with 'Ir.t dav 0' d.llnqu.ncv or nln. (9) tonth. and on. (I) d.v 'rot the data 0'
d.ath to the dlt. 0' p.y'.nt. T.... which baca., d.llnqu.nt b,'or. J.nulrv I, 191Z b..r Int.r..t .t the rlt. of
.1. (6X) p.re.nt p.r ennuI calcul.t.d at a d.llv rat. of ,000164. All t.... which b.ca.. d.llnqu.nt on .nd .,t.r
January I, 191Z will b..r Int.r..t .t a rata ~hlch will v.rv 'rD. cal.ndar v..r to c.land.r y.ar with th.t r.tl
announc.d bv the PA Dap.rt..nt of R.v.nuI. Thl appllc.bl. Int.ra.t rata. 'or 1912 through 1997 ar.t
V.ar 1nt.rut A.tl Oallv Int.r..t Factor Vllr Int.ra.t Rat. 0.11y Int.r..t Flctor
1912 20X .OOOSU 1911 'X .0D021ft1
I'IS lOX .00001 1'11-1991 IIX .00OSOI
191" IIX .000Sol 1992 'X .00021ft1
1'15 UX .00OSS6 1995-1994 7X .000192
1916 \OX .000274 1995-1'91 OX .000241
--Int.r..t I. c.lculat.d a. 'ollow"
INTEREST . BALANCE OF TAX UNPAID X NUNDER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Anv Hotlro. I..u.d a,t.r the t.. blco", d.llnquent will r.,l.ct .n Int.r..t c.lcul.tlon to ,I,t,an CIS) d.V'
b'Vond tha d.t. 0' the ........nt. If p.v..nt I, ..oa aft.r the Int.r..t co.putatlon d.t, .hown on t~
Hotlc., .ddltlon.1 Int.r..t .u.t bl c.lculat.d.
. ,'..
MV.uro IX lWIl
'*'
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
OEPARTh1ENT OF REVENUE
BUREAU OF INOMDUAL TAXES
OEPT.280<101
71 8.0<101
R
DECEDENrS NAME
Herbert J. Storbeck
Shawn Young
FltE NUMBER
REVIEWED BY
ACN
2194-0870
101
SCHEDULE ITEM
NO,
H
EXPLANATION OF CHANGES
Reduced from $3, 600 to $1,698 In accordance with the Information submitted oon the
supplemental return,
B-1
.0./.,.01' , J..
~(A r JI
I ()) I
-----~..---
-~---^
--_...---
,____._._ '"': w____...-
---~~---
ROW
Page 1
-.,'J'
t; It
'l"
-.~ l' '-
"
~ --,
; I, ~ -
.'_'" ~Hm:~ft~"~~"~V
.",_~""------'"1r"-'
.
. '1_ .71/0 '1
{>
;?&'*
lU-IIU ""'111""
HERBERT
J
,
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAMES
IHHERlTAHCE TAlC DIVISION
DEPT. 260601
HARRlSaURG, PA 111Z&.0601
NOTICE OF INHERITANCE TAM
APPRAISEHENT, AtLOWANCE OR DISALLOWANCE
OF DEDUCTIDNS AND ASSESSHENT OF TAX
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiE'v:iii4"'7"EX-jiFji-ni:i:9;Y"iiiificni'F"YNHEiiiTANCE-i'-AX-iiPPRiiisEHEii'r,--,U.i.-ciwANcE-oli-----------------
DISALLDWANCE OF DEDUCTIONS AND ASSESSMFNT OF TAX
HERBEllT J FILE NO. 21 94-oBlo ACN 101 DATE
TAX RETURN WAS' ( I ACCEPTED AS FILED C XI CHANGED SEE ATTACHED
APPROVED DEDUCTIONS AND EXEMPTIONS I
9. Funeral E~p.n.../Adn. Coata/Hi.c. Expans.. (Schedule H) (9)
10. Debta/Hortg.ga Liabiliti../Llana (Schedule Xl l10) .00
11. Total Deduction. ell)
12. Nat Value of Tax R.turn (12)
13. Chari tabla/Governmental Bequ..t. (Schedule J) (13)
141 Nat Value of Eatat. Subject to Ta. (14)
NOTEI If an assessment was issued previouslY, lines 14, 15 and/or 16, 17 and 18 will
reflect figures that include the total of abh returns assessed to date.
ASSESSMENT OF TAXI
15. A.ount of Line 14 .t ~pou..l r.t. t151-2,!1~!!,:,!~ II .03,
16. Allount of LIna 14 taxabl. at Lin..l/Cl... A rat. (16) .00 )( 106.
17. AltOunt of Lin. 14 t.xabl. at Coll.t.rallCla.. Brat. (17) 100 )( .1511
18. Principal Tax Due (18)
JOHN S KOSTUKoVICH
STE 401
3607 ROSEMONT AVE
CAMP HILL PA 17011
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
10-13-97
STORBECK
09-09-94
21 94-oB7o
CUMBERLAND
101
AMount Re..Ht.d
ESTATE OF
STORBECK
RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN NO. 01
11 R..l E.tat. (Sch.dule A) (1)
2. stock.,and Bond. (Sch.dul. B) (2)
3, Clo.elY H.ld stock/Partnership Inter.st ISch.dul. C) (3)
4. Hortg.g../Hota. Recaivabl. ISchedule D) (4)
5. Cash/Bank D.polit./Hisc. P.rsonal Property ISchedul. E) (5)
6. JointlY O"ned Property (Schedule f) (6)
7. Transfar. ISchedule 0) (7)
8. Total AIs.t.
.00
.00
,DO
.00
.00
,DO
.00
leI
.00
TAX CREDITS I
PAYHENT
DATE
12-07-94
11-20-95
DISCOUNT I +l
INTEREST/PEN PAID I-I
240,64
2.19-
AHOUNT PAID
4,572.13
54.06
RECEIPT
NUHBER
MM913266
AA08233B
INTEREST IS CHARGED THROUGH 10-28-97
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS F.oRM
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
10-13-97
NOTICE
HOTEt To in.ure proper
credit to your account,
subMit the upper portion
of this forM with your
tax paYM.nt.
.00
nn
.00
.00
195,317.08
4,866.83
,00
.00
4,866.83
4,864.64
2.19
.38
2.57
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FDR CALCULATION OF ADDIlIONAL INTEREST.
IF TDTAL DUE IS LESS THAN .1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE
A REFUND, SEE REVERSE SIDE DF THIS FOR" FDR INSTRUCTIONS. I
# ,
'\
RESERVATION. E,'at.. of dao~t. dVlng on or b,'ar. Dec.-ber 12, I'll .. I' ~y lutur. Int.r..t In the ....t. I, tr~,'.rr~
In po.....lon or enJow-ent to el... I (col11'.ral) blnefloll'... 0' the dec~ent .,t., the .~Ir.tlon of ~v I.t.t. for
II'. or far v..r., the c~.lth her~V Ixpr..,ly r...rv.. the right to ~r.l.. ~ ...... 'r.nl'.r Inherlt~. 'IX"
at tM lllWful Cl... . (colla'.rlll) nt. on MV .uch lutur. In......'"
, ,
PIlRl'OU Of'
HOlletl
To lulf111 thl ,.qulr..ent. of Seotlon 2140 0' thl Inherlt~. ~ E,t,t, ,.. Aot, Act 11 of 1'95. (72 P.I.
lectlon '140).
PAYttEHTI DliKh the top portion of thh Hotle. and ,ubIIlt with your PIYHf\t to the Rqh'ar of Wllh printed on the revar.. .Ide.
..H.... check or ItOMV ordu Plv.tJla tOI REOIBTER OF MILLS, AGENT
REFtICD (CA)I A r.'.-d of . tl. cr.dlt, whld1 .... not requested on tM ,.. Raturn, "V btI requ....d bv CCHlP1IUntI .., otAPfllIclUon
for R,fund of Plnnlylv.nl. Inherlt~. ~ E.t.t. T.." (REY-l'l'). Appllc.tlon. .ra .v.ll~la .t the Dfflc.
of tha R.gl.t.r of Will., any of thl 25 R.v,nu. Dl.trlct Dfflc.., or by c.lllng tha .pacl.l Z4-hour
an.werlng ..rvlca nuaber. far far.. ard.rlng. In penn.ylvanla 1-laO-S6Z-laSa, aut.ld. Pann.ylvanl. and
within local H.rrl.burg .r.. (717) 717-1094, TDDI (711) 17Z-ZIS1 (KI.rln, 1.,.lrad Dnly).
i
OBJECTIONS I Any p.rty In lnt.r..t not ..tl.fl.d with the .,pral..sent, .llaw~' or dl..llow~' of deduction., or .......-nt
of t.. (lncludlng dl.count or Int.r..t) .. .hown on thl. Notlc. au.t object wlthln .I.ty (60) dlY' of rec.lpt af
this Hotic. by.
--written prab.t to the PA D,plrta."t of R.v......., la.rd of App...., Dept. zalOn, HIIrrhburg, PA 17111-lOU, OR
".Iaction .ta h.v. the ..tt.r dltaralhed .t -Wit of the .ccount of the p.nanal rapr..."t.Uv., OR
-.~.I to the Orph.".' Court.
ADMIN
ISTRATlYE
CORRECTIONS I
PENALTY.
F.ctu.l .rrar. dl.cav.r.d on thl. .......ant ~ld b. addr...ad In writing tal PA Depart.."t of R.v~,
lur.au of Indlvldual T...., ATTNI pa.t A.......nt R.vlaw Unit, Dept. r10601, ~rrl.burg, PA 17121-0601
Phone (717) 717-6505. S.. p.gl S of the baakl.t "In.tructlon. far Inh.rltanc. Ta. R.turn for a RI.ld.nt
D.c.d.nt" (REY-1S01) far an ..pl~tlon of adalnl.tratlv.lY carractabl. .rror..
If any ta. dua I. paid within thr.. (5) c.lend.r .ontha .ft.r the d.c.dant'. ~Ith, . flv. parc."t (SX) dl.count of
the t.. p.ld .. allowed.
The 15X t.. a.ne.ty non.p.rtlclpatlon penalty I. c~tad on the tat.l of the t.. and lnt.r..t ......ad, and not
paid b.far. J.nu.ry II, 1"6, the flr.t d.y aft.r the and of the t.. a.ne.tv parlod. fhl. non-p.rtlclp.tlon
panalty I. app.alabla In tha .... .anntr and In the the .... tl.. parlad .1 you would appa.l thl t.. ~ Int.r..t
thet h.1 ba." ......ad .1 Indlclt.d an thll notlcl,
DISCCUlT.
INTEREST.
Int.r.lt II charged baolnnlng with flr.t dlY of delinquency, or nine (,) ~th. ~ ana (1) dlY fr~ the data of
~.th, to the chit. of P'YMf'Itl Ta"l which bec_ delinquent bafarl January 1, l,aZ bear Inter..t It the r.t. of
I" C6:C) ptIrcent ptIr ...... c.lculatllCl .t a dally r.t. of .000164. AU t.nl whlch bac... daUnquant on and after
Janu.ry 1, l,al will b..r Intlr..t .t . rat. which wlll vary fral calendar ya.r to c.land.r ya.r with th.t rat.
~ad by the Pi c.p.rt...,t of Ravenua. ThI 8PPllc.tJla Int.r..t rat.. far 19lZ through 1991 .r.,
t!!! Int.ra.t Rata D.llv tntar..t Factor :!!!r Int.,...t R.ta D.llv tnt.r..t Factor
1912 'OX .000in 1911 'X .000241
1915 lOX .OOOUI 1911-1"1 llX .000501
1'14 llX 1000301 I"' OX .000247
19l5 lJX .000356 199'-1994 n .00019Z
1.16 lOX .OOU14 1995-1991 'X .000241
ulnt.rllt 1. c.lculat~ " followlI
f,
INTEREST. BALANCE OF TAX UNPAID X NUHBER OF DAYB DELINQUENT X DAILY INTEREST FACTOR
--Any Hatlc. ll.uad .ft.r \hi tax bacoaal 6ellnquant will r.flect an lnt.r..t calcul_tion to fifteen CIS) daYI
bIIyand the chit. of the ........"t. If pspent .. _adI aft.r thl lntara.t cu.put.Uon dab IhcM'l on \hi
HoUca, addl tlDIWI .Int.rllt ....t ba calcul.ted.
'L~.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT, 280001
HARRISBURG A 17128.0601
DECEDENrS NAME
FILE NUMBER
2194.0870
101
. .
RlV-too D {l-UI
*'
INHERITANCE TAX
EXPLANATION
OF CHANGES
Herbert J. Storbeck
REVIEWED BY
ACN
Shawn Young
SCHEDULE ITEM
NO,
EXPLANATION OF CHANGES
This notice is issued in response to the Supplemental Inheritance Tax Return filed with the
Cumberland County Register of Wills' Office on November 21, 1995. Please be advised that
as all items reported on this return have been previously reported and assessed by this
Department on the original return, The information on this return will be reviewed by the
Post Assessment Review Unit for possible administrative correction to the Notice of
Appraisement, Allowance or Disallowance of Debts and Deductions and Assessment of Tax
issued on December II, 1995. That unit will contact you in the near future concerning the
outcome of their reviews, However, any objections you may huve to this assessment should
be fonnully uddressed in writing to the Post Assessment Review Unit, Pleuse note that this
notice is issued for dministrative purposes only and docs not reopen the referenced
assessment to appeul as provided by Section 9186 of the Pennsylvania Inheritance and Estate
Tux Act of 1995.
FILE
Page 1
">, 'oi ,-"."
'1"
"
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"",
,.ii_
" ,,;'- ....J' .
1I[V-noo IX .1"'41
S
C-M
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ULU
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IJ~"
L
.
.
a
"
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L
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.
.
..
'1
)9 -01.</0 - '7
A""t.N~~
-',
I
INHERIT ANCE TAX RETURN
10MMO"I"" or "'Nsn""A RESIDENT DECEDENT
",.,,"'... or OI"NII' ero BE FILED IN DUPLICATE
DfP1.210101
""""Ull~ ,. 11Il1.0'01 WITH REGISTER OF WILLS
OlClO(HT'S '''''dl UST, lUlU, '''0 MIOClf l"ITIAl!
storbeck Herbert J.
SOClAlIlCUllm HUMBIR
'OR CArli Of OIAfM AfflR
If" SPOUSAL
rDYlRTT CRfDIT IS CUIUID
flU HUU.III
UUI/II CHECI HUE
1994 0870
'UR HUMBER
o
em,inder Return
Ifor d.... of de"" prior 10 12.n-821
5. Federll Enlt. Tu Return Required
SIGNATURE Of P[RSDH IIUrOlfSlBU '0" fliNG II(TURN
Ii
U
11
a
21
coum coot
OlClOEh'l"S COMPUTE AOOIIUS
540 8rentwater Road
DATI Of BIRTH Camp Hillr PA 17011
08-02-1916 I..'l'( CUmberland
SOCiAl stCURITl NUMBER AMOUNT ItlUlVfO ISlE IHSTllutllOHSI
DAlfDIOUTH
098-01-0014 09-09-94
U, "Pf\ICAIlQ SURVIVIHC SPOUU'I NAMI lAST, flllST AHO "'IOtlf INITIAl)
x
8. Total Number of SIf. Deposit Boxes
ADDllfSS
See Schedule Attached
ADDRfSl
II"'ATUftl DI PIUP,lftlft ann TKAH II(PIIUIHTAYIV(
1. Origin.' RelUfn
Ii
U
a
.
a
L
o 4. limited Est,l. [!] 41. Future Interest Compromise
Ifor d..e. of d.11l1 After 12-12-821
[jJ 6. Decedent Died Testrte D 7. Decedent Maint,lned a living Trust
nach co of Will) (AnKh co of Trusd
All. CORRI:SPONOENCE AND CONADmTlAlTAX INfORMATION SHOUlO BI: DIRECTED TO:
HAM( COMPUTE MAILING "OOIlUS
John S. Kostukovich CPA 3607 Rosemont Avenue, Suite 401
TnIPHDN' fl\lMS" Camp Hill, PA 17011
.
a
"
.
~
L
.
U
U
K
I 717 I 730-0820
1. R"I El1Ite (Schedule AI
2. Slock. .,d Bond. (Sch.dule BI
3, Closely Held SlocktPmership Interest (Sdl.dul. CI
4. MongJgII ~d Notes Receivable (Schedule 0)
5. c,m, Bd Deposits & MisceU...eous PersonAl Property
(Sdledule EI
6. Jointly Owned Prop.rly (Schedule FI
7. Tr",'e" (Sch.dul. GI(Schedule LI
8, TotAl liro.. As.elS Iloul lines 1-71
9. Fl.I1IrAl E.xpenus, Adminlstntive Costs, Mscellrleous
Expen.e. (Schedule HI
10. OeblS. Mort9ege liabilities, Liens (Schedule II
11, Toul OAductions Itoul Lin.. 9 '" 101
12. N.t V~ue 0' El1Ite ~ine 8 minus Line 111
13. Ch.itlbl. Ind Govermental Bequests (Schedule J)
14. Net V.lue Sub eet to Tu (tine 12 minus Line 13
15, Spous~ Tr.,st... If or dIl.. 0' de"" Alter 6'30-941
See Instructions for ~plicable Perc.ntlge on Revers.
Side. Onclude values from Schedule K or Schedule M)
193 .515.08 x,030
203.648.74
I 11
I 21
I 31
I 41
I 51
9,685.12
102.438.85
10.133.66
193.515.08
3 5 5. 8
5,805.45
5,805.45
5.400.00
405.45
405.45
~~BeSURI:,TO ANSWER AUOUI:STIONS QN,REVEllSESIDE1 AND TO RECHECK MATH~;c ',', '
lII"r P'uJU" ., '''I.." I '.el." III.. I .... "I_III' 11111 "II.... Iflelo'lao tcUIllPlllylllO uh'ul.. Ill' '1'''lIIlnh. U, I. III. hu at .... klt_I.llIa' 11111I b.U." II II II", CD".el
... COIII,ltlt. I ..cllI. 011 .11 1111 "1.10 "" bill lip."" .t III' .llIthl ur... O.d".II.. ., pIlP"" tlllOf 1111. lilt p1f101l11 flplOUIII.rh. Is bud o. .11 hllOlm,UOII ., wlllell
,..par'f II.. uy h..lffg..
4W41U 2.000
I 51
171
91.524. 77
9,730.66
403.00
I 81
I 91
1101
1111
1121
1131
14
1151
15, AmOlJllt 0' Line 14 Imbie Of 5'/, r..e 1151 x ,05'
Onclude v.lues from Schedule K or Schedule MI
17, Amount 0' Line 14 'mbl. Of 15% role 1171 x ,15'
Onclude v.lu.s from Schedule K or Schedule M)
18. Princip.1 Lex due !Add tlX from Lin.. 15, 15 .,d 17,1 1181
19. Credits SpOUSlJ Poverty Credit Prior P,yments Discount Interest
+ 5 ,130.00 + 270.00 - 1191
20. If Line 19 i. gre.." !h., line 18, enler !h. difference on line 20, This I. !he OVERPAYMENT,I201
(A; D':ChKk,'hM~"'if,:y~u:',are;~'~stlnrr.'.;rr;iu~~f~;'.:yOur<p';;~'ymell't.'
21, If Line 18 i. gre..er !h., Line 19, enter the difference on Line 21. This I. !h. TAX DUE. f211
A. Enter the Interen on the bal.,ce du. on L1n. 21A. (21A)
B, Enler the tOIa/ of line 21 ",d 21A on line 21B, This I. !he BALANCE DUE. 120BI
~ke Check Pa able to: Re I"tor of WlJIs A ent
DATE
DAn
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ct' Col "
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1FOfl DATES OF DF,^TII AFT En 12131/91
INHERITANCE TAX RETURN CIlECKIIEflEIFASI'OU5AL [I
RESIDENT DECEDENT I'_OVERTY CnEDITlSCLAIMED . .-
COM~~~~~~::,,,oci/~~'.;'''~~~''''' (TO BE FILED IN DUPLICATE FIl.E 1l~~1UEfI I 1994 0070
".....g~~~.'::~::...o,"' WITH REGISTER OF WilLS) COUtlTY CODE YEAR IlUMBER
CECEDENrs IlAME (UlST, FIIIST, AIlD MICDlE INITlAL)-' DECEDEtlI'S COMPLETE ADDfllSS
storbeck IIcl'locrt .1. 540 BrcntwatCr. Hood
DECEDEtrr SOCIAL SECURITY IlUMBEn DATE OF BEATH DATE OF C1RTH Camp 11111, PA 17011
098-01-0014 09/09/94 08/02 1916 Coun cumberland
~lfr5ilN'tM~ohtEI:~m~8 f'OU~['S ~lAME (~. SOCIAL SECURITY NUMOER AMOUNT RECEIVED (SEe UWTRUCTIONS)
storbeck Dor.oth E. 100-18-2942 160 425.62
1, Ollgl"oJ Roturn :;I. RemaInder Roturn
(IQrd.t..oldUI"Pllo"o'2~1]'UI
o ft. fodornl ESlato Tax Rolurn Rcqulred
~ 48. Futuro Inlorost Compromiso
(for dalos 01 dcalh aftor 12-12-62)
lB 6. Decodent Clod TO:llolo 0 7. Decodont MaintaIned a Uvlng Trusl
(AUach copy a' Will) (Anach copy 01 Tlu,,)
:,a.U.::CORRESPONOENCE;AND CONFIDeNTIAl:. TAX;IHFCRMATJON SHOULD BE DIRECTEO,TO:::'I:il:;::~iililh:,I!I~J::il:;lJl~11H;I;H'i'!\i:l!:i;:i:i;':i:':',":!1 ~ y(;il
IlAME COMPLETE MAILING ADDRESS
Richard R. Lefever 100 Pine street
TELEPHONE NUMBER llarrisl:urg, PA 17101
717-237-5222
1, Real Estale (Schedule A)
2, Slacks and Bonds (Schedule B)
~, Closely Held Stocktpartnorshlp Inlerest (Sch, C)
4, Mongages and NOles Receivable (Schedule D)
s. Cash, Bank Deposits & Miscellaneous Personal
Property (Schodule E)
6, Jolnlly Owned Property (Schedule F)
7, TraM'e.. (Schodule 0) (Schedule L)
6, Tolal Gro.. Assot. (total Une. 1-7)
8. Funeral Expensos, Administrative Costs,
Mlscellaneou. Expense. (Schedule H)
10, DeblO, Mongage Uabllltle., Uens (Schedulal)
11, Total Deducdon. (tolal Une. 0 & 10)
12, Net Value a' Estale (Une 8 minus Une 11)
1~, ChllJ\lable and Governmenlal Bequest. (Schedule J)
14. Not Value Sub oct 10 Tax Uno 12 minus Uno 1:1)
15, spouaaITrand,r. (for dalu at dlllh aft., 1"':10-"" Sn
lnltIul:tlanllar ,,"ppllr..abl,p,runlall,anPall.2.111l1:Iud'
yah.l'llramSCh,dul,K.arSch.dul.M.)
16, Amount 0' Une 14 "",able at 6% ralo
(Include value.lrom Schedule K or Schedule 1.1,)
17, Amount 0' Une14 taxablo a115% rale
(Include value. ~om Schodule K or Schedule M,)
16, Principal tax due (Add lax lrDm Unes18, 16 and 17,)
19. Crodlt:J Spouul Pa\'IIW Cndlt Prior Paymonts DI~count
+ 5r 130.00 + 270.00 -
20. II Uno 191s greator than Uno 18, onter tho dlfferenco on Uno 20. This Is tho OVERPAYMENT.
!'A:;: IQi.ckihe'ro:W -ourate're" ueaun' 'i'a' retund 'or, ,. Qur.,'ove ";I" ei1t::iiii:'I::'h~:!;-!.',li:'iHi
21. If Uno 1813 groater thDn Uno 10, entcr 1ho dlfferenco on Uno 21, this Is tho TAX DUE.
A. Enlor tho Intcrost on tho balance duo on Une 21A.
B, Enler Ihelotal or Une 21 and 21A on Une 21 B, ThI.I. Ihe BAl.AIlCE DUE.
Make Check pa able to: Register 01 Wills, A ent
!!I:(I~;;1J\:hl;~!~I::;i:H:J:Id\~~lmi:mIi:H;!iil!H:~i%i'~;1 BE:SURE':rO:'ANSWER!AU;:'QUESTlONS:ON 'PAGE:2'ANO.TO:RECHECK:MA1lfi:'!;lili"'!iIll:HH!!ItiliilHlt!Hll;li:Hjt:~,hi1li\t1il:l\I\i'i:il
ndot' ponaJUos 01 porJury, dod010 that I hovo oX4ITlInod this return. Including accompanYing schedules and stalomenlS, and to the besl 01 f!tY knowlodgo
and bellof, It Is truo, conect and complete. I declilfo thai all real estoto has been reported al true mot1<el YDluo. OechllDtian 01 preparor other thDn Ihe porsannl
ropresonlaltYo b based on alIlnformatlon of whIch pre parer has any knowledgo. .
SlGNATUj" OF P!,SON R SPONSUlLEFOR FlLIND nURN 'DO."S DATE J J_,-
po,~ < I, See Schedule attached F t2.f'" I '1'!1
SIOHATURE OF P EPAREROTHER THAN REPRESEHTATlVE ADDRESS DATE .I "
R[V-I ,c..>[I(.V~'.1
.
CftECK
APPRO-
PRIATE
BLOCKS
o 4. Urnllod ESll1lu
ceRRES-
PONDEtrr
RECAPIT -
UL.ATlON
TAX
COMPLrrA-
TION
PA 15001 NTF.."
Copyrighl Forml Sollwar, OnIV. lGi4 tbl'O,lnc, HUPAOOI
I
I
"
,
!
8. Tolal Number 01 Safo Dopa sit BoltOS
(1)
( 2)
(3 )
(4 )
(8)
9,685.12
102,438.85
(6 )
(7 )
(9 )
91,524.77
:/I.7tS) ",
,
9,730.66 -..r;"' .
, .
, ,
203,648.74
(10)
403.00
':. .
(11)
(12)
(13)
10,133.66
,--193 , 515.08
14)
(15)
t II.' -
. . -, ...
.
(16)
,06
.
(17)
0.00. ,15
0.00
.
(16)
"
6,-798.14
Interest
: y.'--
5,805.45
(19)
(20)
(21)
(2M)
(21 B)
405.45
0.00
405.45
..'
Estate of: Herp&!: J. storbeck
21-1994-0870
'!he following persons are signing tho return as representatives of the estate:
Dorothy E, storbeck
540 Brentwater Road
camp Hill, PA 17011
"
.'"
.'_."~"__~_"'~;_'~~___~__""'-~','r;#'A"!"""'"''''~-'''~U
, .
PA REV-l!lOO EX (7-94) PDgD 2
, Act #/48 or 1994 provides for Ihe reducllon of the lax rates Imposed on the net value of transfers 10 or for the use or
the spouse. The rates as prescribed by the statute will be: t
. 3% (.03) will be appllcablo lor estates o' decedents dying on or oller 7tl/94 and before 1/1/96
. 2% (.02) will be applicable lor estates 01 decedents dying on or nller 1/1/96 and befora 1/1/97
. 1% (,01) will be applicable lor estates 01 decedents dying on or aller 1/1/97 and belore 1/1/98
. Spousaltrnnslers occurring on or aller 1/1/98 will be oxempt Irom Inhorllance tax.
PLEASE ANSWER THE FOllOWING QUESTIONS
BY PLACING A CHECK MARK (oJ) IN THE APPROPRIATE BLOCKS.
YES I/O
1. Old docedent mako a transfer and:
a. relalntheuseorlncornoot Iheproportytranstorrod., ,....,........,... ,. .,........................... .0......."... X
b, rOIa!n tho right to designate who ahall use tho proporty transforrod or lis Income",.....,... ". ..... ...,.. ,. .....,. .. .. .... X
c. rotaln a reverslonacy Inlorest; or, ..... .0..'......,.......,........ "" ",..............,........... ......,....... X
d. recelvethepromlso for tile olellhorpaymonts. bonefitsorcaro?....... .0........ ..,.. 01....'........ '"" .,...,....... X
2, II dDath Decurrad on or beforo Oacember 12, 1982, did dacedent wllhln two yeara pracedlng death transfer propeny without recalvlng
adaquale consldere~on111 doalh occurrad after Oacember 12, 1982, did decedent transfar propeny within ona yaar 01 daalh wllhout
receiving adequate consideration? I , . . , . . . . , . . , . . . . . . , , , . . . . . . , . , . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . , . . . , , , , . . . .
, . . . . , X
3. Old dDcDdenl own an 1n trusl fol" bank accounl a1 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.
PA15002 H1F""
Cop)'I1;M Fa,,,,. Soft...,.,. Only, lit. Nalco,I"c. NI4PAOOI
PJ.y~tlo:ll:X .'..111
COMMONWt,t,l.Tll OF P1NNSYl.VANIA
INHE.RItANCE t~X RnURN
RUllotH' O[C10tHT
SCHEDULE B
. STOCKS AND BONDS
FILE NUMBER
ESTATE OF
Herbert J, storbeck
(All properl'( lolnllv-owned with Right 01 Survlvorahlp mu.t be dlacloaed on Schedule F,)
ITEM
NO,
OESCRIPTION
1 912.400 6hs MFS Municipal Bard F\.IOO - A
Dividerxl accrued to date of death
TOTAL (Alao enter on nne 2, Recapltuladon
(II mare apace \a needed, Inaert addltlonalahoet. 01 aame .I.e,)
pA\S031 NT' 1.12
Capyrlght Farm' Saltw.,. OnlYI tll. N.tc:a,lnt. N14PA03t
21-1994-0870
VALUE AT OATE
OF OEA TH
9,680.56
4.56
s
9 685.12
1':.
c;'"
,
A('y.uo, rxtl2.I1J
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Ploaso Prlnl or T I 0
FILE NUMBER
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Herbert. J. storbeck
All ro. olnll -own.d wllh th. RI hI 01 Survlvor.hl
ITEM
NO,
21-1994-0870
musl be disclosed on Schadulo F
DESCRIPTION
VALUE AT
DATE OF DEATH
1 Loan Advancement to Richard J. storbeck
2 Pa. Dept. of Revenue - 1994 income tax refund
J 9,506.J52 shs Franklin CUstexlian F\1nds, Inc,; Income Series; IRA
alc #90211960J02
Beneficiary: Dorothy E. Storbeck, surviving spouse
4 Meridian Bank IRA Certificate of Deposit #J21J647401
Beneficiary: Dorothy E. storbeck, surviving spouse
Interest a=ued to date of death
JJ,500,OO
J8.00
21,009.04
20,J08.96
11.1J
5 Meridian Bank IRA Certificate 02 Deposit #J21J562J11
Beneficiary: Dorothy E. storbeck, surviving spouse
Interest a=ued to date of death
27,411. 02
160.70
PA1S081
NTF 1215
TOTAL (AI.o .nlor on line ~, Recapitulation) $
(Anach addlllonaJ 8 1/2'. II" .heel.1I more .pace I. needed,)
102 4J8.85
CopYt'lghl Form, ~ollwlt. OnlV, III. Nlh:o, Inc. N'.PAO'I
RlV-l~10 EX + (2-87)
COMMONWEALTII OF PENNSYLVANIA
INIlERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEiDULE G
TRANSFERS
PLEASE PRINT OR TYPE
FltE NUMBER
Herbert J. storbeck 21-1994-0870
THIS SCH, MUST DE COMPLETED & FILED IF THE ANSWER TO ANY OF TIlE OUESTIONS ON TIlE REVERSE SIDE OF COVER SIIEET IS YES,
DESCRIPTION OF PROPERTY DECO, DOLLAR VAtUE
ITEM Includo na.ma of lho Iransloroo, their EXCLUSION TOTAt VALUE % OF DECEDENrs
NO, relalionshlc-IO decedonl. dalo 01 uanslcr, OF ASSET INT. INTEREST
1 Ohio state Life Insurance CO. 62,471.67
policy #0903602. Decedent was the
CMner, Dorothy E. storbeck,
surviving spouse is the named
beneficiary. Policy was a single
premium annuity to begin at age 80
2 AIG Life Insurance Company policy 29,053.10
#Sl'8345056. Decedent was the
owner, Dorothy E. storbeck,
surviving spouse is the named
beneficiary. Policy was a single
premium defe=e:i annuity.
TOTAL (Also enler on line 7, RecapltuleUonl S 91. 524.77
(II more .paca I. needod, Insert addlUona/ .heets 0' .ame .Izo,)
PA15101 "TF "".
Copyright Farm' San..,.On'v, III" N.lco,lnc. N,4'A10l
'..--.- ...-.,".,
R~V~lSIIUI(1.1I1
COMMONWEALTtI OF PE'Nf.SYl VA",A,
1'H1ERITANCE TAlC RETUnN
RUIOENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
P'U811 Prlnl or Typo
"
ESTATE OF
Herbert J. Storbeck
ITEM
NO,
A. Funeral Expenses:
FILE NUMBER
21-1994-0870
DESCRIPTION
AMOUNT
1 Myers-Harner F\.1neral Home
2 Gigante - funeral luncheon
5,416.00
369.02
8, AdmlnlsltaUve COBb:
1,
Porsonal ReprosenlaUvo Commissions
SocJi1J Security Number 01 Personal RopresontaUvo:
Year Convnlsslons paid
0.00
2. Anornov Fees
~, Fsmllvexemplion
ClalmanC
RelBlion'hlp
"
1 1"'\' . '3 500 00
. ,'n: J~' .
/' I- ,-,(
, 1(:";:1'
.. ~:.;:, 0.00
'. '.'
..,. I':
Address of Clmmant al decedent's dealh
f', . J
,.
~
t
.
,
i
SUBel Addre..
CIIV
Stato
ZIp Cod.
j
r
!
f
,
4. Probate Feos
241.00
CI Miscellaneous Expenses:
1 Olmberland law Journal - Legal advertising
2 'lhe Sentinel - legal advertising
I
40.00 I
64.64 I
I
75.00 1
15.00
10.00
3 McNees, Wallace & Nurick - re.i1nb.1rsement for miscellaneous
expenses
4 Register of Wills of Olmberland County -- fee to file FA
Inheritance Tax Return
5 Register of Wills of Olmberland County - fee to file Inventory
PA15t11 NTF 1211
Copyrlght Forr". Saft"".,. Only, In. N.lca,lnc. N,.PAt t 1
TOTAL (AI,o enteron line 9, Roe.pllUl.llon $
(If more space Is needed, Insert addlUonal sheels 0' same size.)
9 730.66
.' !"'.~ J ..'J--;
.
,
n~V.1I12 EX -Itlnl
COMMONWEAlfH OF P[NN$YLVMHA
INIIERll'ANC[ TAl( RETURN
R[SIDENT OECEOEtlf
SCHEDULE I i
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
plUDe PrInt or T a
FILE NUMBER
21-1994-0B70
ESTATE OF
Herbert J. Storbeck
ITEM
NO,
OESCRIPTION
AMOUNT
1 Internal Revenue SerVice
liability
1/2 share of 1994 income tax
403.00
[I
i
.
~
I
f
TOTAL Also enter on line 10, Recapitulation)
(II more .paeels needed, Insen addltional.heets 0' .ame alze,)
403.00
f
I
!
$
PA15121 NTF 2110
Cop)'flghl Fatm. 5011.....,. Only, 1114 N.I,a,lnc. ND4PA1Z1
Herbert J.
ITEM
NO,
storbeck
NAME AND ADDRESS OF PENEFICIAIlY
RELATIONSltlP
21-1994-0870
AMOUNT OR
SHARE OF ESTATE
.
,
nEv-ISUU.l2.."
COMMONWEAtTH OF PENNSYLVANIA
t INtlERITANCE TAX RETURN
RESIDENT OECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMPER
A. T""abl. Bequ.sts:
1 Dorothy E. Storbeck
540 Brentwater Road
Camp Hill, PA 17011
2 Trustees Under Estate Plan Deed of
surviving spouse
160,425.62
Trustees
33,089.46
r
,
ITEM
NO,
NAME AND ADDRESS OF PENEFICIARV
AMOUNT OR
SHARE OF ESTATE
j1;
'I
.
B. Char11abla and Governmental Bequesls:
None
r
!i
;'
II
" '
TOTAL CHARITABLE AND GOVERNMENTAL BEOUESTS Also ent.r on IIn. 1~, RecapllUl.llon
(It more apace Is needed, Insert addltlonal sheels 01 same size)
$
0.00
PA151~1 HTF 122.A
Copytlghl Form. SOltwl'. Only, III" N"(o,III(. NI4PAI31
,
nEV.'1&14Elt.13~nl
SCHEDULE K
LIFE ESTATFI/I.NNUITY/
TERM CERTAIN
I
.
COMMOIlW[A\.llt or P[NNSYLVANIA
IrHl[RI1ANC[ 1...l( RETUAN
AESID[NT D[CtDUH
ESTATE OF FILE NUMBER
Herbert J. storbeck 21-1994-0B70
Thl~ schodulo I' 10 be usod lor all slnglo hlu, loinl or succo"lvu Illo 0::1111105 nod 10rm cortaln cnlculnlloll!), For dl1lo~ 01 donlh nllor 12-31-01 and
boloro 5-1-89, DCluDrlal 'oclOrtl lor 0111910 Iila cnlcuh1110ns cnn bo lound in Rcvenuo Cooklel (REV-1!101O). For dolos 01 dmUh on or oller !l-1-0!J
~cluarlal .actors can be 'ound In IRS publlcallon "14~7 Actuarial Valu09. At hn Volumo.
Tho In,11U01onl craollng tho 11I0 Inlcro~lls 0: (Plu.uso oUOIch a copy or Intitrumenl)
Olher
'1'L1FE:ESTATE INTEREST CALCULATION
I'!
Inlervlvos Deod 01 T,u51
:',;':'i,,< ',1:1.,
prosent Ago
(No. rut D1r1hd.y)
Torm or Years Ufe Estale Is Payable
o.to of D1r1h
N.mo(o) of Ulo Ten.nt(.)
Term 01 Yonrs
Doroth E. storbeck
10 29 23
71
Torm of Yoars
Torm of Yonrs
Torm 01 Yento
1, V.lu. 0' Fund from which Ufo E.I"e(.) I. pey.blo: '" , '" .... , , ,.. ....' .... , , , , , , ..' , , , , .. .. ' ,.. S
33,089.46
.57618
2. Actuarlnl Factor por approprlalo Table. . , , . , . . . , . . , . . , . . . . . . . . . , . . . . . . . . , . . . . , . . . . . , , . . , , . . . . .
IntoresITabloralo-- 031J2~~ 06~~ O"0~~ ~ar1abloRate 814~.
~, VoIue 01 Ulo E.tel. (Un. 1 . Un. 2) .. , , .. .. . .. , , .. .. , , , , , , " , , , " .. .. .. , , , , , " , .. .. , .. .. , " S
19,065.49
i;lI:il1!dHHiihlillJ!ii!iI\ni1i~m!\l;!ilJ!1l1:mlJll!':i:'il:iiililtl:!,j;:%:~i:;i:iIJ:i!,i:,I;i!;!:!;I:1 ,:i::itANNUITY,'INTEREST.c,CALCULA liON
,ii" :)+!
,......
",,'.'
",....,
";,,,"
Name(.) 0' Annultan~.)
Oel. of BIr1h
Present Age
(N.erest BIr1hday)
Term of Years Annuity Is Payable
Torm of Years
Torm of Years
Term 01 Years
Term 01 Years
1, Velu. 01 Fund Irom which annuity I. pey.ble.. , , ", , .. , .... , , " , , , , , , , , , , , .. , , , .. , , , , , , , , , , , , " S
2, Fr.quency 01 peyoul-- Dwe.kly 0 BI-woekly OMenlhly
DauerterlY Dseml-Annuolly []Annuelly [}Olher
~, Amount 01 peyout per perlod .. , .. , " , , .. " , , , , , , . , , , " , , , " , , , " , , , , . , , , , , , .. , , , , , , , , , , , " '
4, Annuol peyment.. " .. .. " .. .. , .. .. .. " , , .. , , .. .. , " , , , " .. , .. , " " , , , , , , " , , " , , , .. , , , , ,
5. Annuity Factor (500 InstnJctlons)
Inlorosl Table rala -- 03 1J~/. O~/. 010~. OVarlablo Rale ./.
6, Adju'lmOnt Feclor (.e. In.lnJeUon.).. , , , , " , , " , , .. , , .. , , , " , , , , " , , . , , , , , , , , " , , , , , , , , , , " , .
7. Valuo or Annuity --It uslng:l 1J~~. ~~I 10~~ or i. variable rale and period payout Is at end
01 perlod, colculeUon Is: Un. 4 . Uno 5 . Un. 6 .. , , " , , .. , , .. .. .. .. , , " , , .. , , , , , , .. .. , , .. , , , , ,
II u,lng vorlebl. rete ond perlod peyout I. 01 boglnnlng of period, colculeUon I.:
(Un. 4 . Un. S . Un. 6). Un. 3,
NOTE: Tho values o. tho fund!) which creato 1ho above luluro Inlerests must be reported as part 01 the Eslato AsselD, Uno 1 through
Une 7. Tho Resulting Ule/Annul1'( Intorest(s) should bo repOr1ed ntlho appropriate tax roto on Uno, 13. 15 and 16 8S required.
PA1S141 NTF 12"
Copy,IQht Farm. Solt.....,. Only. 1194 Ntlcll.lnc, N94PAI.l
,I
,.
,
I
I
I
,
,
I
i
1
i
[
I
I
\
I'
11
:'
.
"
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.
1
-. -'. ..... -.. .~._. ....'... > -
,/
j'l ':J LID - ?
(/
REV-1607 EX AFP (12-95*
CO~NWEALtH OF PENNSYLVANIA
DEPAAtHENT OF REYEHUE
BUREAU Of INDIVIDUAL tAMES
DEPT. 211601
HARRISBURG, PA 17128.0601
ACN 101
INHERITANCE TAX
STATEMENT OF ACCOUNT
DATE 01-16-96
S E OF STORBECK HERBERT J FILE NO. 21 94-0870
DATE OF DEATH 09-09-94 COUNTY CUMBERLAND
NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUB"IT T"E UPPER PORTION OF THIS FORH WITH YOUR TAX
PAY"EHT TO THE ADDRESS SHOWN. HAKE CHECK PAYABLE AND RE"lT PAYHENT TO. ,
RICHARD R LEFEVER
100 PINE ST
HBG PA 17101
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
A.aunt R..ltt.d
CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR FILES ...
iiE'v=i6iii-E'l("iiFii-nZ=9ifj------.il.-iiiifERii"ANC'E-i'AX-'TA'TEH'E;WiiF-ACcii[iiiT--...---------------------
ESTATE OF STORBECK HERBERT J FILE NO.21 94-0870 ACN 101
THIS STATE"ENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED
ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAK DUE, APPLICATION OF AtL PAYHENTS,
THE CURRENT BAtANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE.
DATE 01-16-96
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT. 12-12-95
PRINCIPAL TAX DUE. 4.812.76
PAVMENTS (TAX CREDITS).
PAYMENT
DATE
12-07-94
11-20-95
RECEIPT
NUMBER
MM913266
AAOB2338
DISCOUNT (+)
INTEREST (-)
240.64
.00
4,572.13
54.06
AMOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
4,866.83
54.07CR
.00
54.07CR
. IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST,
I IF TOTAL DUE IS LESS THAN .1,
NO PAYHEHT IS REQUIRED,
IF TOTAL DUE IS REFtECTED AS A "CREDIT" ICRI,
YOU "AY BE DUE A REFUNa. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS.
,
;'1
I:
;)()
PAYltEHTI
altlch thl top portion of thb Hatlc. wMI ,ubIIlt with your Plpent ,ldl paubta to ttt. n... end ,dcInll
printed on the r.y.r.. ,Ide,
If RESIDENT DECEDENT .... chick or .onl., order pa.,lIbla tal REGISTER OF WILLS, AGENT.
If NON-RESIDENT DECEDENT ,akl check or 10M., ord.r pI.,.'a tal CO""OHWEAL TH OF PENNSYLVANIA.
All P11Hl"1 ree.lv" ,hill ~ ~pllld Url' to WI., Inter..t which "V btI duIi with any r...lnd.r ~pllH to thl! "KI
REfUND (CR)I A r.fund of . tlX cr.dlt, Nhlch w.. not r'qulltad on thl Ta. A.turn, ..., ba r.qua.tad bv co.plating an
oot.ppllclUon for R.fund of pennlylvenla lniwrUMCI and Eat,t. ,.... CAEV.Un). Application, .r. IVIlhbl. at
thl Offle. of thl Rlght,r of W1111, any 0' thl ZS R.v........ DlIlrSct Office' or 'rCHI thl alPlrtlMnt" Zit-hour
.....IIIr!ng nrvlu ""Iab.r. for for" ordering I In pennaylvanta 1"ua"3U-2DSG, out,lda Plnnl.,l"",.a
_ within loul HarrhbUrD .r.. e717J 187-1I09It, TDDI (717) nt-znt (H..rlng J.p.lnd only).
REPLV TOl QuI.tlon. r.gardlnG .rror. contaln.d on thl. not Ie. .hoUld b. .ddr...ed tOI PA Dep.rt..nt af R.venue, Burlau
of Individual T811", An"t po.t A.......nt R.vlew Unit, Dapt. 280601, H.rrlsbUrg, PA UUa.0601, phDM
(717) 787-6505.
DISCOUHH
If any t'M due I. p.ld within thr" (5) cII.ndar .unth' .ft.r thl decld.nt". dl.th, . flvl p.rcent (5XJ dl.count
of thl taM p.ld Is .IlOMad.
INTEREST 1
Intlr..t II ch.rgld b.alMlna Mlth flr.t dey of delinquency, or nln. (9J aanth. Bnd ani (1) dn fro' thl dlt. of
d.ath, to thl d.t. of plyaent, TIM" which blc,,' dallnquent bafor' January 1, 1,lt ba.r Int.r..t It thl rlt. of
.IM (6XJ p.rcent par annuli calculat.d .t a dallv rata af .000160\, All talC" which blca.. dlllnquant on and .ftar
Janu.ry 1, 1.12 will ba.r In'ara.t at a rat. Mhlch will yarv fro' c.lander y.a' to cllandar V.e, with that r.t.
announc.d by tha Pi Dape,t..nt of R.v.nua, Tha applicable Int.r..t r.te. for 1912 through 1.96 .ral
V.ar Int.,..t R.ta D.llv Int.r..t Factor "..r Inter..t R.t. D.IlY Int.n.t Factor
1912 ZOX ,000548 1917 9X .00DZlt7
1.15 16:< ,OOOUI 1981-1991 IlX .0GnDl
1910\ IIX .000501 I'" 'X .nun
1.15 I3X .000556 1995-199,. ]X .0001.2
1916 lOX .000270\ 1995.1996 'X .00DZ47
uInt.,..t I. calculat.d .. folloMII
INTEREST a BALANCE OF TAX UNPAID X NUNBER OF DAYB DELINQUENT lC DAILY INTEREST FACTOR
"Anv Hotlc. 'uuacS Iftar tha taM Mca." d.lInquent will rafl.ct an Int.,..t calculltlon to f1ft.en (15) dill'_
b'Yond the data of tha .......ant. l' p.y.ant I. ~ .,t.r the Int.,..t coaputatlon data .hoWn on thl
Notle., .ctdltlonal Inter..t MI.t ba c.leulatad.
~ -. - --.' -. '.... . ' --
~. ,I .
--- -.- _... - - ~- - ...~. ..- -- -.' -- -- ..- -, -.-
" .
- ..- .-. -_.- ... -'- ..".- -. - ..- .'- - -.. .' .... -. _.. - - ~- -- - -- -- - -- '--
f!,-tl '7 W' 1.1./ ~ 3Y.,
O. AA' .O.r7804 COMMONWEALTH OF PENNSYLVANIA
NO, It DIPARTMINT OF RIVINUI
OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
{,.
,..\tI161I1IU41
.
RECEIVED FROM,
i
ACN
ASSESSMENT r:t
CONTROL IiII
NUMBER
AMOUNT
STORBECK DDROTHV E
100 PINE STREET
101
.40:5.4:5
,
i
!
,
I
I
I
I
'CHD HUf J
I
I
I
HARRISBURG 1'1\ 17101
-'OIOHur
ESTATE INfORMATION,
r:'I filE NUMBER
!WI el-1994-0B70
EJ NAME Of DECEDENT (LASTI
II DATE Of PAYMENT
EJ POSTMAR
COUNTY
BSN 099-01-0014
IflRSTI (Mil
REGISTER OF WILLS
I
I
I
I
I
fa TOTAL AMOUNT PAID .40~ I
9/" . . pW !
, /171 /1 & ",--,:A) .
RECEIVED~.( ;' /J!:N(,.yaU ~ I
~~~rs~ERLB~ SILLS I
DATE Of DEATH
REMARKS
DDROTHY E BTOI~BECK
SEAL
CHECK" b:53
.~-~~------------------------.-------------~-~---~-----
,
~.? .
.~
I
,.
. .
. ~ --. ~'.
----
_:-",_._._.;--:....~~..II rQ., ""lIi~',,, .f.'~_'''',
r - , ,
.
...'''~
\,
/ 'I ,~) 'Ie'
~I
,
"
v
REV-1607 EX AFP 112-95*
CD~ALTH OF PENNSYLVANTa
DEP,lATHENT OF REVEHU(
lUAfAU Of INDIVIDUAL TAXEI
DEPT. lion I
HARRISIURO, PA 111"-0.01
ACN 102
INHERITANCE TAX
STATEMENT OF ACCOUNT
DATE 01-16-96
E 0 STORBECK HERBERT J FILE NO. 21 94-0B70
DATE OF DEATH 09-09-94 COUNTY CUMBERLAND
HOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION Of TNIS fORH WITH YOUR TAX
PAVHENT TO THE ADDRESS SHOWN. HAXE CNECK PAVABLE AND REHIT PAVHENT TO' ,
RICHARD R LEFEVER
100 PINE ST
HBG PA 17101
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
AIoount R..ttt.d
CUT ALONG THIS LINE '~ RETAIN LOWER PORTION FOR YOUR FILES .....
iiE'y:iliiij-ix-jipji-Ci'2:95r-----...--iNHERii:A'iii:ri'AiC"ii"lifEitiflif-ii,;-Acfcouiif--.-Ii.--------------- _m__
ESTATE OF STORBECK HERBERT J FILE ND.21 94-0B70 ACN 102
THIS STATEHENT IS PROVIDED TO ADVISE Of THE CURRENT STATUS Of THE STATED ACN IN THE NAHED
ESTATE. SHOWN BELOW IS A SUHHARV Of THE PRINCIPAL TAX DUE, APPLICATION Of ALL PAVHENTS,
THE CURRENT BALANCE, AND. If APPLICABtE. A PROJECTED INTEREST fIGURE.
DATE 01-16-96
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 01-12-96
PRINCIPAL TAX DUE,. 992,68
PAYMENTS ITAX CREDITS),
PAYMENT
DATE
12-07-94
05-24-95
RECEIPT
NUMBER
MM913266
AA047804
DISCOUNT Ct)
INTEREST C-)
29.36
.00
AMOUNT PAID
557.87
405.45
. If PAID AfTER THIS DATE, SEE REVERSE
SIDE fOR CALCULATION Of ADDITIONAL INTEREST.
If TOTAL DUE IS LESS THAN '1,
NO PAVHENT IS REQUIRED,
If TOTAL DUE IS REfLECTED AS A "CREDIT" ICRI,
VDU HAV BE DUE A REfUND. SEE REVERSE SIDE Of THIS fORH fOR INSTRUCTIONS. I
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
992.6B
.00
.00
.00
"
"..', "
\f
'1
'I
1<
f':'10
PAvtEHTI
D.tltCh the tap portion of thh MoUee McI lublin ..lth your p.,.." .tIde plyllbl. to the ,.... Md add,....
printed on the rav.r.. .Ide.
If RESIDENT DECEDENT ... check 0" 80M)' arIM,. pIIyllbla tal REGISTER OF WILLS, AGENT I
If HOH-RfSlDEHT DECEDENT .ua check Dr" Mne)' order ~l. tal COttHOHWEAL TH OF PEtfrtSVLVAHIA.
All p.penta ranlvR ahliU be eppl1l1d first to M)' lnter..t which ..y ba ctu. wlth MY r...lnder ~l1H to the talll
REFUND (CA)I .. ,..fund of a ta. credit, whIch w.. nat r.qua.ted on the 'a. A.turn, ..y ba requelted bv c~l.tlng ."
"ApplicaUon for A.'t.nd of PIM1n.ylVMla IntMr1tMu Met Est.t. ,-... (REV-UUI. ApplJutlon. .ra I..,IU"", at
the OfficI of thl Alglst.r of Willa, eny of the IS A.v~ Dlttrlct Offlc.. Dr fr~ thl D.,art.-nt'. Z~-hour
.,,~rlna ..rvle. ~r' for for.. ordarlnDI In Penn'VI",enta 1-800-56Z-2050, out.l~ Penn.vl..,.".,
Md within locII H.rrhburll .r.. (717) 717-80M, TOO' C717J nZ-U5Z (H..rlng IlIpalnd onh).
REPLV TO. Qu..Uon. r.gardlng .rron contained on thh notlu .hoUld b. eddr...MI tal PA o.part...,t of Rav.nu., BurDU
of IndIvidual Texa., ATTN. po.t A......ent RlvleH unit, D.pt. Z80601, Harrisburg, PA 11121~0601, phone
(717) 111-6505.
DISC~TI 1f any tax due Sa p.ld within thr.. (3) r..,.ndlir .ontha eft.r the dec:.ct.nt"s death, e five p.runt l5X) dhcount
of the t.x paid 1. allow.d.
INTEREST. Inta,.at h chargad baglMlng with flrat d.v of dall~v, or nln. (9) ItOnth. end OM (1) dav frOll the d.t. of
d..th, to the data of pa't.~t, "Mil whlch b~ dellnq\Mnt before Januarv I, 1912 baar Intar..t It the rat. of
alx (6X) p.rc.nt p.r annul calculet.d .t . d.llv ret. of .0001641 All tlxa. which blc.., d.llnquent on ~ aftar
Januarv 1, 191Z will b..r lnt.r..t It a rat. which will vary frol cllandar y..r to calendar Vllt with that r.t.
announc.d bV the PA DIPart.ant of Ravlnu., ThI appllcabla Int.r..t tata. for 1912 through 1996 .r..
Va.r Int.r.at Alt. Oally Int.r..t Factor
V.ar
Intar..t Rat.
DIlly Int.ra.t Factor
1912 20X .000$4. 1911 'X ...1247
I'IS lOX ,0004:5. 1'11-1991 1IX ,nOSOl
19&4 11" ,Ooosn 1... 'X ."'Z47
1915 ISX .000556 199:5-19M 'X .000192
1916 lOX .000274 1995-1'96 'X ...1141
ulntaraat l. c.lculat.d .. follo...r
INTEREST . BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
uAnv HoUcl luu.d .ftar thl tax bacOMI d.linquent will rlUlct an Int.r..t c.lculatlon to flftaen US) d.n
blYond tha d.tl of the .....~t. If plvaent il ..a. aftar the Int.t..t cDlPUtatlon data .hown on the
NoUn, eddlUonl1 lnt.,...t .....t b. ulcuSated.
/~(l./1. 7 &,tPI- ,,,-> F
J'/A,/().-7
J//"
REV-1547 EX AFP (08"941*
COMMONWEAl tit OF PENNSYlVANIA
DEPARfHENT OF REV[NUE NOTICE OF INHERITANCE TAM
BUREAU OF INDiviDUAl IAII[S APPRAlSEHEHT, ALLOWANCE OR DISALLOWANCE
~miS:~:~:lp. 171/"'''1 OF DEDUCTIONS AND ASSESSHENT OF TAX DATE 12-11-95
ESTATE 0 llerbert J, Storbeck FILE NO. 2194-0870
DATE OF DEATH September 9, 199/. COUNTY Gumberl/lnd
NOTE I TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT TNE UPPER PORTION OF TltIS FORH WITH YOUR TAX
PAYHEHT TO THE REGISTER OF WILLS, HAXE CHECX PAYABLE TO "REGISTER OF WILLS, AGEHT"
REMIT PAYMENT TO:
ACN
101
RICHARD R LEFEVER
100 PINE ST
HARRISBURG PA 17101
Registsr of Wills
Cumberland County Courthouse
Carlisls, PA 17013
Amount Relllitt.d
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~~
ii'iv:isCi7"EX'AF'ii"CCiij:iji'-i"ilci'r"icE"-CiF""iNHEii'ii'ANCE-TliinippjiliisEH€ili'-;"ALi."ow;iffcE"oli--.---'-""_.---
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF Herbert J. Storbeck FILE NO. 2194-0870 ACN 101 DATE 1? 11 95
TAX RETURN WAS I
I ACCEPTED AS FItED
I Xl CHANGED See Attached Notics
RESERVATION CONCERNING FUTURE INTEREST " SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON:
1. R..l Eat.t. (Schedul. AJ (1)
2, Stock. .nd Bond. ISchodulo BI C21 9,685.12
31 Clo..ly Hald stock/Partnarship Int.r.lt (Schadula C) (3)
4, Hortg.g../Hot.. Rac.ivabla (Schedul. DJ l4J
5. C..h/Bonk Do.oo1h/H1oc. Por.onol p.o.od~ (Schodulo EI 151 102,438.85
6. JointlY Owned Property (Schedule fJ (6)
7. T.onofo.. (Schodulo GI 171 91,524.77
8, Tot.l "...t, (8)
203,648.74
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Fun.ral E~p.n.../Adn. COlt./HiIC. E~p.n... (Schedule HJ
10. Debts/Hortg.ga Liabiliti../Llans (Schedule IJ
11. Total Deduction.
12. H.t V.lu. of Tax R.turn
13. Charitable/Govern.."t.l aequa.t, (Schedule J)
14. H.t V.lu. of Eat.t. Subject to Tax
NOTE I
9.730.66
403.00
(91
ClOI
10,133.66
193.S1S.08
IllI
Cl21
1131
C141 193.S1S.08
14, 15 and/or 16. 17 and 18 will
returns assessed to date.
If an assessment was issued previouslY, lines
reflect figures that include the total of ALL
ASSESSMENT OF TAXI
15. Anount of Lin. 14 .t Spou..l rat. (15)
16. Anount of Lina 14 t.xabla .t Lin..l/Cl... A rat. (16)
17. Anount of Lina 14 t.xabl. at Collat.ral/Cl... Brat. (17)
18. Principal rax Du.
4,812.76
160,425.62
X .OJ'
X .06>
X .15'
ClOI
4,812.76
-
-
TAX CREDITS:
PAYHENT
DATE
12-7-945
5-24-95
DISCOUNT 1.1
INTEREST C-I
240.63(+)
RECEIPT
NUHDER
MM9132
AA047804
AHOUNT PAID
5,130.00
405.1.5
'''Credit plus E.dditionlll discount may be applied
to Gompromise Tax ACN 102.
TOTAL TAX CR~DIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
5,77 .08
r,
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL IHTEREST,
IF TOTAL DUE IS LESS THAN ~1, HO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCRl, YOU HAY BE DUE
A REFUHD. SEE REVE~SE SIDE OF THIS FORH FOR INSTRUCTIOHS,I
.y
...~"'"--.,.
. ''--~,.'
--....- - -'-".~--
AESERVATIONI E.tat.. of d.c.d.nt. d~lng an or b.fora O.c..u.r 12, 1912 -- If In~ future lnt.ra.t In tha ..t.t. I. tran.f.rr.d
In pO.....lon or .nJoy..nt to CI... . (coll.t.r.l) b.n.flel.rl.. of the d.c.dant aft.r the ..plr.tlon of any ..tat. far
Ilf. or for y..r., the Co..onw..lth har.b~ ..pr...ly r...rv.. t~a rlaht to appr.I.. end ...... trln.f.r Inheritance 'I..S
.t the lawful CI.ss . (coll.terel) r.te on any such future lnter..t.
PURPOSE OF
NOTICE I To fulfill the r.qulr...nts of Section 2140 of the Inh.rlt.nc. .nd Est.t. 'a. Act, Act 22 of 1991. 71 P.S.
S.ctlon 1140.
Oet.ch tha top portion of thl. Notlc. .nd .ub.lt with your p.y..nt to the Alal.t.r of Wills printed on the r.v.r.. .Id..
....H.k. chick or .0nlY ord.r pay.bl. tal REGISTER OF HILLS, AGENT
All ply..nt. r.c.lvld .h.ll flr.t b. .ppllld to any lnt.r..t which ..~ b. due with .ny r...lnder epplled to tha tl..
REFUND (CR)I A r.fund of . tl. credit, Which w.. not r.qu..tld on the ,.. Return, ..y b. requ..t.d by cOlpletlng ." MAppllc.tlon
for Refund of P.nn.ylvanl. Inheritance and E.t.te ,..M (AEY.1515)1 Appllc.tlon. .r. Iv.llabl. at the Office
of the R.al.ter of Will., 'n~ of the Z5 R.v~ DI.trlct Office., or by cllllng the .p.cl.1 24-hour
.n.w.rlng ..rvlc. nuab.r. for for.. ord.rlng. In p.nn.ylvanl. 1.100-36Z.,050, autsld. P.nn.ylvlnl. and
within loc.l H.rrl.bura .r.. (717) 181"10'4, TOO. (117) 112.1252 (H..rlna I.p.lrad Only).
P""HENTI
OBJECTIONS I Any p.rty In Int.r..t not ..tl.fl.d with the .ppr.I....nt, .llow.nc. or dl.lllowlnc. of daductlon., or ........nt
of t.. (Including dl.count or lnt.r..t) .. .hown on thl. Notlcl .u.t obJ.ct within .Ixty (60) d.y. of r.c.lpt of
thll NoUc. by.
....wrltt." prot..t to the PA D.p.rt..nt of R.venue, lo.rd of App..l., DEPT. 211021, Hlrrl.burg, PA 11111.1021, DR
....I.ctlon to hive thl ..tt.r d.t.r.ln.d at audit of the lecount of the p.r.on.1 r.prl,lntatlva, OR
--app..1 to tha Orphln.' Court.
ACHIN
ISTRATlVE
CORRECTIONS I
INTEREST.
F.ctuII .rror. dl.cov.r.d on thl. ........nt .hould b. .ddr....d In writing tOI PA D.part.,nt of R'V.nul,
Bur..u of Individual T...., ATTNI Po.t A.......nt R.vlaw Unit, DEPT. 280601, Hlrrl.bur., PA 11128.0601
Phon. (711) 711"6505, S.. p.~. 5 0' the bookl.t Mln.tructlon. for Inh.rltenc. T'M A.turn 'or. A..ldant
D.cadantM (REY.IsOl) 'or In a.pllnotlon of .~lnl.tr.tlv.1Y corr.et.bla .rror.,
If an~ t.. due Is Plld within tl.r.a (5) c.l.nd.r .on\h. .,t.r the d.e.dlnt.. d.ath, . 'Iv. p.rc.nt (sk) dl.count of
the t.M P.ld 1. .110w.d.
Int.r..t I. ch.rgad b.glnnlng with flr.t dty of d.llnqu.ncy, or nln. (,) 'onth. .nd on. (1) d.y fro. thl d.t. 0'
daath, to tha date of p.y"nt. h... which b.caa. dalinqu,nt b.fo" Jlnuery 1, 1912 b.er lnte".t .t the "ta 0'
.IM (6k) p.rc.nt p.r annul clleul.t.d at . delly r.te 0' .000164. All t.... which b.ce.. d.llnquent on and ,'t.r
J.nu.ry 1, l'IZ will b..r lnt.r..t .t a r.t. which will v.ry 'roe c.landtr v..r to cII.nd.r y..r ~lth th.t r.ta
Innoune.d bv t~1 "A D.p.rt..nt of R.~.nu.. ThI tppllc.bl. Int.r..t rat.. for 1'12 through 1"5 .r"
DISCOUNTI
'!.!!! Intera" Ret. o.lty Inter..t F.ctor '!!!! Intera.t Rate D.lly Inter..t F.etor
I'az zo:c .000548 1987 .~ .000247
1'15 16:C .oaOU8 198."1991 Ilk . nun
191" Ill( .000501 1992 .~ .000241
1915 13:< .00OS56 1995"1994 7~ .000192
19.6 Uk .000274 1995 .~ .000241
.-Inter..t Is calcul.tad .. follow. I
INTEREST . BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINqUENT X DAILY INTEREST FACTOR
....Any Notlc. I..u.d .ft.r the ta. b.co.a. d.l1nqu.nt will r.flact an Int.r..t c.lcul.tlon to fifteen (15) d.y.
bayond the d.ta of tha ........nt. I' p.v..nt I. ..da .ft.r the Int.r..t co.putatlon d.ta .hown on the
Hotlc., addltlon.1 Int.r..t .Ult b. c.lcut.tad.
.
....,.uroUIt-ItJ
.,
"
\
COMMONWEALTH Of PENNSYLVANIA
DEPARTMENT Of REVENUE
IURlAU OP INDIVIDUAL TAXES
DEPT,280601
HARRIS8URG. PA 17128'()601
DECEDENT'S NAME
INHERITANCE TAX
EXPLANATION
OF CHANGES
fiLE NUMBER
Herbert J. Slorb~ck
A
2194-0870
101
SCHEDULE
ITEM
NO.
EXPLANATION OF CHANGES
The t~x due 00 all current interesto Is refleet~~ on the attnehed
.. Inher1tonee .T/lX ....sculllent~. n,e' tax. 'due on all . future Interest.. uu
uncertainties Is covered on the attached compromise tax propoaal.
NET ESTATE
$193.515.08
LESSl TRANSFERS @ 3%
$160.425.62
TOTAL NON-PRORATE REQUESTS
- 160 .425 .62
RESIDUE SUBJECT TO COHPROHISE
$ 33.089.46
TAX SUMMARY
, ,----- .~- . . . ~ . --...,.'-...-. . ... ,'-. . - -"
SPOUSAL g 3%
TRANSFERS
$160.425.64
. ,. .'.', - _.. . _..n ___._ ,,~., '<,. .' --- -- .'~- ,.. -..~.-
. -. ."-'-'--~ -'-- ~ , ~_. .,..-- ._' ~..,..... -. ~-~..._-----,.~.._--_.-...-
. .-- ..,...,.- ---,...,....- ..>'. -. -'-""" _.. -- .._---~._-'..~..... ~-. ~ --------- .'~,.....- '.'.
.'.'. '. ...._ .,. __ .._ ....n. _. ~. .,~ _" _0 ... .......____.__.. '. ...._..~4. _.' .'~'.._, __'.___,_____ ..- r_____._ ...... ~._~-------.,.. .--. .'* - - --
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TAX EXAMINER,
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May 23, 1995
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
RE: The Estate of Herbert J. Storbeck
Date of Death: September 9, 1994
Social Security No.: 098-01-0014
File No.: 1994-0870
Our File No.: 16717-0001
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ICOn A. GOULD
P. NICHOlA5 QUARNUlCH[W
ROOtAr 0, HAAS
BRIAN" ,.JAC~
DONALD B. MAU'~
MICHAll R. tWJ.E'l'
Pt:ltRr.MttE
..&AMtaw. KUR
CAMIUC C. MAAlON
""lAIC" J. ,",URPt'ly
&HAAOH R. "AIUCH
CHUONQH.PHAtol
.JONA T"""" H. RUDO
BRUCe R. &PICeR
CMOLA.5f[INOU"
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Dear Madam:
Enclosed for filing on behalf of the above-referenced Estate are
the following documents:
1. Two Pennsylvania Inheritance Tax Returns.
2. A check payable to the Register of Wills, Agent in the
amount of $405.45 representing payment of the tax due.
3. Inventory of Real and Personal Estate.
4. A check payable to your office in the amount of $25
representing payment of your filing fees.
Kindly acknowledge receipt of the above by date stamping and
returning the enclosed copy of this letter in the envelope
provided.
Your attention to this matter is appreciated.
Very truly yours,
cy~~~~~9- ~
Estates and Trusts Paralegal
CJR/ck
Enclosures
cc Mrs. Dorothy E. Storbeck
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DRUCE D. BMlLCV
ALAN R. BOYNTON. ~.
WlC L. MOsSMAN
ROBVtT tot CHCnRV
LOWI A. DE.JOIE
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McNEES, WAl.l.ACE & NURICK
ATTORNEYS AT LAW
100 PINE: STRE:E:T
P. O. BOX 1188
HARRISBURG, PA 17108.1186
TeLl.PHONe 17171232.8000 FAX 17171237.5300
1200 G STRE:E:T N.W.
SUITE: 800
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TeLePHoNe 12021434 .8991 FAX 12021434 .8707
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Jnnunry 16, 1997
Mnry C. Lewis, Register of Wills
nnd Clerk of Orphnns' Court
Cumberlnnd County Courthouse
Cnrlisle, PA 17013
Re: Estnte of Herbert J, Storbeck
Denr Ms. Lewis:
ERIC N. ATHEY .JAME8 W. ICUTZ
RtCttAnO ... QIl. LOUSE WrcttNSoH MAnA
AMY DUXOAl..M r. 8t[ptttN8ON ""AntE8
JUTRtY ,. CHAMPl'ONC ~ A. MQONCY
.JAK8 P. acANGELO BHARON R. PAXTON
.JAMe8 P. DOUGHERTY CHAO r. ptFP8
KAnLI:EN A. ~8T PAMtLA C. pOLAceK
IXDRA P. f'QUlLAB ~AntAN H. Rt.OO
ttO.CN L.. OD+LL bRUCC R. &PICE"
ROOD1T ... OOOUTO CAnOL A. DTC~
BCOTT A. OOI.A.D SUDAN V. BTEWART
RANDOU"H a HOUSTON..A ROQCRT r. TEPUTZ
ORlAN F', .JACKSON nOBVtT A. WDSHAAn. .A
ORlAN I:. ICAMOIE DCnRICK P. wt.LlAM&ON
MCHAn R. KD.U::V "K)tfl A. WITHEROW. .A
PCTER F. KREll: tcAn-LtCN A. WOlQW8KI
8AMlD. 8. YUN
Plense be ndvised thnt 1 nm no longer counsel to the Estnte of Herbert J, Storbeck,
RRLllmk
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Richnrd R, Lefever
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!lAMU[L A. !CHRlCMCH<WJ5T. JR.
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ROOtAT J. OODUTO
Geon A. GOULD
December 7, 1994
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
In re:
Estate of Herbert J. Storbeck
Our File No: 16717-0001
Date of Death: September 9, 1994
County File No: 1994-0870
Dear Madam:
P. NICHCllAS OUAAHt.&CHtW
ROOCAT 0, HM5
ORlAN ,. JACK50N
DONAlD B KAUrlolAH
MICHAtL A. tl.ClUY
ptT[R'.KRlCU:
.JAMesw. KlITZ
CANLU: C. MARtON
5HAAON R. PMTON
CHUClHO H. PHAM
~THAHH.RUDD
CAAOLA.S'VNOOR
CA'H[RlH[[.WA&.'CRS
LJovmcNCt A. W'ItD[R
Dl:PAlCKP.w.UW4SOH
This firm represents Dorothy E. storbeck, Executor of the Estate
of Herbert J. Storbeck, who passed away December 9, 1994.
Enclosed at this time is Mrs. Storbeck's personal check in the
amount of $5,130 representing a payment on the inheritance tax.
This payment was calculated as follows:
$180,000 @ 3%
Less 5% discount
$5,400.00
270.00
, .
Please issue your receipt covering this payment.
$5,130.00
1:_
CJR/ck
Ene.
Very truly yours,
~T~
Estates and Trusts Paralegal
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cc Dorothy E. Storbeck
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COHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
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BUREAU OF INDIVIDUAL TAKES
INHERITANCE TAX DIVISION
DEPT. Zl0601
HARRISBURG, PA 17121.0601
NOTICE OF INHERITANCE TAK
APPRAISEHENT, AtLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAK
IINI4IU''''II.'',
JOHN S KOSTUKOVICH
STE 401
3607 ROSEHONT AVE
CAHP HILL PA 17011
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
ACN
10-13-97
STORBECK
09-09-94
21 94-0870
CUMBERLAND
101
"..ount R...1tt.d
HERBERT
J
?.!l_T ALP~.~_!_'!~!~U:!~.!L. ~, . !lETA.IN..lO.~ER
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HAKE CHECK PAYABLE AND REHIT PAYMENT
REGISTER OF WILLS
CUHBERLAND CD COURT HOUSE
CARLISLE, PA 17013
P~RT~O~ FOR YOUR RECORDS ...
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INHERITANCE TAX DIVISION
DEPT. zaa6Dl
HARRISBURG, PA 11128-D6Dl
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
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JOHN S KOSTUKOVICH
STE 401
3607 ROSEMONT AVE
CAMP HILL PA 17011
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
10-02-97
STORBECK
09-09-94
21 94-0870
CUMBERLAND
101
Atnount R."Uhd
HERBERT
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NOTEI To in.ur. prop.r cr.dit to your .ccount, .ub.it th. upp.r portion of tht. for. with your t.. p.y..nt.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS 41
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MAKE CHECK PAYABLE AND REMIT PAYMENT TOt
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
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STATUS REPORT UNDER RULE 6.12
Name of Decedent 1_l\~\\~T ;r. C:::::IU~Q)::{\~"
Date of Death: ,~ \ I l~
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Will No.
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes 't 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 r)presentative file a final
account with the Court? Yes No .
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.
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Signature
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Address
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Capacity:
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